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Essay on Obesity

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Obesity is a chronic health condition in which the body fat reaches abnormal level. Obesity occurs when we consume much more amount of food than our body really needs on a daily basis. In other words, when the intake of calories is greater than the calories we burn out, it gives rise to obesity.

Audience: The below given essays are exclusively written for school students (Class 5, 6, 7, 8, 9, 10, 11 and 12 Standard), college, science and medical students.

Introduction:

Obesity means being excessively fat. A person would be said to be obese if his or her body mass index is beyond 30. Such a person has a body fat rate that is disproportionate to his body mass.

Obesity and the Body Mass Index:

The body mass index is calculated considering the weight and height of a person. Thus, it is a scientific way of determining the appropriate weight of any person. When the body mass index of a person indicates that he or she is obese, it exposes the person to make health risk.

Stopping Obesity:

There are two major ways to get the body mass index of a person to a moderate rate. The first is to maintain a strict diet. The second is to engage in regular physical exercise. These two approaches are aimed at reducing the amount of fat in the body.

Conclusion:

Obesity can lead to sudden death, heart attack, diabetes and may unwanted illnesses. Stop it by making healthy choices.

Obesity has become a big concern for the youth of today’s generation. Obesity is defined as a medical condition in which an individual gains excessive body fat. When the Body Mass Index (BMI) of a person is over 30, he/ she is termed as obese.

Obesity can be a genetic problem or a disorder that is caused due to unhealthy lifestyle habits of a person. Physical inactivity and the environment in which an individual lives, are also the factors that leads to obesity. It is also seen that when some individuals are in stress or depression, they start cultivating unhealthy eating habits which eventually leads to obesity. Medications like steroids is yet another reason for obesity.

Obesity has several serious health issues associated with it. Some of the impacts of obesity are diabetes, increase of cholesterol level, high blood pressure, etc. Social impacts of obesity includes loss of confidence in an individual, lowering of self-esteem, etc.

The risks of obesity needs to be prevented. This can be done by adopting healthy eating habits, doing some physical exercise regularly, avoiding stress, etc. Individuals should work on weight reduction in order to avoid obesity.

Obesity is indeed a health concern and needs to be prioritized. The management of obesity revolves around healthy eating habits and physical activity. Obesity, if not controlled in its initial stage can cause many severe health issues. So it is wiser to exercise daily and maintain a healthy lifestyle rather than being the victim of obesity.

Obesity can be defined as the clinical condition where accumulation of excessive fat takes place in the adipose tissue leading to worsening of health condition. Usually, the fat is deposited around the trunk and also the waist of the body or even around the periphery.

Obesity is actually a disease that has been spreading far and wide. It is preventable and certain measures are to be taken to curb it to a greater extend. Both in the developing and developed countries, obesity has been growing far and wide affecting the young and the old equally.

The alarming increase in obesity has resulted in stimulated death rate and health issues among the people. There are several methods adopted to lose weight and they include different diet types, physical activity and certain changes in the current lifestyle. Many of the companies are into minting money with the concept of inviting people to fight obesity.

In patients associated with increased risk factor related to obesity, there are certain drug therapies and other procedures adopted to lose weight. There are certain cost effective ways introduced by several companies to enable clinic-based weight loss programs.

Obesity can lead to premature death and even cause Type 2 Diabetes Mellitus. Cardiovascular diseases have also become the part and parcel of obese people. It includes stroke, hypertension, gall bladder disease, coronary heart disease and even cancers like breast cancer, prostate cancer, endometrial cancer and colon cancer. Other less severe arising due to obesity includes osteoarthritis, gastro-esophageal reflux disease and even infertility.

Hence, serious measures are to be taken to fight against this dreadful phenomenon that is spreading its wings far and wide. Giving proper education on benefits of staying fit and mindful eating is as important as curbing this issue. Utmost importance must be given to healthy eating habits right from the small age so that they follow the same until the end of their life.

Obesity is majorly a lifestyle disease attributed to the extra accumulation of fat in the body leading to negative health effects on a person. Ironically, although prevalent at a large scale in many countries, including India, it is one of the most neglect health problems. It is more often ignored even if told by the doctor that the person is obese. Only when people start acquiring other health issues such as heart disease, blood pressure or diabetes, they start taking the problem of obesity seriously.

Obesity Statistics in India:

As per a report, India happens to figure as the third country in the world with the most obese people. This should be a troubling fact for India. However, we are yet to see concrete measures being adopted by the people to remain fit.

Causes of Obesity:

Sedentary lifestyle, alcohol, junk food, medications and some diseases such as hypothyroidism are considered as the factors which lead to obesity. Even children seem to be glued to televisions, laptops and video games which have taken away the urge for physical activities from them. Adding to this, the consumption of junk food has further aggravated the growing problem of obesity in children.

In the case of adults, most of the professions of today make use of computers which again makes people sit for long hours in one place. Also, the hectic lifestyle of today makes it difficult for people to spare time for physical activities and people usually remain stressed most of the times. All this has contributed significantly to the rise of obesity in India.

Obesity and BMI:

Body Mass Index (BMI) is the measure which allows a person to calculate how to fit he or she is. In other words, the BMI tells you if you are obese or not. BMI is calculated by dividing the weight of a person in kg with the square of his / her height in metres. The number thus obtained is called the BMI. A BMI of less than 25 is considered optimal. However, if a person has a BMI over 30 he/she is termed as obese.

What is a matter of concern is that with growing urbanisation there has been a rapid increase of obese people in India? It is of utmost importance to consider this health issue a serious threat to the future of our country as a healthy body is important for a healthy soul. We should all be mindful of what we eat and what effect it has on our body. It is our utmost duty to educate not just ourselves but others as well about this serious health hazard.

Obesity can be defined as a condition (medical) that is the accumulation of body fat to an extent that the excess fat begins to have a lot of negative effects on the health of the individual. Obesity is determined by examining the body mass index (BMI) of the person. The BMI is gotten by dividing the weight of the person in kilogram by the height of the person squared.

When the BMI of a person is more than 30, the person is classified as being obese, when the BMI falls between 25 and 30, the person is said to be overweight. In a few countries in East Asia, lower values for the BMI are used. Obesity has been proven to influence the likelihood and risk of many conditions and disease, most especially diabetes of type 2, cardiovascular diseases, sleeplessness that is obstructive, depression, osteoarthritis and some cancer types.

In most cases, obesity is caused through a combination of genetic susceptibility, a lack of or inadequate physical activity, excessive intake of food. Some cases of obesity are primarily caused by mental disorder, medications, endocrine disorders or genes. There is no medical data to support the fact that people suffering from obesity eat very little but gain a lot of weight because of slower metabolism. It has been discovered that an obese person usually expends much more energy than other people as a result of the required energy that is needed to maintain a body mass that is increased.

It is very possible to prevent obesity with a combination of personal choices and social changes. The major treatments are exercising and a change in diet. We can improve the quality of our diet by reducing our consumption of foods that are energy-dense like those that are high in sugars or fat and by trying to increase our dietary fibre intake.

We can also accompany the appropriate diet with the use of medications to help in reducing appetite and decreasing the absorption of fat. If medication, exercise and diet are not yielding any positive results, surgery or gastric balloon can also be carried out to decrease the volume of the stomach and also reduce the intestines’ length which leads to the feel of the person get full early or a reduction in the ability to get and absorb different nutrients from a food.

Obesity is the leading cause of ill-health and death all over the world that is preventable. The rate of obesity in children and adults has drastically increased. In 2015, a whopping 12 percent of adults which is about 600 million and about 100 million children all around the world were found to be obese.

It has also been discovered that women are more obese than men. A lot of government and private institutions and bodies have stated that obesity is top of the list of the most difficult and serious problems of public health that we have in the world today. In the world we live today, there is a lot of stigmatisation of obese people.

We all know how troubling the problem of obesity truly is. It is mainly a form of a medical condition wherein the body tends to accumulate excessive fat which in turn has negative repercussions on the health of an individual.

Given the current lifestyle and dietary style, it has become more common than ever. More and more people are being diagnosed with obesity. Such is its prevalence that it has been termed as an epidemic in the USA. Those who suffer from obesity are at a much higher risk of diabetes, heart diseases and even cancer.

In order to gain a deeper understanding of obesity, it is important to learn what the key causes of obesity are. In a layman term, if your calorie consumption exceeds what you burn because of daily activities and exercises, it is likely to lead to obesity. It is caused over a prolonged period of time when your calorie intake keeps exceeding the calories burned.

Here are some of the key causes which are known to be the driving factors for obesity.

If your diet tends to be rich in fat and contains massive calorie intake, you are all set to suffer from obesity.

Sedentary Lifestyle:

With most people sticking to their desk jobs and living a sedentary lifestyle, the body tends to get obese easily.

Of course, the genetic framework has a lot to do with obesity. If your parents are obese, the chance of you being obese is quite high.

The weight which women gain during their pregnancy can be very hard to shed and this is often one of the top causes of obesity.

Sleep Cycle:

If you are not getting an adequate amount of sleep, it can have an impact on the hormones which might trigger hunger signals. Overall, these linked events tend to make you obese.

Hormonal Disorder:

There are several hormonal changes which are known to be direct causes of obesity. The imbalance of the thyroid stimulating hormone, for instance, is one of the key factors when it comes to obesity.

Now that we know the key causes, let us look at the possible ways by which you can handle it.

Treatment for Obesity:

As strange as it may sound, the treatment for obesity is really simple. All you need to do is follow the right diet and back it with an adequate amount of exercise. If you can succeed in doing so, it will give you the perfect head-start into your journey of getting in shape and bidding goodbye to obesity.

There are a lot of different kinds and styles of diet plans for obesity which are available. You can choose the one which you deem fit. We recommend not opting for crash dieting as it is known to have several repercussions and can make your body terribly weak.

The key here is to stick to a balanced diet which can help you retain the essential nutrients, minerals, and, vitamins and shed the unwanted fat and carbs.

Just like the diet, there are several workout plans for obesity which are available. It is upon you to find out which of the workout plan seems to be apt for you. Choose cardio exercises and dance routines like Zumba to shed the unwanted body weight. Yoga is yet another method to get rid of obesity.

So, follow a blend of these and you will be able to deal with the trouble of obesity in no time. We believe that following these tips will help you get rid of obesity and stay in shape.

Obesity and overweight is a top health concern in the world due to the impact it has on the lives of individuals. Obesity is defined as a condition in which an individual has excessive body fat and is measured using the body mass index (BMI) such that, when an individual’s BMI is above 30, he or she is termed obese. The BMI is calculated using body weight and height and it is different for all individuals.

Obesity has been determined as a risk factor for many diseases. It results from dietary habits, genetics, and lifestyle habits including physical inactivity. Obesity can be prevented so that individuals do not end up having serious complications and health problems. Chronic illnesses like diabetes, heart diseases and relate to obesity in terms of causes and complications.

Factors Influencing Obesity:

Obesity is not only as a result of lifestyle habits as most people put it. There are other important factors that influence obesity. Genetics is one of those factors. A person could be born with genes that predispose them to obesity and they will also have difficulty in losing weight because it is an inborn factor.

The environment also influences obesity because the diet is similar in certain environs. In certain environments, like school, the food available is fast foods and the chances of getting healthy foods is very low, leading to obesity. Also, physical inactivity is an environmental factor for obesity because some places have no fields or tracks where people can jog or maybe the place is very unsafe and people rarely go out to exercise.

Mental health affects the eating habits of individuals. There is a habit of stress eating when a person is depressed and it could result in overweight or obesity if the person remains unhealthy for long period of time.

The overall health of individuals also matter. If a person is unwell and is prescribed with steroids, they may end up being obese. Steroidal medications enable weight gain as a side effect.

Complications of Obesity:

Obesity is a health concern because its complications are severe. Significant social and health problems are experienced by obese people. Socially, they will be bullied and their self-esteem will be low as they will perceive themselves as unworthy.

Chronic illnesses like diabetes results from obesity. Diabetes type 2 has been directly linked to obesity. This condition involves the increased blood sugars in the body and body cells are not responding to insulin as they should. The insulin in the body could also be inadequate due to decreased production. High blood sugar concentrations result in symptoms like frequent hunger, thirst and urination. The symptoms of complicated stages of diabetes type 2 include loss of vision, renal failure and heart failure and eventually death. The importance of having a normal BMI is the ability of the body to control blood sugars.

Another complication is the heightened blood pressures. Obesity has been defined as excessive body fat. The body fat accumulates in blood vessels making them narrow. Narrow blood vessels cause the blood pressures to rise. Increased blood pressure causes the heart to start failing in its physiological functions. Heart failure is the end result in this condition of increased blood pressures.

There is a significant increase in cholesterol in blood of people who are obese. High blood cholesterol levels causes the deposition of fats in various parts of the body and organs. Deposition of fats in the heart and blood vessels result in heart diseases. There are other conditions that result from hypercholesterolemia.

Other chronic illnesses like cancer can also arise from obesity because inflammation of body cells and tissues occurs in order to store fats in obese people. This could result in abnormal growths and alteration of cell morphology. The abnormal growths could be cancerous.

Management of Obesity:

For the people at risk of developing obesity, prevention methods can be implemented. Prevention included a healthy diet and physical activity. The diet and physical activity patterns should be regular and realizable to avoid strains that could result in complications.

Some risk factors for obesity are non-modifiable for example genetics. When a person in genetically predisposed, the lifestyle modifications may be have help.

For the individuals who are already obese, they can work on weight reduction through healthy diets and physical exercises.

In conclusion, obesity is indeed a major health concern because the health complications are very serious. Factors influencing obesity are both modifiable and non-modifiable. The management of obesity revolves around diet and physical activity and so it is important to remain fit.

In olden days, obesity used to affect only adults. However, in the present time, obesity has become a worldwide problem that hits the kids as well. Let’s find out the most prevalent causes of obesity.

Factors Causing Obesity:

Obesity can be due to genetic factors. If a person’s family has a history of obesity, chances are high that he/ she would also be affected by obesity, sooner or later in life.

The second reason is having a poor lifestyle. Now, there are a variety of factors that fall under the category of poor lifestyle. An excessive diet, i.e., eating more than you need is a definite way to attain the stage of obesity. Needless to say, the extra calories are changed into fat and cause obesity.

Junk foods, fried foods, refined foods with high fats and sugar are also responsible for causing obesity in both adults and kids. Lack of physical activity prevents the burning of extra calories, again, leading us all to the path of obesity.

But sometimes, there may also be some indirect causes of obesity. The secondary reasons could be related to our mental and psychological health. Depression, anxiety, stress, and emotional troubles are well-known factors of obesity.

Physical ailments such as hypothyroidism, ovarian cysts, and diabetes often complicate the physical condition and play a massive role in abnormal weight gain.

Moreover, certain medications, such as steroids, antidepressants, and contraceptive pills, have been seen interfering with the metabolic activities of the body. As a result, the long-term use of such drugs can cause obesity. Adding to that, regular consumption of alcohol and smoking are also connected to the condition of obesity.

Harmful Effects of Obesity:

On the surface, obesity may look like a single problem. But, in reality, it is the mother of several major health issues. Obesity simply means excessive fat depositing into our body including the arteries. The drastic consequence of such high cholesterol levels shows up in the form of heart attacks and other life-threatening cardiac troubles.

The fat deposition also hampers the elasticity of the arteries. That means obesity can cause havoc in our body by altering the blood pressure to an abnormal range. And this is just the tip of the iceberg. Obesity is known to create an endless list of problems.

In extreme cases, this disorder gives birth to acute diseases like diabetes and cancer. The weight gain due to obesity puts a lot of pressure on the bones of the body, especially of the legs. This, in turn, makes our bones weak and disturbs their smooth movement. A person suffering from obesity also has higher chances of developing infertility issues and sleep troubles.

Many obese people are seen to be struggling with breathing problems too. In the chronic form, the condition can grow into asthma. The psychological effects of obesity are another serious topic. You can say that obesity and depression form a loop. The more a person is obese, the worse is his/ her depression stage.

How to Control and Treat Obesity:

The simplest and most effective way, to begin with, is changing our diet. There are two factors to consider in the diet plan. First is what and what not to eat. Second is how much to eat.

If you really want to get rid of obesity, include more and more green vegetables in your diet. Spinach, beans, kale, broccoli, cauliflower, asparagus, etc., have enough vitamins and minerals and quite low calories. Other healthier options are mushrooms, pumpkin, beetroots, and sweet potatoes, etc.

Opt for fresh fruits, especially citrus fruits, and berries. Oranges, grapes, pomegranate, pineapple, cherries, strawberries, lime, and cranberries are good for the body. They have low sugar content and are also helpful in strengthening our immune system. Eating the whole fruits is a more preferable way in comparison to gulping the fruit juices. Fruits, when eaten whole, have more fibers and less sugar.

Consuming a big bowl of salad is also great for dealing with the obesity problem. A salad that includes fibrous foods such as carrots, radish, lettuce, tomatoes, works better at satiating the hunger pangs without the risk of weight gain.

A high protein diet of eggs, fish, lean meats, etc., is an excellent choice to get rid of obesity. Take enough of omega fatty acids. Remember to drink plenty of water. Keeping yourself hydrated is a smart way to avoid overeating. Water also helps in removing the toxins and excess fat from the body.

As much as possible, avoid fats, sugars, refined flours, and oily foods to keep the weight in control. Control your portion size. Replace the three heavy meals with small and frequent meals during the day. Snacking on sugarless smoothies, dry fruits, etc., is much recommended.

Regular exercise plays an indispensable role in tackling the obesity problem. Whenever possible, walk to the market, take stairs instead of a lift. Physical activity can be in any other form. It could be a favorite hobby like swimming, cycling, lawn tennis, or light jogging.

Meditation and yoga are quite powerful practices to drive away the stress, depression and thus, obesity. But in more serious cases, meeting a physician is the most appropriate strategy. Sometimes, the right medicines and surgical procedures are necessary to control the health condition.

Obesity is spreading like an epidemic, haunting both the adults and the kids. Although genetic factors and other physical ailments play a role, the problem is mostly caused by a reckless lifestyle.

By changing our way of living, we can surely take control of our health. In other words, it would be possible to eliminate the condition of obesity from our lives completely by leading a healthy lifestyle.

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Causes and Effects of Obesity Essay

Introduction, laziness as the main cause of obesity, social effects of obesity, effects of obesity: health complications.

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Maintaining good body weight is highly recommended by medical doctors as a way of promoting a healthy status of the body. This is to say that there is allowed body weight, which a person is supposed to maintain. Extreme deviations from this weight expose a person to several health complications.

While being underweight is not encouraged, cases of people who are overweight and increasing effects of this condition have raised concerns over the need of addressing the issue of obesity in the society today, where statistics are rising day and night. What is obesity? This refers to a medical condition in which a person’s body has high accumulation of body fat to the level of being fatal or a cause of serious health complications. Additionally, obesity is highly associated with one’s body mass index, abbreviated as BMI.

This denotes the value obtained when a person’s weight in kilograms is divided by the square of their height in meters (Burniat 3). According to medical experts, obesity occurs when the BMI exceeds 30kg/m 2 . While this is the case, people who have a BMI of between 25 and 29 and considered to be overweight. Obesity has a wide-range of negative effects, which may be a threat to the life of a person.

The fist effect of obesity is that it encourages laziness in the society. It is doubtless that obese people find it hard and strenuous to move from one point to the other because of accumulated fats. As a result, most of these people lead a sedentary lifestyle, which is usually characterized by minimal or no movement. In such scenarios, victims prefer being helped doing basic activities, including moving from one point to another.

Moreover, laziness makes one to be inactive and unproductive. For example, a student who is obese may find it hard to attend to his or her homework and class assignments, thus affecting performance. With regard to physical exercises, obese people perceive exercises as punishment, which is not meant for them (Korbonits 265). As a result, they do not accept simple activities like jogging because of their inability to move.

In line with this, obese people cannot participate in games like soccer, athletics, and rugby among others. Based on this sedentary lifestyle, obese people spend a lot of their time watching television, movies, and playing video games, which worsen the situation.

The main effect of obesity is health complications. Research indicates that most of the killer diseases like diabetes, heart diseases, and high blood pressure are largely associated with obesity. In the United States, obesity-related complications cost the nation approximately 150 billion USD and result into 0.3 million premature deaths annually.

When there is increase in body fat, it means that the body requires more nutrients and oxygen to support body tissues (Burniat 223). Since these elements can only be transported by the blood to various parts of the body, the workload of the heart is increased.

This increase in the workload of the heart exerts pressure on blood vessels, leading to high blood pressure. An increase in the heart rate may also be dangerous due to the inability of the body to supply required blood to various parts. Moreover, obesity causes diabetes, especially among adults as the body may become resistant to insulin. This resistance may lead to a high level of blood sugar, which is fatal.

Besides health complications, obesity causes an array of psychological effects, including inferiority complex among victims. Obese people suffer from depression, emanating from negative self-esteem and societal rejection. In some cases, people who become obese lose their friends and may get disapproval from teachers and other personalities (Korbonits 265). This is mainly based on the assumption that people become obese due to lack of self-discipline. In extreme cases, obese people may not be considered for promotion at workplaces, because of the negative perception held against them.

Due to inferiority complex, obese people avoid being in public and prefer being alone. This is because they imagine how the world sees them and may also find it hard being involved in public activities because of their sizes.

This further makes them to consider themselves unattractive based on their deviation from what is considered as the normal body size and shape. Regardless of how obese people are treated, they always believe that they are being undermined because of their body size.

In summary, obesity is a major cause of premature deaths in the United States and around the world. This health condition occurs when there is excess accumulation of body fat, caused by unhealthy lifestyles. Obesity is largely associated with several killer diseases like high blood pressure, diabetes, and diseases of the heart.

These diseases drain world economies since most of them are fatal and expensive to manage. Additionally, obesity promotes sedentary life where victims minimize movement by adopting an inactive lifestyle. Moreover, obese victims suffer psychologically because of societal rejection. In general, obesity has a wide-range of negative effects, which may be a threat to the life of a person.

Burniat, Walter. Child and Adolescent Obesity: Causes and Consequences, Prevention and Management . United Kingdom: Cambridge University Press, 2002. Print.

Korbonits, Márta. Obesity and Metabolism . Switzerland: Karger Publishers, 2008. Print.

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Article Contents

Obesity: causes, consequences, treatments, and challenges.

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Obesity: causes, consequences, treatments, and challenges, Journal of Molecular Cell Biology , Volume 13, Issue 7, July 2021, Pages 463–465, https://doi.org/10.1093/jmcb/mjab056

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Obesity has become a global epidemic and is one of today’s most public health problems worldwide. Obesity poses a major risk for a variety of serious diseases including diabetes mellitus, non-alcoholic liver disease (NAFLD), cardiovascular disease, hypertension and stroke, and certain forms of cancer ( Bluher, 2019 ).

Obesity is mainly caused by imbalanced energy intake and expenditure due to a sedentary lifestyle coupled with overnutrition. Excess nutrients are stored in adipose tissue (AT) in the form of triglycerides, which will be utilized as nutrients by other tissues through lipolysis under nutrient deficit conditions. There are two major types of AT, white AT (WAT) and brown AT, the latter is a specialized form of fat depot that participates in non-shivering thermogenesis through lipid oxidation-mediated heat generation. While WAT has been historically considered merely an energy reservoir, this fat depot is now well known to function as an endocrine organ that produces and secretes various hormones, cytokines, and metabolites (termed as adipokines) to control systemic energy balance. Studies over the past decade also show that WAT, especially subcutaneous WAT, could undergo ‘beiging’ remodeling in response to environmental or hormonal perturbation. In the first paper of this special issue, Cheong and Xu (2021) systematically review the recent progress on the factors, pathways, and mechanisms that regulate the intercellular and inter-organ crosstalks in the beiging of WAT. A critical but still not fully addressed issue in the adipose research field is the origin of the beige cells. Although beige adipocytes are known to have distinct cellular origins from brown and while adipocytes, it remains unclear on whether the cells are from pre-existing mature white adipocytes through a transdifferentiation process or from de novo differentiation of precursor cells. AT is a heterogeneous tissue composed of not only adipocytes but also nonadipocyte cell populations, including fibroblasts, as well as endothelial, blood, stromal, and adipocyte precursor cells ( Ruan, 2020 ). The authors examined evidence to show that heterogeneity contributes to different browning capacities among fat depots and even within the same depot. The local microenvironment in WAT, which is dynamically and coordinately controlled by inputs from the heterogeneous cell types, plays a critical role in the beige adipogenesis process. The authors also examined key regulators of the AT microenvironment, including vascularization, the sympathetic nerve system, immune cells, peptide hormones, exosomes, and gut microbiota-derived metabolites. Given that increasing beige fat function enhances energy expenditure and consequently reduces body weight gain, identification and characterization of novel regulators and understanding their mechanisms of action in the beiging process has a therapeutic potential to combat obesity and its associated diseases. However, as noticed by the authors, most of the current pre-clinical research on ‘beiging’ are done in rodent models, which may not represent the exact phenomenon in humans ( Cheong and Xu, 2021 ). Thus, further investigations will be needed to translate the findings from bench to clinic.

While both social–environmental factors and genetic preposition have been recognized to play important roles in obesity epidemic, Gao et al. (2021) present evidence showing that epigenetic changes may be a key factor to explain interindividual differences in obesity. The authors examined data on the function of DNA methylation in regulating the expression of key genes involved in metabolism. They also summarize the roles of histone modifications as well as various RNAs such as microRNAs, long noncoding RNAs, and circular RNAs in regulating metabolic gene expression in metabolic organs in response to environmental cues. Lastly, the authors discuss the effect of lifestyle modification and therapeutic agents on epigenetic regulation of energy homeostasis. Understanding the mechanisms by which lifestyles such as diet and exercise modulate the expression and function of epigenetic factors in metabolism should be essential for developing novel strategies for the prevention and treatment of obesity and its associated metabolic diseases.

A major consequence of obesity is type 2 diabetes, a chronic disease that occurs when body cannot use and produce insulin effectively. Diabetes profoundly and adversely affects the vasculature, leading to various cardiovascular-related diseases such as atherosclerosis, arteriosclerotic, and microvascular diseases, which have been recognized as the most common causes of death in people with diabetes ( Cho et al., 2018 ). Love et al. (2021) systematically review the roles and regulation of endothelial insulin resistance in diabetes complications, focusing mainly on vascular dysfunction. The authors review the vasoprotective functions and the mechanisms of action of endothelial insulin and insulin-like growth factor 1 signaling pathways. They also examined the contribution and impart of endothelial insulin resistance to diabetes complications from both biochemical and physiological perspectives and evaluated the beneficial roles of many of the medications currently used for T2D treatment in vascular management, including metformin, thiazolidinediones, glucagon-like receptor agonists, dipeptidyl peptidase-4 inhibitors, sodium-glucose cotransporter inhibitors, as well as exercise. The authors present evidence to suggest that sex differences and racial/ethnic disparities contribute significantly to vascular dysfunction in the setting of diabetes. Lastly, the authors raise a number of very important questions with regard to the role and connection of endothelial insulin resistance to metabolic dysfunction in other major metabolic organs/tissues and suggest several insightful directions in this area for future investigation.

Following on from the theme of obesity-induced metabolic dysfunction, Xia et al. (2021) review the latest progresses on the role of membrane-type I matrix metalloproteinase (MT1-MMP), a zinc-dependent endopeptidase that proteolytically cleaves extracellular matrix components and non-matrix proteins, in lipid metabolism. The authors examined data on the transcriptional and post-translational modification regulation of MT1-MMP gene expression and function. They also present evidence showing that the functions of MT1-MMP in lipid metabolism are cell specific as it may either promote or suppress inflammation and atherosclerosis depending on its presence in distinct cells. MT1-MMP appears to exert a complex role in obesity for that the molecule delays the progression of early obesity but exacerbates obesity at the advanced stage. Because inhibition of MT1-MMP can potentially lower the circulating low-density lipoprotein cholesterol levels and reduce the risk of cancer metastasis and atherosclerosis, the protein has been viewed as a very promising therapeutic target. However, challenges remain in developing MT1-MMP-based therapies due to the tissue-specific roles of MT1-MMP and the lack of specific inhibitors for this molecule. Further investigations are needed to address these questions and to develop MT1-MMP-based therapeutic interventions.

Lastly, Huang et al. (2021) present new findings on a critical role of puromycin-sensitive aminopeptidase (PSA), an integral non-transmembrane enzyme that catalyzes the cleavage of amino acids near the N-terminus of polypeptides, in NAFLD. NAFLD, ranging from simple nonalcoholic fatty liver to the more aggressive subtype nonalcoholic steatohepatitis, has now become the leading chronic liver disease worldwide ( Loomba et al., 2021 ). At present, no effective drugs are available for NAFLD management in the clinic mainly due to the lack of a complete understanding of the mechanisms underlying the disease progress, reinforcing the urgent need to identify and validate novel targets and to elucidate their mechanisms of action in NAFLD development and pathogenesis. Huang et al. (2021) found that PSA expression levels were greatly reduced in the livers of obese mouse models and that the decreased PSA expression correlated with the progression of NAFLD in humans. They also found that PSA levels were negatively correlated with triglyceride accumulation in cultured hepatocytes and in the liver of ob/ob mice. Moreover, PSA suppresses steatosis by promoting lipogenesis and attenuating fatty acid β-oxidation in hepatocytes and protects oxidative stress and lipid overload in the liver by activating the nuclear factor erythroid 2-related factor 2, the master regulator of antioxidant response. These studies identify PSA as a pivotal regulator of hepatic lipid metabolism and suggest that PSA may be a potential biomarker and therapeutic target for treating NAFLD.

In summary, papers in this issue review our current knowledge on the causes, consequences, and interventions of obesity and its associated diseases such as type 2 diabetes, NAFLD, and cardiovascular disease ( Cheong and Xu, 2021 ; Gao et al., 2021 ; Love et al., 2021 ). Potential targets for the treatment of dyslipidemia and NAFLD are also discussed, as exemplified by MT1-MMP and PSA ( Huang et al., 2021 ; Xia et al., 2021 ). It is noted that despite enormous effect, few pharmacological interventions are currently available in the clinic to effectively treat obesity. In addition, while enhancing energy expenditure by browning/beiging of WAT has been demonstrated as a promising alternative approach to alleviate obesity in rodent models, it remains to be determined on whether such WAT reprogramming is effective in combating obesity in humans ( Cheong and Xu, 2021 ). Better understanding the mechanisms by which obesity induces various medical consequences and identification and characterization of novel anti-obesity secreted factors/soluble molecules would be helpful for developing effective therapeutic treatments for obesity and its associated medical complications.

Bluher M. ( 2019 ). Obesity: global epidemiology and pathogenesis . Nat. Rev. Endocrinol . 15 , 288 – 298 .

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Cheong L.Y. , Xu A. ( 2021 ). Intercellular and inter-organ crosstalk in browning of white adipose tissue: molecular mechanism and therapeutic complications . J. Mol. Cell Biol . 13 , 466 – 479 .

Cho N.H. , Shaw J.E. , Karuranga S. , et al.  ( 2018 ). IDF Diabetes Atlas: global estimates of diabetes prevalence for 2017 and projections for 2045 . Diabetes Res. Clin. Pract . 138 , 271 – 281 .

Gao W. , Liu J.-L. , Lu X. , et al.  ( 2021 ). Epigenetic regulation of energy metabolism in obesity . J. Mol. Cell Biol . 13 , 480 – 499 .

Huang B. , Xiong X. , Zhang L. , et al.  ( 2021 ). PSA controls hepatic lipid metabolism by regulating the NRF2 signaling pathway . J. Mol. Cell Biol . 13 , 527 – 539 .

Loomba R. , Friedman S.L. , Shulman G.I. ( 2021 ). Mechanisms and disease consequences of nonalcoholic fatty liver disease . Cell 184 , 2537 – 2564 .

Love K.M. , Barrett E.J. , Malin S.K. , et al.  ( 2021 ). Diabetes pathogenesis and management: the endothelium comes of age . J. Mol. Cell Biol . 13 , 500 – 512 .

Ruan H.-B. ( 2020 ). Developmental and functional heterogeneity of thermogenic adipose tissue . J. Mol. Cell Biol . 12 , 775 – 784 .

Xia X.-D. , Alabi A. , Wang M. , et al.  ( 2021 ). Membrane-type I matrix metalloproteinase (MT1-MMP), lipid metabolism, and therapeutic implications . J. Mol. Cell Biol . 13 , 513 – 526 .

Author notes

Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China E-mail: [email protected]

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Definition and Overview

The World Health Organization (WHO) defines overweight and obesity as having “excessive fat accumulation that presents a risk to health.” There are various methods to calculate body fat , as each range in accuracy and can have limitations. Body mass index (BMI) is one tool used to screen for excessive body fat. A BMI value of more than 25 is categorized as overweight, and a BMI value of more than 30 is categorized as obese.

Why use BMI?

Health impacts.

There are negative health impacts associated with excess body fat. The WHO estimates that in 2019, 5 million deaths from noncommunicable diseases such as cardiovascular disease and diabetes were caused by a high BMI, and rates of obesity continue to grow globally in children and adults. [1] According to the Centers for Disease Control and Prevention in the U.S., 1 in 5 children and 1 in 3 adults has obesity. [2] Children with obesity are more likely to have obesity as adults and the associated risks of heart disease, high blood pressure, type 2 diabetes, and certain types of cancer.

A healthy amount of body fat in children and teens varies based on age as well as sex. The Centers for Disease Control and Prevention (CDC) developed growth charts for boys and girls ages 2-19 that show the distribution of BMI values at each age. [3] By the CDC’s definition, a child whose BMI falls between the 85th and 94th percentile for age and sex is considered overweight; a BMI at the 95th percentile or higher for age is considered obese. As the rates of obesity rise in children, there is also a category for severe obesity in which the BMI is 120% of the 95th percentile. The American Academy of Pediatrics provides more specific classifications of severe obesity:

• Class 2 Obesity: BMI ≥120% to <140% of the 95th percentile or BMI ≥35 to <40 kg/m 2
• Class 3 Obesity: BMI ≥140% of the 95th percentile or BMI ≥40 kg/m 2

Obesity can negatively affect nearly every system in a child’s body – the heart, lungs, muscles, bones, kidneys, digestive tract, and hormones that control blood sugar and puberty – and can also take a heavy social and emotional toll. Children with obesity may be burdened by stigma and discrimination from bullying, teasing and victimization. Youth with obesity have substantially higher odds of remaining overweight or obese into adulthood increasing their risk of disease and disability later in life. [4]

The risk of developing diabetes, heart disease, and other weight-related health risks increases with an increasing body mass index (BMI). But evidence shows that in some ethnic and racial groups, weight gain and higher fat mass even if BMI remains in the normal range can still increase health risks.

The Nurses’ Health Study tracked patterns of weight gain and type 2 diabetes (T2D) development in 78,000 U.S. women to see differences by ethnic group. [5] All women were healthy at the start of the study. After 20 years, researchers found that at the same BMI, Asians had more than twice the risk of developing T2D than Whites; Hispanics and Blacks also had higher risks of diabetes than Whites, but to a lesser degree. Increases in weight over time were more harmful in Asians than in other ethnic groups – for every 11 pounds Asians gained during adulthood, they had an 84% increased risk of T2D; Hispanics, Blacks, and Whites who gained weight also had higher risk, but to a much lesser degree than Asians. Other studies have found that even with a lower BMI than Whites, increasing weight in Asians with a BMI of 25 or higher increased risk of high blood pressure, T2D, and early death from all causes. [6-8]

One reason for this difference could be amount and location of body fat. Even with a lower BMI than other populations, Chinese and South Asians tend to carry higher abdominal fat than Whites, which increases the risk for T2D, cardiovascular disease, and other metabolic disorders. [9-11] In contrast, some studies have found that blacks have lower body fat and higher lean muscle mass than whites at the same BMI, and therefore at the same BMI, may be at lower risk of obesity-related diseases. [12,13]

For this reason, the World Health Organization and other organizations have recommended a lower BMI cutoff to classify obesity in Asian people (BMI of 25-27 or greater) as well as a smaller waist circumference to measure visceral fat. [9,14]

Weight gain of greater than 10 pounds in adulthood also increases disease risk (i.e., heart disease, high blood pressure, type 2 diabetes, gallstones) even in those whose BMI remains in the normal range, according to research from the Nurses’ Health Study and Health Professionals Follow-up Study. [15-19]

With the five leading causes of death – heart disease, cancer , chronic lower respiratory disease, cerebrovascular diseases such as stroke, and unintentional injuries – obesity is a major risk factor for the first four. [20] Obesity is also associated with other health conditions such as sleep apnea, fatty liver disease, gallstones, infertility, respiratory diseases, gastroesophageal reflux disease, and musculoskeletal disorders such as arthritis. No less real are the social and emotional effects of obesity which may include discrimination, lower quality of life, and susceptibility to depression.

Economic Impacts

Obesity costs the U.S. health care system almost $173 billion annually. [2] This includes money spent directly on medical care and prescription drugs related to obesity. In the workplace, research has shown that the number of sick days, short-term disability, and workers’ compensation days increase with increasing BMI. [21] Compared with an employee with a BMI of 25, an employee with a BMI of 35 has nearly double the risk of a disability or workers’ compensation claim. Perhaps one of the most surprising consequences of the current obesity epidemic in the U.S. is its impact on recruitment for the armed services, with data showing that 3 in 5 young adults carry too much weight to qualify for military service. [2]

According to the WHO, worldwide obesity rates are rising with 1 in 8 people, or more than 1 billion people, around the world living with obesity. [14] A Lancet review showed that global adult obesity doubled from 1990 to 2022, and adolescent obesity quadrupled. [22] As low to middle-income countries adopt unhealthy eating patterns and behaviors of industrialized nations such as less physical activity, so do their obesity rates. Specific regions including Polynesia, Micronesia, the Caribbean, the Middle East, and north Africa showed the greatest increases in obesity, as well as higher-income countries such as Chile. [22] Increased eating out of home, access to ultra-processed low-nutrient-dense foods, and sedentariness (e.g., sitting at work, driving instead of walking or bicycling) have contributed. Higher cost and limited access to healthy foods and decreased opportunities for play and sports may cause inequalities in obesity and could limit the impact of policies that target unhealthy foods. [22]

The NCD Risk Factor Collaboration visualizes the prevalence of obesity globally as well as changing obesity rates in various countries since 1990. Below are data summaries of obesity rates for both adults and children around the world:

In 2018, the United States had the highest prevalence of adult obesity among high-income Western countries worldwide. [23]   From 1999 through 2018, the age-adjusted prevalence of adults with obesity increased significantly from 31% to 42%. [24]. If trends continue, projections estimate that by 2030 nearly 50% of adults will have obesity, and nearly 1 in 4 adults will have severe obesity (BMI ≥35). [25]

Obesity disproportionately affects U.S. racial/ethnic minority populations. Compared to 42% of non-Hispanic whites, 50% of non-Hispanic Black and 45% of Hispanic adults have obesity. [24] There are considerable differences in obesity among non-Hispanic Black adults by sex, with 57% of non-Hispanic Black women having obesity compared to 41% of men. [24] Trends estimate that severe obesity may become the most common BMI category among non-Hispanic Black and low-income adults by 2030. [25]

Obesity rates in Canada are not as high as they are in the U.S., but Canada has seen dramatic increases over the past three decades. Obesity prevalence among Canadian adults increased from 9% in 1975 to 31% by 2016. [23] Indigenous populations in Canada are also disproportionately affected by the burden of obesity. [26]

The U.S. has among the highest childhood obesity rates in the world, with nearly 1 in 3 children with overweight or obesity. In 2015-2016, nearly 19% of children 2-19 years old had obesity, affecting an estimated 14 million children nationwide. Obesity prevalence was highest among adolescents 12-19 years old (21%) and lowest among preschool-aged children 2-5 years old (14%). [27] Recently, the prevalence of obesity declined among children ages 2-5 years old, held steady for children 6-11 years, and continued to rise among adolescents 12-19 years. [28,29] Current trends suggest that an alarming 57% of children currently between 2 and 19 years old will have obesity at age 35. [30]

Overweight and obesity disproportionally affects racial/ethnic minority populations, and such disparities exist as early as age 2 and persist into adulthood. [27,30] The highest obesity prevalence are among Hispanic (26%) and non-Hispanic Black children (22%), compared with the lowest prevalence among non-Hispanic White (14%) and non-Hispanic Asian (11%) children. [27]

Canada has also seen a rise in childhood obesity since the late 1970s. Obesity rates have more than doubled, and in some age groups, tripled. [31] But childhood obesity rates are lower there than they are in the U.S; in 2013, 10% of children ages 6-11 years old and 17% of children ages 12-17 had obesity. [32] Childhood obesity is significant among Canada’s Aboriginal groups. In a 2006 survey of Aboriginal Peoples in Canada, nearly 33% of children ages 6-8 had obesity, and 13% among children ages 9-14. [33]

Over the past several decades, obesity has become a significant health challenge in Latin America. While undernourishment persists among vulnerable groups, so do overweight and obesity. Each year, obesity among the population grows by 3.6 million individuals, and now exceeds undernourishment as the greatest nutritional threat. [34] Between 1975 and 2014, among the largest increases in BMI in regions worldwide occurred for men in central Latin America, and for women in Andean Latin America and the Caribbean. [35] In 2016, approximately 104 million adults in Latin America had obesity; 15% of men and 16% of women. [23] Countries with the highest prevalence of obesity included Bermuda (women 43%, men 30%) and Puerto Rico (women 42%, men 29%). [23]

While Latin America has shown significant progress in reducing child stunting due to undernourishment, prevalence of overweight and obesity due to malnutrition has grown to be among the highest in the world. [34] As a result, Latin American children have the dual burden of undernutrition coexisting with overweight and obesity. [36] In 2016, 15% of children ages 5-9 years and 10% of adolescents ages 10-19 years had obesity in Latin America and the Caribbean. [34] Among girls ages 5-19 years old, central Latin America demonstrated the highest increase of BMI per decade worldwide over the past 40 years. [37] Inequality further exacerbates overweight and obesity in populations with lower income, and among women, indigenous peoples, Afro-descendants, and rural families. [34]

Since 1975, obesity rates have been rising across Europe, though not as rapidly or as high as they are in the U.S. [35] Countries with the highest prevalence include Malta and the United Kingdom, hovering around 30% for both men and women. Countries with the lowest obesity prevalence include Austria, Sweden, Denmark, and Switzerland for women and Moldova and Russia for men (<20% for all). [23] The rise in women’s BMI in central and southwestern Europe has been among the lowest over the past 40 years, one of the few places worldwide that can report such a trend. [23,35]

Over the past several decades, many European countries had among the largest increases in the number of children and adolescents with obesity. [37] More recently, obesity has plateaued in many regions, particularly in eastern, northwestern, and southwestern Europe, but prevalence rates remain high in Mediterranean countries. [37,38] In Greece, Malta, and Cyprus, 16% of boys ages 5-19 have obesity, and 11% of girls in Greece and Malta. [37]  

Regional surveys and analyses demonstrate similar childhood obesity trends in Europe. A 2019 systematic review of 130 studies across 28 European countries assessed prevalence trends in overweight and obesity among 2-13-year-old children between 1999-2016. [39] The prevalence of overweight and obesity tended to decrease in the Iberian region and increase in the Mediterranean regions, with no significant changes in Atlantic or Central Europe. Although the overall prevalence of childhood overweight and obesity remains high, trends have stabilized in most European countries, but continues to rise in some Mediterranean countries. [39]

Undernutrition has historically received more public health attention in Africa than overnutrition. Yet today, obesity and associated chronic diseases have become a growing problem across the continent. Some have called it a “silent epidemic,” striking countries that are still struggling with the health and economic burdens of malnutrition, stunting, infectious disease, and high childhood mortality rates. [40]

Obesity prevalence is higher among African women compared with men, and can vary widely from country to country. For example in 2016, 41% of women in South Africa had obesity (higher than in U.S. women) compared with 16% of men. In stark contrast, the lowest prevalence of obesity was in Ethiopia for women (7.3%) and in Uganda for men (2%); prevalence of undernutrition exceeds that of overnutrition in these African countries among many others. [35]  Between 1975 and 2016, Botswana experienced the largest increases in obesity prevalence in these African regions, jumping from 5% to 31%. [35]

Hunger, underweight, and stunting have long been the more pressing child nutrition concerns across Africa. Even today, more children and adolescents are moderately or severely underweight than obese, particularly in central, east, and west Africa. [35] Yet here too, child obesity rates are on the rise, particularly in southern Africa. In 1975, less than 0.5% of girls and boys in South Africa had obesity, but by 2016 the prevalence jumped to 13% for girls and 10% for boys. [37]

Researchers have taken a closer look at obesity trends in the six Persian Gulf states (Oman, Bahrain, United Arab Emirates, Saudi Arabia, Qatar, and Kuwait), since these countries have seen tremendous increases in wealth since the discovery of oil reserves in the 1960s. [41] Even in 1975, obesity prevalence in Kuwait, Qatar, and the United Arab Emirates exceeded 20% among women, raking among the top 20 countries worldwide with the highest prevalence. Among men, Kuwait and Qatar also ranked among the top 20 countries with the highest prevalence in 1975, but only at 12%. [23] In 2016, the prevalence of obesity increased to 47% in Kuwait and 45% in Qatar for women, and to approximately 30% for men in both countries. The most significant increases have been observed in Saudi Arabia and Jordan, from 6% in 1975 to around 30% in 2016. [23]

The Middle East and north Africa have seen sharp increases in obesity since 1975, and this region now has among the highest prevalence of child and adolescent obesity worldwide. [38] Girls in Kuwait and Egypt and boys in Kuwait, Qatar, and Saudi Arabia have the highest obesity prevalence in the region, all hovering around 20% of the child and adolescent population. [37] In 1975, girls in the Middle East and north Africa had higher age-standardized BMI than boys, but by 2016 this gap shrank or reversed as boys gained more weight than girls. [37]

Some countries in Asia have the lowest obesity prevalence worldwide, yet here too it has become a serious problem across the region over the past four decades, even while underweight concerns persist. Japan and South Korea have among the lowest obesity prevalence in the world (<9%) for both men and women. However, recent trends in China are of special concern. Although obesity rates are still low overall, there has been a substantial increase from <1% in 1978, to 6% for women and 7% for men in 2016. [23] China is one of the most populous nations on the planet with more than 1.4 billion people, so even small percentage increases in obesity prevalence translate into millions more cases of chronic disease. Furthermore, Asians have a higher risk of weight-related diseases like type 2 diabetes at lower BMI levels , further exacerbating the health issues related to overweight and obesity.

South Asian countries like Bangladesh, India, and Pakistan have among the highest prevalence of moderate and severe underweight worldwide; 20% in girls and 29% in boys. Nevertheless, trends in mean BMI have significantly accelerated in east, south, and southeast Asia between 1975 and 2016. Although obesity prevalence remains relatively low in south Asia, their large populations add up to large numbers of children who have obesity.

Compared to south Asia, the prevalence of child and adolescent obesity is greater in high income Asia Pacific and east/southeast Asia, particularly among boys. [37,38] Obesity prevalence in Malaysia, Taiwan, and China for boys was less than 0.5% in 1975 and jumped to 15% in 2016. Girls in Asia have lower obesity prevalence compared to boys, but has still been increasing over time, most notably in Malaysia where obesity increased from 0.2% to 10% during this time period. [37]  

It’s important to note that in Asian adults, the health complications associated with overweight and obesity start at a lower BMI than seen in the U.S. and Europe; therefore these estimates of child obesity prevalence in Asia likely underestimate the true public health burden of obesity in Asia.

The top 13 countries with the highest obesity prevalence worldwide are located within Oceania. Eight of the countries exceed 45% obesity prevalence among men, and 13 countries exceed 50% among women. American Samoa and Nauru have the highest obesity prevalence among women (68%) worldwide; for men it is Nauru at 60%. Australia and New Zealand have lower prevalence in the region but still hover around 30% for both men and women. [23]

Of the top 13 countries with the highest child and adolescent obesity prevalence in 2016, 11 were located in Oceania. There was more than 30% obesity prevalence for both girls and boys in the Cook Islands, Nauru, Palau, and additionally for boys in Niue and American Samoa. [37]

High-income countries in Oceania, Australia and New Zealand have childhood obesity rates in the double digits, but there’s some evidence that rates have hit a plateau. In Australia, 13% of boys and 11% of girls have obesity; in New Zealand the prevalence is higher at 18% and 15% respectively. [37] Overweight and obesity prevalence is even higher in some of New Zealand’s ethnic groups (Maori, 37%; Pacific Islanders, 57%) but have largely unchanged since early 2000. [42]

Risk Factors

Various factors can influence body weight or greater weight gain in specific areas of the body. Some of these cannot be changed, but others may be modified:

• Non-modifiable risk factors (risk factors you can’t change): age, gender, genes, ethnic origin, and sometimes medications that change how energy is processed in the body leading to weight gain. There’s also strong evidence that having obesity in infancy or childhood increases the chances of remaining obese in adulthood.
• Risk factors that can be modified: food and beverages consumed, level of physical activity, daily screen time (increased screen time is associated with reduced physical activity time and also increases exposure to marketing of unhealthy foods/beverages), poor sleep hygiene, uncontrolled negative stress. While easier said than done, evidence has shown that addressing these factors as early as possible, even in childhood, may reduce the risk of developing obesity.

Obesity is complex and not just about being born with a certain body size, taking in more calories than the body needs, or burning extra calories through exercise to lose weight. It is often the result of a combination of several non-modifiable and modifiable risk factors. When looking at diet and food, which is often the focus with obesity, there are various factors to consider than just calories in/calories out:

• Living in a food environment that lacks access to healthy food choices or income-related barriers to regularly consuming a variety of healthy foods.
• Amount of low-nutrient ultra-processed foods and sugary beverages consumed, especially when displacing high-fiber whole foods, which can increase cravings .
• Eating behaviors such as skipping meals and eating heavy meals or snacks at night before bed.
• Overeating portions not from hunger but from stress or boredom.

The environments that surround us also play an important role, as they can make a modifiable risk factor a non-modifiable one. Examples are when someone does not have the ability to secure healthy food choices due to living in a food desert or a safe place to perform regular physical activity .

There are various risk factors for obesity, but not everyone with these risk factors develops obesity. And not everyone who has obesity develops health problems. In these cases, genes may play a role. Studies of siblings or twins show genetic factors that can determine weight and body size throughout life. [43] Some research suggests differences in genes in people who are of normal weight versus those carrying extra weight that may influence appetite control, metabolic rate, or even ability to change behavior. Gene-nutrient interactions can also promote obesity. For example, genes that increase risk of developing obesity have been reported to be stimulated by saturated fatty acids but not by unsaturated fatty acids . [43] The gut microbiome may also play a role in a person’s risk of developing obesity and chronic health conditions. [44]

However, obesity caused by mutations in a single gene, or monogenic obesity, is rare and is more likely influenced by changes in many different genes, called “common” obesity. Still, the modern obesity epidemic is largely fueled by environmental factors, with excess energy intake and low physical activity pinned as the main culprits. [45] First-degree family members (parents, siblings) who live together typically share similar environments that increase the risk of obesity, and health-related habits of parents are often passed onto their children. Examples include food choices, meal preparation methods (cooking at home vs. reliance on fast food), exercise, screen time, and sleep habits, as well as lack of access to outdoor green space.

These findings suggest that genetic factors make a small contribution to obesity risk, and that our genes are not our destiny. Many people who carry potential “obesity genes” do not become overweight, and healthy lifestyles can counteract these genetic effects.

Is Prevention Possible?

Many factors contribute to rising rates of obesity in children and adults. Among them, the abundance of low-priced, high-calorie ultra processed foods and sugary drinks; incessant marketing driving people to eat more; and an environment that reduces the need for regular physical activity.

Although preventing weight gain over the years of life may not be possible for everyone due to a variety of circumstances, there are strategies to reduce the amount of weight change by increasing awareness of modifiable risk factors and working toward healthy lifestyle behaviors.

However, focusing only on the individual (e.g., nutrition and lifestyle education, weight loss medications) has little impact on global obesity prevalence. Prevention requires a broader scope that addresses food systems and an obesogenic environment , including policy changes such as regulating the marketing of ultra-processed low-nutrient-dense foods and taxing items such as sugar-sweetened beverages.

Indeed, what sometimes gets lost in the discussion is that obesity is preventable . We can turn around the obesity epidemic by collaboratively creating an environment where the default option is the healthy choice.

Obesity prevention at the individual level and beyond

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• Review Article
• Published: 27 February 2019

Obesity: global epidemiology and pathogenesis

• Matthias Blüher 1  

Nature Reviews Endocrinology volume  15 ,  pages 288–298 ( 2019 ) Cite this article

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The prevalence of obesity has increased worldwide in the past ~50 years, reaching pandemic levels. Obesity represents a major health challenge because it substantially increases the risk of diseases such as type 2 diabetes mellitus, fatty liver disease, hypertension, myocardial infarction, stroke, dementia, osteoarthritis, obstructive sleep apnoea and several cancers, thereby contributing to a decline in both quality of life and life expectancy. Obesity is also associated with unemployment, social disadvantages and reduced socio-economic productivity, thus increasingly creating an economic burden. Thus far, obesity prevention and treatment strategies — both at the individual and population level — have not been successful in the long term. Lifestyle and behavioural interventions aimed at reducing calorie intake and increasing energy expenditure have limited effectiveness because complex and persistent hormonal, metabolic and neurochemical adaptations defend against weight loss and promote weight regain. Reducing the obesity burden requires approaches that combine individual interventions with changes in the environment and society. Therefore, a better understanding of the remarkable regional differences in obesity prevalence and trends might help to identify societal causes of obesity and provide guidance on which are the most promising intervention strategies.

Obesity prevalence has increased in pandemic dimensions over the past 50 years.

Obesity is a disease that can cause premature disability and death by increasing the risk of cardiometabolic diseases, osteoarthritis, dementia, depression and some types of cancers.

Obesity prevention and treatments frequently fail in the long term (for example, behavioural interventions aiming at reducing energy intake and increasing energy expenditure) or are not available or suitable (bariatric surgery) for the majority of people affected.

Although obesity prevalence increased in every single country in the world, regional differences exist in both obesity prevalence and trends; understanding the drivers of these regional differences might help to provide guidance for the most promising intervention strategies.

Changes in the global food system together with increased sedentary behaviour seem to be the main drivers of the obesity pandemic.

The major challenge is to translate our knowledge of the main causes of increased obesity prevalence into effective actions; such actions might include policy changes that facilitate individual choices for foods that have reduced fat, sugar and salt content.

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Blüher, M. Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol 15 , 288–298 (2019). https://doi.org/10.1038/s41574-019-0176-8

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Published : 27 February 2019

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DOI : https://doi.org/10.1038/s41574-019-0176-8

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