Obesity is one of the most serious worldwide public health concerns of our modern society. Obesity has been described as a global epidemic, as the number of people dealing with obesity has nearly tripled since 1975 around the world [1]. What is most concerning, however, is that obesity hasn’t only increased among adults, but also among adolescents and small children around the world.
In what follows, we will discuss which are the factors that trigger obesity and which are its consequences regarding health risks and its associated comorbidities. But first, we will start by exploring the difference between overweight, obesity, and morbid obesity; we will then show a greater picture of how widespread this problem is among different nations. We will conclude by listing the safest and most effective alternatives that are available for the treatment of obesity.
Diagnosis
Many years ago, obesity was perceived as a “matter of bad choices” among many people, including doctors. However, this is very far from the truth. Obesity is not just a matter about what you eat and what kind of choices you make. It is, in fact, a multifactorial health issue that can arise depending on many different circumstances like:
- Genetics
- Family history
- Medical history and pre-existing health issues
- Usage of certain medications
- Social and economic conditions
- Age
- Pregnancy
- Stress
- Lack of sleep
- Inactivity
- Prevalence of food deserts and lack of healthy food choices
- Culture about food consumption
- Type of diet
- Unhealthy eating habits
- Even the way you chew and swallow!
Nowadays, obesity is more clearly perceived as a complex social problem more than an individual problem.
Obesity was recognized as a disease in 1998 by the World Health Organization [2]. Overweight and obesity is currently defined as an abnormal or excessive fat accumulation that may impair health [1]. These conditions are usually diagnosed by considering a person’s body mass index (BMI). The BMI is regarded as the main indicator of obesity, but there are many others, like the size of the waistline and clinical indicators like blood pressure, cholesterol and sugar levels.
To calculate your BMI, you need to divide your weight in kilograms by the square of your height in meters.
BMI = kg/m²
According to this calculation, here are the different weight categories for adults, based solely on their BMI:
- Underweight: BMI below 18.5
- Healthy weight: BMI between 18.5 and 24.9
- Overweight: BMI between 25 to 29.9
- Obese: BMI between 30 and 39.9
- Morbidly obese: BMI of 40 or higher [3]
Different criteria apply in children, though. In the cases of adolescents and children, obesity is diagnosed based on which percentile their BMI is in growth charts for adolescents and children of the same age and sex in their country.
Prevalence
Unfortunately, obesity has become very common in the last decades. It has been estimated that, by 2016, 650 million adults in the world were obese. This represents, approximately, a 13% of the world population. Another 23% of the world’s population in 2016 was considered overweight; this means that at least 39% of the world population (1.9 billion adults) is either overweight or obese [1].
The obesity rate varies in each country, though. The United States has one of the highest obesity rates in the world: 37% of its adult population, and 21% of its adolescent population is obese. Canada and Mexico also have high rates on this issue. In Canada, 31% of the adult population and 11% of the adolescent population is obese. In Mexico, 28% of the adult population and 14% of the adolescent population is obese. In all these three countries, the obesity trend is projected to be on the rise for the next following years, so this problem is yet getting bigger and bigger [4].
Obesity rates and world rankings
| World ranking [5] | Country | Obesity rate (% of adult population) |
| 1 | Naubu | 61% |
| 12 | United States | 37% |
| 26 | Canada | 31% |
| 29 | Mexico | 28% |
Main causes
So exactly what causes obesity? There are many causes that contribute to this problem and most of them act simultaneously. The main cause for the increased prevalence in obesity, however, is the fact that our modern lifestyle has led us into more sedentary habits and that the food that is available for our consumption is highly processed and rich in both carbohydrates and fats. In many cases, getting healthy high-quality food, at convenient prices, has become more and more difficult in certain regions. These circumstances, combined with a more hectic, stressful environment sets our path to unhealthy habits that lead to excess weight gain and many other related diseases.
Calories
The energy food gives us is measured in calories. When we eat food high in calories, high in carbohydrates and high on fats, we usually accumulate more energy than we can burn out with our daily activity. Frequent excess in calorie intake causes weight gain. A healthy diet usually contains an average of 2,0500 calories for men and 2,000 calories for women a day; this includes foods and liquids.
Inactivity
Sedentarism and low physical activity causes obesity too. Exercise and movement make us burn calories and fat, and this strengthens our physical condition and health. When we spend big amounts of time sitting or lying down, we just store the energy in our body as fat. The World Health Organization recommends dedicating between 150 and 300 minutes a week to moderate exercise [6]. Walking at least 30 minutes a day is a great way of keeping yourself active and healthy.
Unhealthy eating habits
Overeating, emotional eating, eating junk food and binge-eating are all examples of unhealthy eating habits that cause obesity. We usually fall in these behaviors when we are most vulnerable: we are either stressed, anxious, sad or simply in a rush. It is important to practice self-care and to lower our stress triggers so we can make better decisions with food. Taking our time to chew food thoroughly also helps. This helps us enjoy our food more, it signals our body when it is full on time and it eases our digestion.
Genes and family history
Our physique and health tendencies are usually dependent (or at least highly susceptible) to our family’s history. After all, family members do share many similarities both in physical aspect and in medical conditions, which sometimes are inherited. If many members of your family struggle from obesity, odds are that you might be prone to it too. But this is not unavoidable; it can be preventable even if it runs in your family. Having a healthy diet and lifestyle that includes frequent exercise can hold obesity back.
Health conditions and medications
Medical conditions and the usage of certain medications are causes of undesired weight gain. For instance, hypothyroidism, where the thyroid gland fails to produce enough hormones, usually causes overweight. An excessive production of steroids, like in the case of the Cushing’s syndrome, also causes obesity. In women, polycystic ovary syndrome (POCS) usually causes weight gain too.
On the other hand, the usage of medications such like antidepressants, antipsychotics, corticosteroids, seizure medicines, and antihyperglycemics also causes weight gain.
There are also certain physical conditions that tend to reduce mobility, which in turn leads to inactivity and weight gain. For instance, his may happen in the case of arthritis or joint pain.
Consequences
Obesity itself causes a series of different health problems. An excessive weight increases the risk of:
- General mortality
- Hypertension (high blood pressure)
- Dyslipidemia (high cholesterol)
- Type 2 diabetes
- Heart disease
- Obstructive sleep apnea
- Joint pain
- Gallbladder disease
- Digestive issues
- Non-alcoholic fatty liver disease
- Urinary incontinence
- Osteoarthritis
- Low fertility
- Certain types of cancers
- Depression
- Anxiety
- Severe COVID-19
- Losing weight can alleviate and resolve many of these consequences.
Treatments
Most people turn to dieting and exercise as a method for losing weight. This usually works for people with overweight or people with a high BMI that don’t have any serious medical conditions. But sometimes this approach fails to deliver results by itself.
Bariatric surgery is the most effective treatment for obesity. Bariatric surgery helps to get rid of most of the excess body weight and it also contributes to the amelioration and resolution of many obesity-related diseases. There are many types of bariatric surgery. Some use restrictive methods in which the size of the stomach is significantly reduced so the patient can have a higher control over the portions she or he consumes. The intragastric balloon procedure and the gastric sleeve are examples of restrictive bariatric surgeries. Others use malabsorptive methods in which the metabolic system of the patient gets modified in order to favor a faster digestion. In this method, the size of the stomach gets reduced and the small intestine gets a little shortened so it can absorb less nutrients from food. Examples of this type of bariatric surgeries are the gastric bypass, the mini-gastric bypass and the duodenal switch.
A bariatric treatment should be complemented with a healthy diet and constant exercise. The bariatric surgery achieves dramatic weight loss in just a few months after surgery, but changing to a healthier lifestyle allows the patient to maintain his or her new weight and to avoid further weight gain.
Contact LIMARP today
At LIMARP, our clinic in Tijuana, Mexico, we offer an integral bariatric program for people struggling with obesity. If you are interested in knowing if bariatric surgery is the right choice for you, please call us at (619) 270-8823, fill our contact form in this webpage or send us a message through any of our social media pages.
References
- [1] World Health Organization (June 9, 2021). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
- [2] Arrieta, F. & Pedro-Botet, J. (2021). Recognizing obesity as a disease: A true challenge. Rev Clin Esp. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8144115/
- [3] National Heart, Lung, and Blood Institute (n.d.). Overweight and Obesity. https://www.nhlbi.nih.gov/health-topics/overweight-and-obesity
- [4] World Health Organization (2018). Noncommunicable Diseases (NCD) Country Profiles. https://apps.who.int/iris/handle/10665/274512
- [5] World Population Review (2021). Obesity Rates by Country 2021. https://worldpopulationreview.com/country-rankings/obesity-rates-by-country
- [6] World Health Organization (2020). Physical activity. https://www.who.int/news-room/fact-sheets/detail/physical-activity