The Weighty Issue Of Obesity

by Anna Lo, MD

Obesity is a major health problem worldwide. According to the World Health Organization, in 2016 an estimated 1.9 billion adults were overweight, of these 650 million were obese, and amongst children and adolescents, over 340 million children and adolescents were considered as overweight or obese.

Obesity is defined as having a body mass index (BMI) of 30 or higher, and it is a leading cause of preventable death and disability. A major global study from The Global Burden of Disease, published in the medical journal The Lancet, estimated that about 5.02 million deaths across all age groups and sexes were attributed to obesity as a risk factor.

Obesity refers to abnormal or excessive fat accumulation that presents a health risk. Obesity is associated with numerous health consequences, including cardiovascular disease, type 2 diabetes, cancer, joint problems, sleep apnea, and mental health disorders.

There are many factors that contribute to the development of obesity. Genetics, environment, and behavior all play a role. People with a family history of obesity are more likely to become obese themselves.

Environmental factors such as access to unhealthy foods and a sedentary lifestyle can also contribute to obesity. Behavioral factors, such as overeating and lack of physical activity, are major contributors to the obesity epidemic. An increased intake of energy-dense foods that are high in fat and sugars coupled with an increase in physical inactivity causes an energy imbalance between calories consumed and calories expended, leading to an increase in amount of fat the body wants to carry.

Some people may have hormonal or neurologic issues that contribute to obesity. This may warrant further investigation by an appropriate health care provider as managing the underlying disorder can help treat obesity.

Obesity is a chronic disease that often requires a multifaceted approach in preventing and managing this complex disease state. Eating a balanced diet, engaging in regular physical activity, and seeking behavioral therapy are all important strategies.

There are various nutrition programs such as the Mediterranean or DASH diets which can help patients lose weight and stay healthy. This can often be challenging and advice and support from a dietician may be helpful.

For some people, medications or bariatric surgery may be necessary. There are several weight loss medications that are approved by the FDA for safe and effective management of obesity. Those who pursue bariatric surgeries may elect to undergo gastric bypass surgery or sleeve gastrectomy.

Discussions with an obesity specialist can help guide patients in choosing the right care for their weight loss journey.

Addressing the obesity epidemic requires a comprehensive public health approach that includes policy interventions, such as sugar taxes and labeling laws, and urban planning and education campaigns. By working together to address obesity, we can improve health outcomes for individuals and communities.

ANNA MELISSA LO, MD is board certified through the American Board of Internal Medicine, both in Internal Medicine and Endocrinology, Diabetes, and Metabolism. She is currently practicing at the Primary Specialty Clinic of Hawaii across different islands including Oahu, Lihue, and in Hilo.

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