how to reduce obesity essay

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How to Prevent Obesity

• Early Prevention
• Stress Reduction
• Improving Sleep
• Next in Obesity Guide Obesity: What You Need to Know

Preventing obesity involves making healthy lifestyle choices every day. To prevent obesity, you need to stay active, follow a healthy diet, and get adequate sleep. Obesity prevention also involves saying no to certain preferences, like soft drinks, or driving short distances when you could walk instead.

Obesity is generally defined as a chronic disease characterized by excessive body fat. More than 42% of adults and 19% of children and adolescents in the U.S. have obesity, and those numbers are rising. Obesity is often caused by a combination of risk factors, including genetics , poor diet, sedentary behaviors , medical conditions, and lack of access to healthy foods.

While obesity prevention should start in childhood, it is never too late to start making healthier choices. This article discusses how to prevent obesity starting in childhood and later in life. It includes diet, exercise, and lifestyle strategies, along with how these strategies can reduce your obesity risk.

Daniel Llao Calvet / Getty Images

Preventing Obesity in Childhood

Obesity often begins in childhood . Research shows that if a person has obesity at age 5, they are more likely to have obesity as an adult. Conversely, if a child does not have obesity at age 5, their lifetime risk of obesity is significantly lower.

Obesity results from a combination of genetic, environmental, and lifestyle factors. Although families cannot change their genes, they can model healthy lifestyle patterns for children to start preventing obesity from a young age.

To prevent obesity in childhood, families can:

• Promote healthy eating: Families can try swapping out processed snacks like potato chips for healthier snacks like baked cinnamon apple crisps. Saying no to soft drinks is another great starting point.
• Get active together: Parents and children can both benefit from engaging in physical activity together. Make a tradition of physical activity, like playing frisbee or riding bikes together after school. Children ages 6 to 17 should get 60 minutes of physical activity per day.
• Ensure consistent sleep: Children who don't get enough sleep have a greater risk of developing obesity, type 2 diabetes, and other health conditions. The amount of uninterrupted sleep your child needs depends on their age group, but the key is a consistent bedtime—even on weekends.
• Minimize screen time: Too much screen time in childhood increases the risk of obesity, poor sleep, unhealthy eating, and more. Whenever possible, it's important to replace screen time with family time or physical activity. At a minimum, screens should be turned off at least one hour before bed.

If you are concerned about your child's weight, reach out to a healthcare provider. Your provider may be able to help you identify lifestyle factors that are contributing to your child's weight gain. They can also assess any health risks your child may have based on their weight or your family history.

Diet to Prevent Obesity

Obesity can be prevented by following basic principles of healthy eating. Here are simple changes you can make to your eating habits that will help you lose weight and prevent obesity.

Eat More Fruits and Vegetables

Eating a diet rich in fruits and vegetables decreases the risk of obesity. Fruits and vegetables contain a variety of beneficial nutrients and are associated with a lower risk for diabetes and insulin resistance . They are also high in fiber, which keeps you feeling full with fewer calories and ensures your digestive system stays regulated.

Focus on filling your plate with whole vegetables and fruits at every meal. Aim for lots of natural colors—carrots, sweet potatoes, broccoli, bananas, eggplant—the more color, the merrier.

Go easy (or eliminate) protein sources that are heavy in saturated fats, such as red meat and dairy. If you choose to cut out meat entirely, consult with a healthcare provider to ensure you are not at risk for nutritional deficiencies.

Does a Plant-Based Diet Prevent Obesity?

Eating more plant foods and less animal foods lowers insulin resistance and contributes to a healthier body mass index (BMI, an imperfect but commonly used metric). Following a plant-based diet will not increase the risk of obesity. However, more research is needed to evaluate the benefits of plant-based diets for reducing obesity long-term.

Avoid Processed Foods

Highly processed foods , like white bread and many boxed snack foods, are a common source of empty calories, which tend to add up quickly. A 2019 study found that people who were offered a highly processed diet consumed more calories and gained weight, while those offered a minimally processed diet ate less and lost weight.

There are many healthy alternatives to processed snacks that can be just as satisfying, such as:

• Unsalted almonds, cashews, walnuts, and pistachios
• Roasted chickpeas
• Crispy lettuce wraps
• Frozen yogurt-covered blueberries
• Baked banana chips

While it may take a little more time and creativity, planning and preparing healthy snacks can be an enjoyable and rewarding experience.

Limit Sugar and Artificial Sweeteners

It is important to keep your intake of added sugars low. According to current dietary guidelines, most adult women should have no more than 24 grams of sugar per day, while most adult men should have no more than 36.

Major sources of added sugar to avoid include: 

• Sugary beverages, including sodas and energy or sports drinks
• Grain desserts like pies, cookies, and cakes
• Fruit drinks (which are seldom 100% fruit juice)
• Dairy desserts like ice cream

Artificial sweeteners have been linked to obesity and diabetes , too. While some natural sweeteners like agave do not raise glucose as fast as table sugar, they still raise blood sugar and should also be used in moderation.

Reduce Saturated Fats

Numerous studies show that eating foods high in saturated fat contributes to obesity. Foods that are high in saturated fats include:

• Whole and reduced-fat milk
• Butter and dairy desserts
• Meat products, such as sausage, bacon, beef, hamburgers
• Cookies and other grain-based desserts
• Many fast-food dishes

Focus instead on sources of healthy fats (monounsaturated and polyunsaturated fats) like:

• Olive oil and canola oils
• Pumpkin and sesame seeds

Although these fats are healthier for you, they should still be limited to about 20% to 35% of daily calories. People with elevated cholesterol or vascular disease may need an even lower level.

Pay Attention to Beverages

A single, 12-ounce can of Coca-Cola contains 39 grams of sugar. That means one can of Coke alone exceeds the recommended daily intake of sugar.

Sugar and calories in soft drinks, energy drinks, sports drinks, and juices quickly add up and may contribute to weight gain. But drinks marketed as "sugar-free" and "low-calorie" aren't much better. Artificially sweetened drinks also carry a risk of numerous health problems, including obesity.

Rather than focusing on which artificial sweetener is best, it's better to avoid sweeteners in general. Make water or unsweetened drinks and your go-to instead.

Cook at Home

People who prepare meals at home are less likely to gain weight or develop type 2 diabetes, studies show.

One such study found that people who ate home-cooked meals more than five times per week were 28% less likely to have an overweight BMI than people who ate home-cooked meals less than three times per week. Eating more home-cooked meals was also associated with having less body fat.

BMI is a dated, flawed measure. It does not take into account factors such as body composition , ethnicity, sex, race, and age. Even though it is a biased measure, BMI is still widely used in the medical community because it’s an inexpensive and quick way to analyze a person’s potential health status and outcomes.

Exercising to Prevent Obesity

Most national and international guidelines recommend that the average adult get at least 150 minutes of moderate-intensity physical activity per week. That means at least 30 minutes per day, five days per week.

Researchers have also found that people who walk at a brisk or fast pace are more likely to have a lower weight, lower BMI, and lower waist circumference compared to individuals doing other activities.  

In addition, experts recommend keeping active throughout the day, whether by using a standing desk, taking frequent stretch breaks, or finding ways to work in walking meetings throughout your day.

Reducing Stress to Prevent Obesity

Chronic stress raises levels of the stress hormone cortisol and leads to weight gain. It can also result in poor dietary choices, as cortisol and other stress hormones can increase “carb cravings” and make it difficult to exercise good judgment and willpower.

Look into the many healthy ways to beat stress, and find what works best for you. This might include:

• Going for a daily walk
• Engaging in regular yoga or tai chi
• Listening to music you love
• Getting together with friends

Studies show having a pet can lower blood pressure. Additionally, pets, especially dogs, can increase your level of physical activity and help you stave off weight gain.

Improving Sleep to Prevent Obesity

The role of sleep in overall well-being cannot be overstated. This extends to the goal of preventing obesity, too. The Centers for Disease Control and Prevention recommends seven or more hours of sleep for adults 18 and over and even more sleep for younger people.

Studies have linked later bedtimes to weight gain over time. One of these studies included 137,000 people from 26 countries. It showed that, compared to people who go to bed before 10 p.m., people who go to bed after 10 have a 20% greater risk of general and abdominal obesity. Meanwhile, the risk is up to 38% higher in people who go to bed after 2 a.m.

If you are having trouble falling asleep earlier, it may help to:

• Set a consistent bedtime.
• Make sure your bedroom is quiet, dark, and a comfortable temperature.
• Keep phones, computers, and televisions out of the bedroom.
• Cut off screen time within one hour of going to bed.
• Avoid large meals and caffeine before bedtime.
• Increase physical exercise to help your body relax better at night.

There are several possible contributors to obesity. The fact that the two biggest ones—diet and activity—are ones you can influence is good news. A healthy lifestyle that puts exercise and eating at its center can also bring myriad other health benefits. Getting good sleep and finding ways to reduce stress is important, too.

If you have made significant lifestyle changes and are still gaining weight or unable to lose weight, see a healthcare professional to rule out other possible causes of weight gain.

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Martins F, Conde S. Impact of diet composition on insulin resistance . Nutrients . 2022 Sep;14(18):3716. doi:10.3390/nu14183716

Hall KD, Ayuketah A, Brychta R, et al. Ultra-processed diets cause excess calorie intake and weight gain: an inpatient randomized controlled trial of ad libitum food intake . Cell Metab . 2019;30(1):67–77.e3. doi:10.1016/j.cmet.2019.05.008

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Mills S, Brown H, Wrieden W, White M, Adams J. Frequency of eating home cooked meals and potential benefits for diet and health: Cross-sectional analysis of a population-based cohort study . Int J Behav Nutr Phys Act . 2017 Aug;14(1):109. doi:10.1186/s12966-017-0567-y

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Chao A, Jastreboff A, White M, Grilo C, Sinha R. Stress, cortisol, and other appetite-related hormones: Prospective prediction of 6-month changes in food cravings and weight . Obesity (Silver Spring) . 2017 Apr;25(4):713-720. doi:10.1002/oby.21790

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By Yasmine S. Ali, MD, MSCI Yasmine Ali, MD, is board-certified in cardiology. She is an assistant clinical professor of medicine at Vanderbilt University School of Medicine and an award-winning physician writer.

Preventing Obesity

Let’s be clear: To make strides in reversing the obesity epidemic , changes must come from all parts of society—from governments and schools, businesses and non-profit organizations, neighborhoods and communities. Effective policies and programs are essential in ensuring that children and adults live, work, and play in environments that are conducive to healthy eating and offer opportunities for physical activity .

Personal preferences and knowledge or beliefs can influence lifestyle choices, but there are so many complex factors that strongly impact individual behaviors. This page covers individual- and family-level strategies associated with maintaining a healthy weight, with the acknowledgement that we are too often fighting against a flood of accessible unhealthy options, persuasive advertising, and policies that make it far from easy.

Strategies for a Healthy Weight

Preventing weight gain over the years may not be possible for everyone, but there are strategies to help reduce the amount of weight change by increasing awareness of modifiable risk factors and working toward healthy lifestyle behaviors. Most of these strategies are covered in-depth throughout the website, so keep an eye out for links to more information below.

Nutritional quality matters when maintaining a healthy weight, and a healthy eating pattern is crucial to good health. Additionally, how we eat matters too.

Eat and drink these:

• Vegetables , fresh or frozen (choose a rainbow!)
• Whole fruits , fresh or unsweetened frozen (but minimize fruit juices)
• Healthy protein sources, including plant protein (tofu, tempeh, legumes, nuts, seeds) and lean animal protein (seafood and skinless poultry)
• Whole grains like whole wheat, steel-cut oats, intact whole grains like brown rice, bulgur, barley, amaranth, quinoa
• Healthy fats , including liquid plant oils such as olive, avocado, and sunflower oil
• Water , tea , coffee (limit excess sweeteners and creams added to these beverages)

Eat and drink less of these:

• Sugar-sweetened beverages (soda, fruit drinks, high-sugar sports drinks) and foods with added sugar
• Fruit juices
• Refined grains (white bread, white rice, white pasta)
• Red meat (beef, pork, lamb) and processed red meats (salami, ham, bacon, sausage)
• Low-nutrient ultra-processed foods and snacks, and other highly processed foods, such as fast food

How we eat and how much:

Age, gender, body size, and level of physical activity dictate how much food you need each day to achieve and maintain a healthy weight. With extra-large restaurant portions, easy access to low-cost ultra-processed snacks and fast food, it’s far too easy to overeat. Try the tips below to avoid overeating.

• Eat breakfast.  While it seems like skipping a meal is an easy way to cut calories and is often promoted with certain intermittent fasting regimens, skipping breakfast entirely can backfire when hunger comes raging back mid-day, often leading to overeating. Breakfast doesn’t have to mean a big bowl of cereal, eggs, and toast. It may mean a slice of whole grain toast with nut butter, a hardboiled egg or leftover piece of chicken and an orange, or a low-sugar protein smoothie blended with plain Greek yogurt, calcium-fortified plant milk, and fresh fruit.
• Choose small portions and eat slowly.  Slowing down while eating and using smaller bowls or plates can help avoid overeating by giving the brain time to tell the stomach when it’s had enough food. Limiting distractions like turning off screens from phones and computers can also help us to increase our focus and enjoyment on food.
• Eat at home.  Fast food, restaurant meals, and other foods prepared away from home tend to have larger portions and richer ingredients. When cooking meals at home, you have more control what you put into them. If you feel too busy to cook, try meal prep strategies .
• Eat mindfully.  Taking time to think about why you’re eating and if you’re truly hungry can help you to make better food choices. When you do eat, focus all of your senses on the food with sight, smell, touch, and taste so that you can fully enjoy what you are eating. Learn more about mindful eating .

What about GLP-1 RA weight loss medications?

After eating a meal, a hormone called glucagon-like peptide-1 (GLP-1) is secreted by the small intestine. It sends messages to the brain indicating fullness. Normally, the hormone leaves the gut very quickly, so GLP-1 receptor agonist (GLP-1 RA) medications are designed to mimic and prolong the action of GLP-1. This helps food to digest more slowly so you feel full sooner and longer, thus promoting reduced caloric intake and thus weight loss. GLP-1 RAs also lower blood sugar by triggering the release of insulin. Early research has also found these drugs to lower the risk of cardiovascular diseases such as stroke and heart attack.

GLP-1 RAs are used to treat both diabetes and obesity, but the U.S. Food and Drug Administration has approved specific dosages and brand names for each condition. Ozempic (semaglutide), Victoza (liraglutide), and Mounjaro (tirzepatide) are prescribed for diabetes, and Wegovy (semaglutide), Saxenda (liraglutide), and Zepbound (tirzepatide) are prescribed for obesity. Rates of weight loss have been substantial, with tirzepatide achieving up to 21% weight loss in 18 months, comparable to 25-30% weight loss achieved with gastric bypass surgery. [1] Unpleasant side effects of GLP-1 RAs are mostly gastrointestinal, with 58% of users in one study reporting stomach pain; other common complaints are constipation, nausea, vomiting, and diarrhea. Most of reported GI side effects appear to be mild and moderate. [2] Pancreatitis and gastroparesis (severely decreased stomach emptying) are less common but appear in a small percentage of users. Clinical trials such as SURMOUNT-4 and STEP 1 have shown that discontinuation of the medications causes weight regain, although it should be noted that these trials are authored by scientists who have affiliations with pharmaceutical companies that produce these medications. [3,4]

Shortages of GLP-1 RAs have led to the creation of falsified versions that are sold through unregulated outlets. They are discouraged by the World Health Organization, as falsified medications may lack efficacy, cause toxic reactions, and may be produced in unhygienic conditions that lead to bacterial contamination. [5]

Stay active

Regular physical activity is not only a key component of weight control, but it also offers a host of other health benefits such as reducing the risk of various chronic diseases and improving quality of life in those who have chronic illnesses and conditions. In children and adults, it is important to not just move more but to limit “sit time” or being sedentary. See Staying Active for further guidance on safe physical activity at all ages.

Limit screen time

Watching television or other devices can be enjoyable and informative; unfortunately it is associated with increased sedentariness and less exercise, weight gain, increased exposure to marketing of unhealthy foods and beverages, and body image issues in youth due to unrealistic portrayals of body size and habits.

Get enough sleep

Chronically poor sleep (less than 7 hours a night) is associated with weight gain and obesity, increased abdominal fat, poorer diet quality, increased cravings, and difficulty in controlling weight. Poor sleep quality can also lead to fatigue and less desire to exercise. See Sleep for more guidance.

Today’s world is full of daily stresses. This is a normal part of life, but when these stresses become too much, they can take a toll on health and contribute to weight gain by leading to unhealthy eating habits, poor sleep quality, and other unhealthy activities.

Regular physical activity is one way to manage stress as well as control weight gain. Meditation, deep breathing exercises, nature walks or spending regular time outdoors, and finding other relaxing and enjoyable activities are important self-care strategies. See Stress and Health for more information and tips .

• Elmaleh-Sachs A, Schwartz JL, Bramante CT, Nicklas JM, Gudzune KA, Jay M. Obesity management in adults: a review. JAMA . 2023 Nov 28;330(20):2000-15.
• Aldhaleei WA, Abegaz TM, Bhagavathula AS. Glucagon-like Peptide-1 Receptor Agonists Associated Gastrointestinal Adverse Events: A Cross-Sectional Analysis of the National Institutes of Health All of Us Cohort. Pharmaceuticals . 2024 Feb 2;17(2):199.
• Aronne LJ, Sattar N, Horn DB, Bays HE, Wharton S, Lin WY, Ahmad NN, Zhang S, Liao R, Bunck MC, Jouravskaya I. Continued treatment with tirzepatide for maintenance of weight reduction in adults with obesity: the SURMOUNT-4 randomized clinical trial. JAMA . 2024 Jan 2;331(1):38-48.
• Wilding JP, Batterham RL, Davies M, Van Gaal LF, Kandler K, Konakli K, Lingvay I, McGowan BM, Oral TK, Rosenstock J, Wadden TA. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes, Obesity and Metabolism . 2022 Aug;24(8):1553-64.
• World Health Organization. Shortages impacting access to glucagon-like peptide 1 receptor agonist products; increasing the potential for falsified versions . January 29, 2024.

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Obesity Prevention

Obesity statistics.

Obesity is a chronic disease affecting an increasing number of children, teens and adults. Obesity rates among children in the U.S. have doubled since 1980, and have tripled for teens. About 19.7% of children ages 2 to 19 are considered obese, compared with over 41% of adults who are considered obese.

Earlier onset of type 2 diabetes, heart and blood vessel disease, and obesity-related depression and social isolation in children and teens are being seen more often by health care professionals. The longer a person is obese, the more significant obesity-related risk factors become. Given the chronic diseases and conditions associated with obesity and the fact that obesity is hard to treat, prevention is extremely important.

A primary reason that prevention of obesity is so vital in children is because the likelihood of childhood obesity persisting into adulthood increases as the child ages. This puts the person at high risk of diabetes, high blood pressure and heart disease.

Childhood Obesity

Children and teens can become overweight or obese because of poor eating habits and lack of physical activity. Genetics and lifestyle also contribute to a child’s weight status.

Recommendations for prevention of overweight and obesity in children and teens include the following:

Gradually work to change family eating habits and activity levels rather than focusing on a child’s weight.

Be a role model. Parents who eat healthy foods and participate in physical activity set an example, so a child is more likely to do the same.

Encourage physical activity. Children should have 60 minutes of moderate physical activity most days of the week. More than 60 minutes of activity may promote weight loss and provide weight maintenance.

Reduce screen time in front of phones, computers and TV to less than one to two hours daily.

Encourage children and teens to eat only when hungry and to eat slowly.

Don’t use food as a reward or withhold food as a punishment.

Keep the refrigerator stocked with fat-free or low-fat milk, fresh fruit and vegetables instead of soft drinks and snacks high in sugar and fat.

Serve at least five servings of fruits and vegetables daily.

Encourage children and teens to drink water rather than beverages with added sugar, such as soft drinks, sports drinks and fruit juice drinks.

Eat meals together as a family. Family meals can create healthier eating habits.

Does Breastfeeding Prevent Obesity?

The answer is complicated. According to the American Academy of Pediatrics and the CDC, breastfed babies are less likely to become overweight. The CDC also reports that the longer babies are fed at the breast (not just given breast milk from a bottle), the less likely they are to become overweight as they grow older. However, many formula-fed babies grow up to be adults of healthy weight.

Further research has questioned the link between breastfeeding and obesity. Parents who can afford to stay with their babies and breastfeed for three months or more are likely to be in higher income families and have more access to healthy food, health care and exercise opportunities for their children. These advantages could account for the lower incidence of obesity in these children. 

Preventing Obesity in Adults

Many of the strategies that produce successful weight loss and maintenance help prevent obesity. Improving eating habits and increasing physical activity play a vital role in preventing obesity. Recommendations for adults include:

Keep a food diary of what you eat, where you were and how you were feeling before and after you ate.

Eat five to nine servings of fruits and vegetables daily. A vegetable serving is 1 cup of raw vegetables or 1/2 cup of cooked vegetables or vegetable juice. A fruit serving is one piece of small to medium fresh fruit, 1/2 cup of canned or fresh fruit or fruit juice, or 1/4 cup of dried fruit.

Choose whole grain foods, such as brown rice and whole wheat bread. Don’t eat highly processed foods made with refined white sugar, flour, high fructose corn syrup and saturated fat.

Weigh and measure food to learn correct portion sizes. For example, a 3-ounce serving of meat is the size of a deck of cards. Don’t order supersized menu items.

Learn to read food nutrition labels and use them; keep the number of portions you are really eating in mind.

Balance the food “checkbook.” If you eat more calories than you burn, you will gain weight. Weigh yourself weekly.

Don’t eat foods that are high in “energy density,” or that have a lot of calories in a small amount of food. For example, an average cheeseburger with an order of fries can have as many as 1,000 calories and 30 or more grams of fat. By ordering a grilled chicken sandwich or a plain hamburger and a small salad with low-fat dressing, you can avoid hundreds of calories and eliminate much of the fat intake. For dessert, have a serving of fruit, yogurt, a small piece of angel food cake, or a piece of dark chocolate instead of frosted cake, ice cream or pie.

Simply reducing portion sizes and using a smaller plate can help you lose weight.

Aim for an average of 60 to 90 minutes or more of moderate to intense physical activity three to four days each week. Examples of moderate intensity exercise are walking a 15-minute mile or weeding and hoeing a garden. Running or playing singles tennis are examples of more intense activities.

Look for ways to get even 10 or 15 minutes of some type of activity during the day. Walking around the block or up and down a few flights of stairs is a good start.

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Obesity, Sugar and Heart Health

ABCs of Knowing Your Heart Risk

Doctors Who Specialize in Obesity

Related Topics

• Kids' and Teens' Health
• Healthy Eating for Kids

Obesity and Weight Loss Strategies Essay

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Introduction

Otc product and diet.

The obesity epidemic is among the most urgent healthcare issues in the United States and worldwide. According to recent estimations, between 39% and 49% of the world’s population are overweight or obese nowadays (Powell-Wiley et al., 2021). This trend has led to many people seeking weight loss through different means, including diet, eating behavior management, and pharmacological weight loss agents (Kushner, 2018). However, over-the-counter (OTC) weight loss products have also gained popularity despite serious health risks (Rodriguez-Guerra et al., 2021). Therefore, it is essential for healthcare professionals to keep the broad public well-informed about the nature and potential adverse effects of such products.

The model client is a 40-year-old man with a family history of obesity-related cardiovascular disease. The client pursues weight loss primarily out of concerns for personal health due to recently developed hypertension. The client has considered using an OTC, non-prescription herbal weight loss supplement, AMPK Metabolic Activator. The drug is advertised as a mixture of two botanical components that supposedly help the body burn stored abdominal fat (AMPK Metabolic Activator, n. d.). The patient’s product choice was primarily driven by the desire to achieve quick weight loss using natural products instead of synthetic medications.

However, the client was strongly advised against using OTC products due to a broad range of associated health hazards. Despite advertisement, most OTC herbal weight loss drugs are adulterated with active pharmaceutical agents (Dastjerdi et al., 2018). The pharmaceutical components in such products include tramadol, caffeine, fluoxetine, rizatriptan, venlafaxine, and methadone (Dastjerdi et al., 2018). Legal in most countries, these agents present serious health risks in case of excessive consumption. Furthermore, sibutramine, associated with a high risk of cardiovascular diseases even among consumers without a known history of CVDs, remains in many herbal medications (Rodriguez-Guerra et al., 2021). Therefore, the list of potential negative side-effects of the OTC weight loss products contradicts the client’s initial expectations and desires.

A healthier and more effective weight loss strategy is changing the lifestyle. Healthcare experts agree that weight loss depends primarily on reducing total caloric intake and sufficient physical activity (Kushner, 2018). Additionally, this strategy helps prevent a broad range of cardiovascular diseases and improves the overall physical condition. Therefore, a diet based on the client’s metabolic profile and health condition is the strategy’s primary focus. Experts recommend the calorie-reduced Dietary Approaches to Stop Hypertension (DASH) diet, rich in fruits, vegetables, and low-fat dairy products, for patients with hypertension (Kushner, 2018). The proposed day 1 menu would consist of the following:

• a whole-wheat bagel with 2 tablespoons peanut butter, an orange, and a cup of fat-free milk for breakfast;
• spinach salad with reduced-sodium wheat crackers for lunch;
• baked cod with 1/2 cup brown rice pilaf with vegetables, 1/2 cup fresh green beans, and herbal tea for dinner (Sample menus for the DASH diet, 2020).

This diet corresponds to the client’s goals and is optimal for his health profile.

Intermittent fasting (IF) has become an increasingly popular approach to treating obesity. Its proponents argue that the strategy is more effective in addressing weight loss than traditional daily caloric intake reduction (Halpern & Mendes, 2021). The IF advocates claim that high insulin levels in the organism associated with high carbohydrate intake facilitate the development of obesity. Intermittent fasting addresses this issue by reducing insulin levels via specially developed fasting schedules. However, experimental models in animals and humans have repeatedly discredited the insulin-related theory (Halpern & Mendes, 2021). Nevertheless, many people still see IF as a preferable alternative, mainly due to its widely marketed supposed benefits and the absence of strict dietary limitations and excessive physical activity.

Obesity remains a significant public health hazard globally, requiring the development and broad introduction of efficient and affordable weight loss strategies and programs. While many still resort to OTC medications and other questionable weight loss strategies, public health professionals and institutions must promote evidence-based approaches. These include safe, personally developed, balanced dietary measures, prescription pharmaceutical agents, and a healthy lifestyle with sufficient physical activity and caloric intake.

AMPK Metabolic Activator (n. d.). Life Extension. Web.

Dastjerdi, A. G., Akhgari, M., Kamali, A., & Mousavi, Z. (2018). Principal component analysis of synthetic adulterants in herbal supplements advertised as weight loss drugs . Complementary Therapies in Clinical Practice, 31 , 236–241. Web.

Halpern, B., & Mendes, T. B. (2021). Intermittent fasting for obesity and related disorders: unveiling myths, facts, and presumptions. Archives of Endocrinology and Metabolism, 65 (1). Web.

Kushner, R. F. (2018). Weight Loss Strategies for Treatment of Obesity: Lifestyle Management and Pharmacotherapy . Progress in Cardiovascular Diseases. Web.

Powell-Wiley, T. M., Poirier, P., Burke, L. E., J.-P., Després, Gordon-Larsen, P., Lavie, C. J., Lear,S. A., Ndumele, C. E., Neeland, I. J., Sanders, P., & St-Onge, M.-P. (2021). Obesity and cardiovascular disease: A scientific statement from the American Heart Association . Circulation, 143 (21), 984–1010. Web.

Rodriguez-Guerra, M., Yadav, M., Bhandari, M., Sinha, A., Bella, J. N., & Sklyar, E. (2021). Sibutramine as a cause of sudden cardiac death . Case Reports in Cardiology, 2021 , 1–5. Web.

Sample menus for the DASH diet (2020). Mayo Clinic. Web.

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Essays About Obesity: Top 5 Examples and 7 Writing Prompts

Obesity is a pressing health issue many people must deal with in their lives. If you are writing essays about obesity, check out our guide for helpful examples and writing prompts. 

In the world we live in today, certain diseases such as obesity are becoming more significant problems. People suffering from obesity have excess fat, which threatens their health significantly. This can lead to strokes, high blood pressure, heart attacks, and even death. It also dramatically alters one’s physical appearance.

However, we must not be so quick to judge and criticize obese people for their weight and supposed “lifestyle choices.” Not every obese person makes “bad choices” and is automatically “lazy,” as various contributing causes exist. Therefore, we must balance concern for obese people’s health and outright shaming them. 

To write insightful essays about obesity, you can start by reading essay examples. 

5 Best Essay examples

1. obesity as a social issue by earnest washington, 2. is there such a thing as ‘healthy obesity’ by gillian mohney, 3. problems of child obesity by peggy maldonado, 4.  what is fat shaming are you a shamer by jamie long.

• 5. ​​The Dangerous Link Between Coronavirus and Obesity by Rami Bailony

Writing Prompts for Essays About Obesity

1. what causes obesity, 2. what are the effects of obesity, 3. how can you prevent obesity, 4. what is “fat shaming”, 5. why is obesity rate so higher, 6. obesity in the united states, 7. your experience with obesity.

“Weight must be considered as a genuine risk in today’s world. Other than social issues like body shaming, obesity has significantly more to it and is a risk to human life. It must be dealt with and taken care of simply like some other interminable illness and we as people must recollect that machines and innovation has progressed to help us not however not make us unenergetic.”

Washington writes about the dangers of obesity, saying that it can significantly damage your digestive and cardiovascular systems and even cause cancer. In addition, humans’ “expanded reliance on machines” has led us to become less active and more sedentary; as a result, we keep getting fatter. While he acknowledges that shaming obese people does no good, Washington stresses the dangers of being too heavy and encourages people to get fit. 

“‘I think we need to move away from using BMI as categorizing one as obese/overweight or unhealthy,” Zarabi told Healthline. “The real debate here is how do we define health? Is the vegetarian who has a BMI of 30, avoiding all saturated fats from meats and consuming a diet heavy in simple carbohydrates [and thus] reducing his risk of cardiac disease but increasing likelihood of elevated triglycerides and insulin, considered healthy?

Mohney, writing for Healthline, explains how “healthy obesity” is nuanced and should perhaps be retired. Some people may be metabolically healthy and obese simultaneously; however, they are still at risk of diseases associated with obesity. Others believe that health should be determined by more factors than BMI, as some people eat healthily and exercise but remain heavy. People have conflicting opinions on this term, and Mohney describes suggestions to instead focus on getting treatment for “healthy obese” people

“The absence of physical movement is turning into an increasingly normal factor as youngsters are investing more energy inside, and less time outside. Since technology is turning into an immense piece of present-day youngsters’ lives, exercises, for example, watching TV, gaming, messaging and playing on the PC, all of which require next to no vitality and replaces the physical exercises.”

In her essay, Maldonado discusses the causes and effects of childhood obesity. For example, hereditary factors and lack of physical activity make more children overweight; also, high-calorie food and the pressure on kids to “finish their food” make them consume more. 

Obesity leads to high blood pressure and cholesterol, heart disease, and cancer; children should not suffer as they are still so young. 

“Regardless of the catalyst at the root of fat shaming, it persists quite simply because we as a society aren’t doing enough to call it out and stand in solidarity against it. Our culture has largely bought into the farce that thinness equals health and success. Instead, the emphasis needs to shift from the obsession of appearance to promoting healthy lifestyle behaviors for all, regardless of body size. A lean body shouldn’t be a requisite to be treated with dignity and respect. Fat shaming is nonsensical and is the manifestation of ignorance and possibly, hate.”

Long warns readers of the dangers of fat shaming, declaring that it is reprehensible and should not be done. People may have “good intentions” when criticizing overweight or obese people, but it does not, in fact, help with making them healthier. Long believes that society should highlight a healthy lifestyle rather than a “healthy” body, as everyone’s bodies are different and should not be the sole indicator of health. 

5. ​​ The Dangerous Link Between Coronavirus and Obesity by Rami Bailony

“In a study out of NYU, severe obesity (BMI >40) was a greater risk factor for hospitalization among Covid-19 patients than heart failure, smoking status, diabetes, or chronic kidney disease. In China, in a small case series of critically ill Covid-19 patients, 88.24% of patients who died had obesity versus an obesity rate of 18.95% in survivors. In France, patients with a BMI greater than 35 were seven times more likely to require mechanical ventilation than patients with a BMI below 25.”

Bailony’s essay sheds light on research conducted in several countries regarding obesity and COVID-19. The disease is said to be “a leading risk factor in mortality and morbidity” from the virus; studies conducted in the U.S., China, and France show that most obese people who contracted the coronavirus died. Bailony believes obesity is not taken seriously enough and should be treated as an actual disease rather than a mere “lifestyle choice.”

It is well-known that obesity is an excess buildup of body fat, but what exactly causes this? It is not simply due to “eating a lot,” as many people simply understand it; there are other factors besides diet that affect someone’s body size. Look into the different causes of obesity, explaining each and how they are connected.

Obesity can result in the development of many diseases. In addition, it can significantly affect one’s physique and digestive, respiratory, and circulatory systems. For your essay, discuss the different symptoms of obesity and the health complications it can lead to in the future.

It can be safely assumed that no one wants to be obese, as it is detrimental to one’s health. Write an essay guide of some sort, giving tips on managing your weight, staying healthy, and preventing obesity. Include some dietary guidelines, exercise suggestions, and the importance of keeping the balance between these two.

“Fat shaming” is a phenomenon that has become more popular with the rise in obesity rates. Define this term, explain how it is seen in society, and explain why it is terrible. Also, include ways that you can speak about the dangers of obesity without making fun of obese people or making them feel bad for their current state. 

The 21st century has seen a dramatic rise in obesity rates worldwide compared to previous decades. Why is this the case? Explore one or more probable causes for the increase in obese people. You should mention multiple causes in your essay, but you may choose to focus on one only- explain it in detail.

The United States, in particular, is known to be a country with many obese people. This is due to a combination of factors, all connected in some way. Research obesity in the U.S. and write about why it is a bigger problem than in other countries- take a look at portion size, fitness habits, and food production. 

If applicable, you may write about your experience with obesity. Whether you have struggled or are struggling with it in the past or know someone who has, discuss how this makes you feel. Reflect on how this knowledge has impacted you as a person and any lessons this may have taught you. 

For help with your essays, check out our round-up of the best essay checkers .If you’re looking for more ideas, check out our essays about bullying topic guide !

Health Encyclopedia

Preventing obesity in children, teens, and adults, facts about obesity.

Obesity is a long-term (chronic) disease. It affects growing numbers of children, teens, and adults. Obesity rates among children in the U.S. have doubled since 1980. They have tripled for teens. About 19 out of 100 children ages 2 to 19 are obese. More than 7 out of 20 adults are obese.

Healthcare providers are seeing more of these obesity-related problems in children and teens:

Type 2 diabetes starting at a younger age

Heart and blood vessel disease

Obesity-related depression and social isolation

The longer a person is obese, the more they are at risk for problems. Many chronic diseases are linked to obesity. Obesity may be hard to treat. That's why prevention is very important.

Preventing obesity in children is vital. This is because childhood obesity is more likely to last into adulthood. An obese person has a high risk of diabetes, high blood pressure, and heart disease.

Breastfed babies are less likely to become overweight. And the longer babies are breastfed, the less likely they are to be overweight as they grow older. But many babies fed with formula do grow up to be adults of healthy weight. If your child was not breastfed, it doesn't mean that they can't have a healthy weight. Talk with your child’s healthcare provider if you have concerns.

Children and teens

Young people can become obese from poor eating habits, lack of physical activity, and not getting enough sleep. Genes can also affect a child's weight.

To help prevent obesity in children and teens:

Don’t just focus on a child's weight. Work to change family eating habits and activity levels over time.

Be a role model. Parents who eat healthy foods and do physical activity set an example. A child is more likely to do the same.

Encourage physical activity. Children ages 3 to 5 should have active play each day. Children ages 6 to 17 should have at least 60 minutes of medium physical activity most days of the week. More than 60 minutes of activity may help with weight loss and keeping a healthy weight.

Reduce screen time. The American Academy of Pediatrics (AAP) does not recommend screen time for children under the ages of 18 to 24 months. AAP recommends a 1-hour screen time limit for children ages 2 to 5. And AAP recommends an appropriate parent-monitored media use plan for older children. Do not allow screens in your child's room. Have your child stop using screens at least 1 hour before bed.

Encourage children to eat only when hungry. Tell them to eat slowly.

Don't use food as a reward. Don't keep food away from your child as a punishment.

Serve healthy foods and drinks. These include fat-free or low-fat milk, fresh fruit, and vegetables. Don't buy soft drinks or snacks that are high in sugar and fat.

Fill half of your child's plate with fruits and vegetables. Recommended serving sizes vary based on age, sex, height, weight and physical activity levels. Go to https://www.myplate.gov/myplate-plan to see your child's personalized diet recommendations.

Encourage your child to drink water instead of drinks with added sugar. These include soft drinks, sports drinks, and fruit juice drinks.

Promote good sleep with a consistent bedtime routine. Preschoolers need 11 to 13 hours of sleep per day, including naps. Children ages 6 to 12 need 9 to 12 hours of uninterrupted sleep a night. And teens ages 13 to 18 need 8 to 10 hours.

Good eating habits and physical activity can help prevent obesity. Tips for adults include:

Keep a food diary. Write down what you eat, where you eat, and how you feel before and after you eat.

Make half your plate and vegetables. Recommended serving sizes vary based on age, sex, height, weight and physical activity levels. Go to https://www.myplate.gov/myplate-plan to see your personalized diet recommendations.

Choose whole-grain foods. These include brown rice and whole-wheat bread. Don't eat foods made with refined white sugar, flour, high-fructose corn syrup, or saturated fat.

Weigh and measure food. This is so you can learn healthy portion sizes. For instance, a 3-ounce serving of meat is the size of a deck of cards. Don't order super-sized menu items.

Learn to read food nutrition labels and use them. Keep the number of portions you are really eating in mind.

Balance your food checkbook. If you eat more calories than you burn, you will gain weight. Weigh yourself each week.

Don't eat foods that are high in energy density. This means foods that have a lot of calories in small amounts. For instance, a cheeseburger with fries can have as much as 1,000 calories and 30 or more grams of fat. Order a grilled chicken sandwich or a plain hamburger and a small salad with low-fat dressing instead. You can avoid hundreds of calories and lower your fat intake. For dessert, have a serving of fruit, yogurt, a small piece of angel food cake, or a piece of dark chocolate.

Reduce portion sizes. Using a smaller plate can help you do this.

Exercise each week. Aim for at least 150 minutes of medium to intense physical activity per week. For instance, this can be 30 minutes of exercise 5 days a week. Examples of medium-intensity exercise are walking a 15-minute mile. Or weeding and hoeing a garden. Running is a more intense activity.

Build activity into your day. Look for ways to get 10 or 15 minutes of some type of activity during the day. Walk around the block. Walk up and down a few flights of stairs.

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• Preventing Childhood Obesity
• Health Care Strategies
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Obesity Strategies: What Can Be Done

At a glance.

Obesity is a complex and costly chronic disease with many contributing factors. Access to healthy, affordable foods and safe, convenient places for physical activity can impact obesity. Addressing obesity requires organizations and people to work together to create communities, environments, and systems that support healthy, active lifestyles for all.

The federal government is:

• Studying what works in communities to make it easier for people to be more physically active and have a healthier diet.
• Monitoring trends in obesity and related risk factors.
• Developing and promoting  guidelines on dietary patterns and amounts of physical activity needed for good health .
• Helping families with lower incomes get affordable, nutritious foods through programs such as the Supplemental Nutrition Program for Women, Infants, and Children (WIC) and farm-to-education programs.
• Supporting children and families who are at higher risk for obesity through services at Federally Qualified Health Centers, Head Start, WIC, and other service agencies.
• Funding programs and providing training and resources for initiatives that promote healthy eating, food and nutrition security, and physical activity .
• Working with state, tribal, local, and territory governments, academia, the private sector, and nonprofit and community groups to implement the White House National Strategy on Hunger, Nutrition, and Health —to end hunger and reduce diet-related diseases and disparities.

Some states and communities are:

Two priority obesity-prevention strategies for state and local programs are:

• Improving nutrition, physical activity, and breastfeeding in early care and education programs.
• Establishing policies and activities that implement, spread, and sustain Family Healthy Weight Programs .

In addition, state and local programs are:

• Designing communities that connect sidewalks, bicycle routes, and public transportation with homes, schools, parks, and workplaces to increase physical activity.
• Expanding voucher incentive and produce prescription programs to make healthy foods more available.
• Promoting food service and nutrition guidelines in worksites, food pantries, and faith-based organizations.
• Implementing policies and activities that achieve continuity of care for breastfeeding .
• Partnering with business and civic leaders to plan and carry out local, culturally tailored interventions to address poor nutrition, physical inactivity, and tobacco use.

Health Care providers can:

• Measure patients' weight and height, calculate body mass index , and counsel them on its role in disease prevention.
• Refer patients with obesity to intensive programs, including Family Healthy Weight and Diabetes Prevention programs.
• Counsel patients about nutrition, physical activity, and optimal sleep.
• Use respectful and non-stigmatizing, person-first language in all weight-related discussions.
• Connect patients and families with community services to help them access healthy foods and ways to be active.
• Discuss the use of medications and other treatments for excess weight.
• Seek continuing medical education  about obesity.

Everyone can take steps to:

• MyPlate resources.
• Tips for healthy eating for a healthy weight .
• Get the recommended amount of physical activity.
• Get enough sleep .
• Manage stress .
• Talk to your health care provider about whether weight is a health concern. If so, discuss available obesity treatment options to help reduce potential health risks.
• Get involved in local efforts, such as local committees and councils , to improve options for healthier foods and physical activity.

CDC's obesity prevention efforts focus on policy and environmental strategies to make healthy eating and active living accessible for everyone.

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Research for Healthy Living

Obesity and Nutrition

More than one-third of U.S. adults — and about 17 percent of U.S. children — are obese. Obesity puts people at risk for many health issues including heart disease, stroke, type 2 diabetes, arthritis, and certain types of cancer. Because these conditions are some of the top preventable causes of chronic illness and death, NIH has a considerable interest in addressing obesity.

The problem of obesity seems straightforward: When we eat more calories than we burn, our bodies store this extra energy as fat. Yet, we all know how hard it can be just to lose a few pounds. And solving this problem on  a population-sized scale has proven to be tremendously difficult. That is because so many factors play a role: where we live and work, how much time we spend sitting – and the availability of safe spaces for exercise – and the fact that many people cannot choose alternatives. Access to nutritious food can be a major barrier for many with low incomes or mobility limitations.

Heredity also has an impact. For example, NIH research shows that certain gene variations that occur in one  of six people of European descent translate into an extra 7 pounds, on average. Those discoveries are pointing to pathways involved in obesity that suggest potential ways to prevent undesirable weight gain. Research on the social factors contributing to obesity also offers ideas for intervention. When people are provided funds to buy food once a week, instead of monthly, they are more likely to buy fresh fruits and vegetables instead of pre-packaged (and often less-nutritious) goods. We also know that affordable housing programs lead to better nutrition, because people no longer must compromise on food  in order to pay rent. 

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Essay on Obesity

List of essays on obesity, essay on obesity – short essay (essay 1 – 150 words), essay on obesity (essay 2 – 250 words), essay on obesity – written in english (essay 3 – 300 words), essay on obesity – for school students (class 5, 6, 7, 8, 9, 10, 11 and 12 standard) (essay 4 – 400 words), essay on obesity – for college students (essay 5 – 500 words), essay on obesity – with causes and treatment (essay 6 – 600 words), essay on obesity – for science students (essay 7 – 750 words), essay on obesity – long essay for medical students (essay 8 – 1000 words).

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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• Research article
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Obesity prevention and the role of hospital and community-based health services: a scoping review

• Claire Pearce   ORCID: orcid.org/0000-0003-2129-467X 1 , 2 , 3 ,
• Lucie Rychetnik 1 , 2 , 4 ,
• Sonia Wutzke 1   an1 &
• Andrew Wilson 1 , 2  

BMC Health Services Research volume  19 , Article number:  453 ( 2019 ) Cite this article

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Control of obesity is an important priority to reduce the burden of chronic disease. Clinical guidelines focus on the role of primary healthcare in obesity prevention. The purpose of this scoping review is to examine what the published literature indicates about the role of hospital and community based health services in adult obesity prevention in order to map the evidence and identify gaps in existing research.

Databases were searched for articles published in English between 2006 and 2016 and screened against inclusion and exclusion criteria. Further papers were highlighted through a manual search of the reference lists. Included papers evaluated interventions aimed at preventing overweight and obesity in adults that were implemented within and/or by hospital and community health services; were an empirical description of obesity prevention within a health setting or reported health staff perceptions of obesity and obesity prevention.

The evidence supports screening for obesity of all healthcare patients, combined with referral to appropriate intervention services but indicates that health professionals do not typically adopt this practice. As well as practical issues such as time and resourcing, implementation is impacted by health professionals’ views about the causes of obesity and doubts about the benefits of the health sector intervening once someone is already obese. As well as lacking confidence or knowledge about how to integrate prevention into clinical care, health professional judgements about who might benefit from prevention and negative views about effectiveness of prevention hinder the implementation of practice guidelines. This is compounded by an often prevailing view that preventing obesity is a matter of personal responsibility and choice.

Conclusions

This review highlights that whilst a population health approach is important to address the complexity of obesity, it is important that the remit of health services is extended beyond medical treatment to incorporate obesity prevention through screening and referral. Further research into the role of health services in obesity prevention should take a systems approach to examine how health service structures, policy and practice interrelationships, and service delivery boundaries, processes and perspectives impact on changing models of care.

Peer Review reports

Chronic diseases place a significant burden on the Australian healthcare system. They account for 90% of all deaths [ 1 ] and significantly reduce quality of life [ 2 ]. Being obese is a major risk factor for many chronic diseases including heart disease, cancer, kidney failure, pulmonary disease and diabetes [ 3 , 4 ]. Being overweight can impede the management of chronic conditions and is the second highest contributor to burden of disease. Obesity has been shown to reduce quality-adjusted life expectancy [ 5 ].

The World Health Organisation (WHO) highlights prevention of obesity as an important priority to reduce the impact of non-communicable disease. Both supporting people who are currently overweight to attain modest weight loss as well as preventing further increases in weight may eventually see a decrease in overall rates of obesity and a reduction in the rates of chronic diseases [ 6 ] and therefore a decrease in associated costs [ 7 ].

International guidelines recommend that preventive care be provided across the whole health system, integrated into ‘curative’ or disease management focused consultations, regardless of age or health status [ 8 ]. For obesity prevention, there are specific guidelines for the role of the general practitioner, for example the Royal Australian College of General Practitioners ‘Guidelines for preventive activities in general practice’ [ 9 ]. However, the prevention role of hospital and community health services is not as clearly articulated, particularly in relation to an adult population.

In this research we present a review of published literature investigating the role of hospital and community based health services in adult obesity prevention. The aim is to improve understanding of the role for hospital and community based health services in prevention as well as the potential enablers and barriers to the delivery of preventive health services in order to inform future research to support the development of obesity prevention guidelines applicable to a range of health service settings.

A scoping review [ 10 ] was conducted to map evidence and identify gaps in the extent, range, and nature of research undertaken in relation to the role of health services in obesity prevention. The focus of the review was on hospital and community based health services as unlike primary care, the roles of these services in obesity prevention are not clearly outlined in clinical guidelines.

Research question

The overarching question for this scoping study was: What does the peer reviewed literature reveal about the role of adult health services (excluding general practice) in the provision of obesity prevention and what are the key elements of implementation?

Data sources and search

Three databases (CINAHL and Medline concurrently and PubMed) were searched for references containing the words “obese” AND “prevent*” AND “healthcare/ health services” AND “adult”. Medline and CINAHL were searched concurrently to cover medical, nursing and allied health research. PubMed was searched to pick up those articles not yet assigned MESH headings. For practical reasons, the scope was limited to articles published in English between 2006 and 2016 (November). The Cochrane database was searched using the phrase “Prevention of overweight and obesity” to include systematic reviews conducted in the last 10 years.

Inclusion and exclusion criteria

As the aim of the review was to highlight clinical interventions as well as issues relating to implementation, papers were included if they fell into any of the following categories: (1) Evaluation of a specific hospital or community health based obesity prevention intervention; (2) Clinical guidelines featuring obesity prevention; (3) Systematic or scoping reviews of health service based obesity prevention or (4) Empirical description of obesity prevention within a health setting. A fifth category was identified in the process of undertaking the review: (5) Health staff or health service consumer perceptions of and beliefs about obesity and obesity prevention. For each of these categories, the focus of the intervention was on services for adults. We included primary studies as well as literature reviews.

Articles that were excluded were those that:

focused on prevention of childhood obesity;

were medical treatments aimed solely at weight loss, such as surgical or pharmaceutical interventions;

described an intervention that did not take place in a health setting or if that setting was focused solely on the role of general practitioners.

Papers were also excluded if they described obesity or associated disease but did not focus on interventions with a goal of prevention or if the focus was on population health initiatives that were not within the remit of health services, such as introducing food taxes. Opinion pieces and editorials were not included.

Data extraction

All articles were reviewed and divided into the categories described above. Information was summarised using a standardised extraction form developed for the review (see Tables  1 , 2 , 3 , 4 , 5 ) to identify the clinical areas where prevention is effective and the fundamental elements of implementation.

The primary aim of analysis was to determine the main factors in delivering adult obesity prevention within a health setting. Analysis commenced with an examination of intervention type, sample size, setting and duration. Studies were then grouped into categories that were empirically derived from the type of studies identified as summarised in Tables  1 , 2 , 3 , 4 , 5 . Analysis has been framed with the 5As framework [ 9 ] which is utilised as a preventative healthcare tool to identify risk factors for chronic disease. It originated as a smoking cessation tool but has been adapted for use with obesity.

Literature search

An initial PubMed search using the search terms “obese” AND “prevent*” AND “healthcare/ health services” AND “adult”, produced 710 articles. The first 40 of these articles were screened and found to be highly irrelevant. Subsequently, the PubMed search was changed to a title search “The Role of Health Services in the Prevention of Overweight and Obesity in Adults”. This produced 240 references, which on initial scan appeared to highlight more relevant documents. CINAHL and Medline searches using the same search terms produced 584 articles which on screening appeared to hold relevant studies. The Cochrane database search resulted in 151 references.

All references were then screened for duplicates before being assessed against the specific inclusion/ exclusion criteria. Further references were highlighted through a manual search of the reference list of those references which met the inclusion criteria. In all, 43 articles were included for review. Figure  1 presents the review flow chart.

Scoping review flow chart

Scope of literature by category

Of the 43 papers included in the review, seven were primary studies of a specific health based obesity prevention intervention (Category 1) and seven were scoping or systematic reviews of specific health based obesity prevention interventions (Category 2). Four clinical guidelines were included (Category 3); two specific to the Australian context [ 9 , 41 ], one from the United States [ 42 ] and one from the United Kingdom [ 43 ]. One guideline, the Royal Australian Council of General Practitioners (RACGP) Red Book [ 44 ] focussed on primary healthcare but was included as it does examine implementation of the 5As framework. This framework is frequently utilised in preventive care and though most commonly used in primary care, is one which is applicable to a range of health services. The other three focus on primary healthcare, but also consider other health services. A group of 12 papers (Category 4) provided general descriptions of obesity prevention interventions within health settings. Thirteen papers (Category 5) surveyed health professionals or consumers about their perceptions or knowledge of obesity and/or obesity prevention. A summary of the papers in each category, and the extracted data can be found in Tables  1 , 2 , 3 , 4 , 5 .

How the 5A framework informs obesity prevention

The specific health based obesity prevention interventions (Category 1 and 2), were examined using the 5As framework [ 44 ]. The 5As framework is used to identify risk factors for chronic disease, including obesity, and to plan interventions to take into account the behavioural and physiological elements to be addressed [ 45 ]. The 5As refer to Ask (about risk factors); Assess (level of risk factors, health literacy and readiness to change); Advise/ Agree (use motivational interviewing to agree goals); Assist (develop a plan to address goals) and Arrange (organise support to achieve goals and maintain change) [ 44 ].

Whilst not all the papers explicitly referred to the 5As, elements of the framework were noted in each of the seven primary studies and three of the six literature reviews concerned with health service based prevention interventions. In the section below we apply the 5A framework to consider different elements of obesity prevention and how these have been reported in the literature.

Ask and assess

For this review, Ask and Assess have been considered together as both focus on gathering the initial information which will determine the next step. A focus on screening is supported by evidence which shows that weighing people and discussing the risks associated with putting on excess weight has an impact on individual knowledge and readiness for change which are basic factors if obesity prevention is to be effective [ 36 , 46 ]. The US Preventive Task Force and the National Heart, Lung, and Blood Institute guidelines recommend health services screen all adults for obesity [ 42 ].

Screening should include not only identifying risk factors but also ascertaining if a person is wanting to make changes to address the risk factors and their ability to do so based on factors such as health literacy, which is an individual’s ability to understand, interpret and apply information to their own health and healthcare [ 47 ]. In the included studies, there was a focus on determining risk factors but not on establishing an individual’s health literacy. The seven evaluation based papers identified a need to assess for obesity risk factors and the potential impact of these on health but only one [ 12 ] specifically concluded that there is a need to train staff in issues such as health literacy and readiness for change. This factor was missing all together from the systematic review summarising best practice in applying the framework [ 23 ].

All the primary study papers (Category 1) concluded that there is a role for health professionals in the provision of prevention advice and five of these seven studies discussed providing specific training to support this role [ 12 , 13 , 15 , 16 , 17 ]. However, targeted training does not automatically change practice. Two studies, one with community health staff and one with mental health clinicians, found that training changed practice in terms of assessment of risk factors but did not change practice in relation to providing advice [ 16 , 17 ]. In studies which reported that clinicians did provide advice, in most cases patients could recall that advice but these papers did not report on whether the people receiving the advice changed their behaviour or on the long term retention of that advice [ 11 , 12 , 13 , 15 ]. One systematic review [ 23 ] framed ‘advise’ in terms of telling people they needed to lose weight and how they should do that on the basis that sustained weight loss has the most significant impact on health. It did not consider supporting people to set their own goals around their weight or risk factors. The remaining six literature reviews did not report on health professionals providing advice.

The next step of the 5As framework is providing intervention aimed at assisting people to set goals to self-manage lifestyle changes. The primary studies (category 1) did not address this element, instead framing the role of health services not as providing support but instead referring to other agencies to provide this support. One literature review concluded that intensive long term support was required to assist people to embed changes but did not provide specific details of what this might look like [ 23 ]. Another concluded that assisting people to set goals related to weight management achieves better outcomes than linking goals to more general improvements in health [ 20 ]. The remaining literature reviews did not address the ‘assist’ element.

The final step of the 5As framework recommends providing support to help people achieve and maintain their weight goals. Three of the Category 1 health service evaluations focussed specifically on this step. All were unsuccessful in increasing health professional’s rate of referral to support services. [ 15 , 16 , 17 ]. For example, a recent study undertaken across several community health centres focussed on supporting community health staff to incorporate assessment, brief advice and referral in relation to addressing chronic disease risk factors, including obesity risk factors. The intervention was well supported over the 12 months of implementation by a range of initiatives including pre-intervention policy change, electronic resources and staff training. The intervention was successful in getting staff to undertake more assessments for risk factors but did not change practice in relation to brief advice or referral for intervention [ 17 ] . Similar results were obtained within a community mental health setting, concluding that even when clinical guidelines explicitly direct clinicians to incorporate preventive care into interactions, rates of care given around issues such as fruit and vegetable intake or physical activity remain low [ 16 ]. The study concluded that prevention may need to be delivered within a different model of care [ 16 ]. Two of the systematic reviews concluded that successful obesity prevention needs to include the provision of or referral to intensive, multicomponent behavioural interventions which aim to support weight loss and management [ 21 , 23 ].

Clinical areas in which obesity prevention may be warranted

The National Health and Medical Research Council (NHMRC) Clinical Practice Guidelines [ 6 ] identify different life stages where there is a greater risk of weight gain. The empirical studies were therefore analysed to identify the clinical areas where prevention may have the most significant impact and the specific elements key to working with these clinical groups. Fifteen of the papers included in the review focused on a particular life stage or cohort of patients. The clinical areas identified were maternity, which has received the most focus but has not been rigorously evaluated [ 13 , 14 , 26 , 27 , 31 , 33 , 34 , 36 , 48 ] and mental health [ 37 ]. Definitive evidence of how obesity prevention should be delivered in mental health services was not available.

The papers which focussed on maternity based services highlight the immediate consequences of maternal obesity including higher rates of gestational diabetes, high blood pressure and pre-eclampsia and higher risk births. Excess weight gain in pregnancy combined with not losing the weight after pregnancy are predictors of long-term maternal obesity and increases the risk of the child developing obesity whilst mothers with gestational diabetes are more likely to develop type 2 diabetes later in life [ 36 ]. Along with the individual risks to mother and child, there is an increased demand for services and a requirement for more specialised services to support woman and baby both during and after the birth [ 18 , 26 , 30 , 31 , 33 , 34 ].

Only one of the papers targeting obesity prevention in maternity care settings reported on a specific intervention. This found that women at risk of gestational diabetes who receive advice in relation to limiting weight gain during pregnancy are less likely to develop diabetes despite no significant difference in weight gain compared with a control group [ 13 ]. The other maternity focussed papers were more descriptive, providing a broad overview of implementation factors including the need for a multidisciplinary approach to reinforce the benefits of diet and physical activity beyond weight management. For example, obese pregnant women who are physically active have been shown to experience less depressive symptoms and report higher quality of life to obese women who are not physically active in pregnancy [ 14 ]. Two papers stated that discussions about safe weight gain and weight management needs to be done in a way that does not stigmatise or cause feelings of shame [ 27 , 33 ].

Only one paper looked at a life stage other than child bearing years, namely older adults [ 29 ]. This paper summarised the results of a large survey, focussing specifically on older persons’ perceptions of receiving weight management advice. As with similar studies looking at the adult population more generally [ 28 ], it was found that older adults were more likely to receive lifestyle advice if they were already obese or had a number of chronic conditions [ 29 ]. The disadvantage of many of the survey based studies was the reliance on self-reported weight and height.

In terms of specific clinical areas, studies have been conducted in mental health and community health services. It was reported that it is very difficult to change the practice of mental health staff to include a focus of physical health risk factors [ 16 ] with mental health clinicians not necessarily seeing this as their role [ 37 ] despite the fact that people with mental illness do want to reduce their risk factors [ 40 ]. Similarly in services delivering general community health care, despite the presence of risk factors and an openness by clients to receive preventive advice, community health staff do not deliver opportunistic prevention, particularly in relation to diet [ 8 , 17 ].

Perceptions and beliefs towards obesity prevention in health services

This review found that along with practical barriers to changing practice including a lack of time, resources or clinical guidelines [ 34 , 38 , 39 , 49 ], a key barrier to healthcare based obesity prevention is the perceptions and beliefs of health professionals towards obesity. As well as lacking confidence or knowledge about how to integrate prevention into clinical care, health professionals may simply not see it is their role [ 37 ]. There is also an issue with judgements being made in relation to who might benefit from prevention along with a negative view of the effectiveness of prevention, compounded by a view that preventing obesity is a matter of personal responsibility and choice [ 25 , 38 ].

The 13 studies which specifically looked at this issue are summarised in Category 5 of Tables  1 , 2 , 3 , 4 , 5 . These papers used a range of methods to ascertain attitudes, including questionnaires or surveys [ 8 , 32 , 36 , 37 , 39 , 40 , 46 , 49 , 50 ] and semi-structured interviews or focus groups [ 33 , 34 , 35 , 38 ] and were conducted with health professionals [ 33 , 34 , 35 , 37 , 38 , 39 , 49 , 50 ] and consumers [ 8 , 32 , 36 , 40 , 46 ]. Due to the range of methods and small numbers of many of the studies the results are not necessarily generalisable but a recurrence of themes indicates that perceptions and beliefs should be considered when incorporating obesity prevention into health care services.

The view of health professionals, that prevention is not their role, may be reinforced by the fact that they will probably not have had specific training in assessment and advice [ 16 ]. They may make judgements on who would benefit from preventive advice and tend to only raise the issue of weight if they know the patient [ 38 ]. Whilst health professionals are aware of the health implications of excess weight there may be a perception that they cannot be effective in their role due to a lack of patient motivation to enact change [ 25 ]. Other studies have shown that patients may not be told they are overweight or have the health consequences of being overweight discussed [ 21 , 32 ]. This is despite evidence to suggest that being told firstly they are overweight and secondly the health risks of excess weight can impact on an individual’s readiness to make changes to diet and levels of physical activity [ 28 ]. When discussions do occur, they are more likely to be with people who are already obese [ 24 , 28 ] or who have more frequent health encounters indicating that they have more complex health problems [ 29 ]. By clinicians not discussing weight and lifestyle with people before it becomes a significant problem there is a missed opportunity to prevent illness development based on known risk factors.

The uptake of prevention may also be impacted by a view that obesity is an issue of lifestyle choice and personal responsibility and therefore not the responsibility of health services unless linked to the treatment of a specific clinical condition [ 35 , 38 ]. Clinical guidelines may not be consistently followed because of a lack of knowledge of the guidelines existence or a belief that the guidelines will be ineffective due to pre-conceived ideas about the group of clients being targeted or a lack of confidence in the guidelines [ 19 , 35 ] . Specific to maternity services, clinicians acknowledge that weight gain in pregnancy is an issue but do not perceive that their patients see it as a problem [ 30 ]. In some instances, health professionals don’t feel confident talking to their patients about excess weight [ 35 , 38 , 39 , 51 ]. These findings occur even in areas where policy is in place directing clinicians to incorporate prevention, highlighting the need for more comprehensive, multi component change management strategies to enable health professionals to develop their practice to incorporate prevention routinely into interventions [ 8 ].

Without further training, baseline knowledge on appropriate interventions to support obesity prevention is generally poor [ 39 ] and advice may be given based on the clinicians own experience of weight management [ 38 ]. Educating staff about prevention may lead to an increase in assessment of risk but not a significant increase in brief advice or referral to other services for prevention intervention [ 15 , 17 ]. Both of these later elements are key to impacting on an individual’s chronic disease risk profile [ 16 ]. Training of staff may need to extend beyond principles of prevention and also include training on communicating complex information to people with low health literacy. This should include teaching techniques to ensure health professionals clarify their patient has understood information, [ 12 ] as this is a significant element in someone being able to adopt and follow preventive care advice [ 45 ].

However, the evidence of what education strategies are most effective, particularly in relation to increasing assessment and referral across all risk factors, is limited [ 52 ]. A systematic review of interventions to change the behaviour of health professionals found just six randomised control trials and the combined results of these were ambiguous [ 19 ]. When specifically looking at factors influencing health professionals decision to provide counselling regarding physical activity, the health professionals own levels of physical activity, whether or not they have specific training, knowing the patient well and the patient having risk factors for chronic disease were all influencing factors [ 22 ].

This review examined the literature in order to ascertain the role of hospital and community- based health services in adult obesity prevention as well as the potential enablers and barriers to the delivery of preventive health services. Whilst it is acknowledged that the health care system alone is not the answer to reducing the population impact of obesity [ 53 ], there is evidence that health services can significantly contribute to obesity prevention commencing with screening all patients for risk factors and providing brief advice. This should be followed up with referral to a service which provides long term follow-up with a focus on lifestyle change rather than just weight loss and should include consideration of an individual’s health literacy [ 41 , 42 , 43 , 44 ].

However, the reviewed evidence indicates that existing clinical guidelines, including the application of the 5As framework, are not being fully implemented. Where training and resources have focussed on prevention, there is an increase in the rate of screening provided but only a limited change in the rates of brief advice or referral to an intervention service [ 12 , 15 , 16 , 17 ]. Whilst assessment of risk factors may offer some benefits, greater change is achieved when this is followed up by advice and clear, individualised input to assist people to apply the advice to their own circumstances [ 54 ].

In taking a scoping approach to the role of health services, this review was able to draw out that a significant barrier to the implementation of prevention guidelines are the perceptions of health professionals. They may not see prevention as their role [ 16 ], make judgements about the causes of and responsibility for an individual’s weight, or make subjective decisions about who will benefit from their advice [ 25 , 35 , 38 ]. Health professionals may also not feel sufficiently confident to raise the issue of weight because of the social meanings attached or lack of knowledge [ 35 , 38 , 39 , 51 ]. Our review reveals these issues are common to nursing, allied health and medical staff.

Health care is predominantly delivered within a reactive model of care which is at odds with the concept of prevention [ 55 ]. Whilst there are obesity prevention guidelines which highlight the need to apply a framework such as the 5As, this fundamentally linear tool is designed to work within a traditional health care approach which focusses on the diagnosis and treatment of acute disease. As has been shown by this review, health professionals’ willingness or ability to change practice may be influenced by a range of factors, including their personal perceptions of obesity and of the potential value of prevention. So, whilst at a macro level policy and guidelines may be in place, implementation is hindered at a meso level by the mismatch between the medical model and the multifactorial causes of obesity and at a micro level by the impact of personal beliefs on patient interaction. Each of the factors dynamically influence the others so need should not be considered in isolation [ 53 ].

Changing the health system to implement effective action for the prevention of obesity therefore calls for an examination of the issues through a systems lens rather than taking a simple problem-solution driven approach. Health services are a complex system, constituted of a range of people, processes, activities, settings and structures. The interrelationships, boundaries, processes and perspectives connect in dynamic and non-linear ways which may result in emergent self-organised behaviour [ 56 ]. Importantly it should be acknowledged that systems are often nested within other systems with their own dynamics at play. Consequently, a search for solutions means identifying multiple causes as well as multiple points for intervention and being aware of unintended consequences [ 2 , 57 ]. The studies identified by this review focussed on a linear approach to implementing guidelines or examined the perspectives of just one clinical team or group within a system. There is a need for research to be undertaken which, using a systems approach, examines the opportunities and threats to prevention from the perspective of a range of players within the system and considers how these perspectives might be influenced by policy and guidelines, as well as each other. This could include looking at moving beyond traditional structural boundaries to look at alternative models of care to the medical model including the use of support roles outside of those typically considered to be health professionals, particularly in the role of ongoing support [ 56 , 58 ].

Obesity is often described as a ‘wicked’ problem due to the multifactorial causes requiring complex solutions. Whilst a population health approach is important to address this complexity, it is important that the remit of health services is extended beyond medical treatment to incorporate obesity prevention. [ 59 ]. Though this scoping review has demonstrated that there is evidence for incorporating obesity prevention into clinical care, research to date has taken a linear approach to the implementation of guidelines without explicitly factoring in the impact of the perceptions of clinicians and managers to the prevention role or addressing the individual responsibility discourse. Further research into the role of health services in obesity prevention should take a systems approach to examine the impacts of changing models of care whilst also taking into account the perceptions of health staff towards obesity and obesity prevention and the breadth of issues impacting on each individual’s ability to make lifestyle changes.

Strengths and limitations of the reviews

This review contributes to an understanding of the role of health services in obesity prevention by specifically focussing on services outside of primary health. The use of a scoping review allowed for broad coverage of the literature in order that the main issues could be highlighted in order to inform health policy, clinical practice and future research. The broad aims of the review may impact on attempts to replicate the review. Limiting the review to English language references may have excluded some evidence.

Availability of data and materials

Not applicable

Abbreviations

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Acknowledgements

The primary author, Claire Pearce, receives a scholarship from the Australian Prevention Partnership Centre (TAPPC) to support her PhD candidacy. The co-authors all have an affiliation with TAPPC. The funding body was not involved directly in the design or completion of the study or in the writing of the manuscript.

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CP conceived the study, screened citations and full-text articles, analysed and interpreted the data, and wrote and edited the manuscript. LR reviewed the analysis.

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Pearce, C., Rychetnik, L., Wutzke, S. et al. Obesity prevention and the role of hospital and community-based health services: a scoping review. BMC Health Serv Res 19 , 453 (2019). https://doi.org/10.1186/s12913-019-4262-3

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26 Conclusion: Obesity and its prevention in the 21st century

• Published: September 2010
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The case for a preventative approach to the obesity epidemic is compelling. Obesity poses what is arguably one of the most significant threats to population health that is currently faced. The data presented in this book highlight just how common obesity has become in children and in adults across the globe, and how it impacts disproportionately on the poor. This chapter presents a summary of the discussions in the preceding chapters.

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Prevention of Overweight and Obesity: How Effective is the Current Public Health Approach

Obesity is a public health problem that has become epidemic worldwide. Substantial literature has emerged to show that overweight and obesity are major causes of co-morbidities, including type II diabetes, cardiovascular diseases, various cancers and other health problems, which can lead to further morbidity and mortality. The related health care costs are also substantial. Therefore, a public health approach to develop population-based strategies for the prevention of excess weight gain is of great importance. However, public health intervention programs have had limited success in tackling the rising prevalence of obesity. This paper reviews the definition of overweight and obesity and the variations with age and ethnicity; health consequences and factors contributing to the development of obesity; and critically reviews the effectiveness of current public health strategies for risk factor reduction and obesity prevention.

1. Introduction

Obesity is a public health problem that has raised concern worldwide. According to the World Health Organization (WHO), there will be about 2.3 billion overweight people aged 15 years and above, and over 700 million obese people worldwide in 2015 [ 1 ]. Although a few developed countries such as the United Kingdom and Germany experienced a drop in the prevalence rate of obesity in the past decade, the prevalence of obesity continues to rise in many parts of the world, especially in the Asia Pacific region [ 2 , 3 ]. For example, the combined prevalence of overweight and obesity increased by 46% in Japan from 16.7% in 1976–1980 to 24.0% in 2000, and by 414% in China from 3.7% in 1982 to 19.0% in 2002 [ 4 ].

An exhaustive body of literature has emerged to show that overweight and obesity are major causes of co-morbidities, including type II diabetes, cardiovascular diseases, various cancers and other health problems, which can lead to further morbidity and mortality [ 5 , 6 ]. The related health care costs are also substantial. In the United States, the total costs associated with obesity accounted for 1.2% gross domestic product (GDP) [ 7 ]. In Europe, up to 10.4 billion Euros was spent on obesity-related healthcare, and the reported relative economic burdens ranged from 0.09% to 0.61% of national GDP [ 8 ]. In China, the total medical cost attributable to overweight and obesity was estimated at about 2.74 billion US dollars and these accounted for 3.7% of national total medical costs in 2003 [ 9 ]. The total direct costs attributable to overweight and obesity in Canada has been estimated to be 6.0 billion US dollars (of which 66% is attributable to obesity), corresponding to 4.1% of the total health expenditure for 2006. Furthermore, if related co-morbidities were included, the direct cost increased by 25% [ 10 ].

In view of the epidemic of obesity as a global public health concern, this paper aims to discuss four topic areas: (1) definition of overweight and obesity; (2) health consequences of obesity; (3) factors contributing to the development of obesity; and (4) the effectiveness of current public health strategies for risk factor reduction and obesity prevention.

2. Definition of Overweight and Obesity

2.1. in adults.

Obesity can be defined as a condition of abnormal or excess fat accumulation in adipose tissue, to the extent that health may be impaired [ 11 ]. Body Mass Index (BMI), which is calculated as [(weight in kg) / (height in m) 2 ], is considered to be the most useful population-level measure of obesity, and it is a simple index to classify underweight, overweight and obesity in adults. The WHO has classified overweight and obesity in adults based on various BMI cutoffs [ 11 ]. These cutoffs are set based on co-morbidities risk associated with BMI ( Table 1 ). However, the use of BMI does not distinguish between weight associated with muscle and weight associated with fat, and the relationship between BMI and body fat content varies according to body build and proportion [ 12 ]. In contrast, the measure of intra-abdominal or central fat accumulation to reflect changes in risk factors for cardiovascular diseases and other forms of chronic diseases is better than BMI [ 13 , 14 ]. Therefore, an assessment of central fat accumulation greatly assists in defining obesity.

Classification of overweight and obesity in adults according to BMI.

Numerous studies have compared the appropriateness of various anthropometric indices for assessing obesity and predicting obesity-related health risks, including BMI, waist-to-hip ratio (WHR), waist circumference (WC), and waist-to-height ratio (WHtR) [ 14 – 17 ]. However, there is no agreement on which index should be applied universally for defining obesity.

WHR was shown to be a good predictor of health risk [ 18 ], and a high WHR (>1.0 in men and >0.85 in women) indicates abdominal fat accumulation [ 19 ]. However, the use of WHR has been recently challenged due to several reasons [ 14 , 20 ]. First, hip circumference could not be obtained routinely and the measure is more difficult to perform and less reliable. Second, WHR is not useful in practical risk management as the ratio could remain constant when the weight of individual increases or decreases.

A health risk classification based on WC is suggested to be more useful for health assessment than either BMI or WHR, alone or in combination [ 19 , 21 – 23 ]. Data from a random sample of 2,183 men and 2,698 women aged 20−59 years from the Netherlands indicated that a WC greater than 102 cm in men, and greater than 88 cm in women, is associated with a substantially increased risk of obesity-related metabolic complications ( Table 2 ) [ 24 ]. The relation between WC and clinical outcome is consistently strong for diabetes risk, coronary heart diseases, and all-cause and selected cause-specific mortality rates, and WC is a stronger predictor of cardiometabolic risks than is BMI [ 13 ]. In Chinese adults, the best anthropometric measurements to screen for metabolic syndrome is WC, since it was better associated with metabolic risk factors than BMI, WHR and WHtR [ 14 ]. However, the influence of the optimal cutoff values of WC by sex, age and race-ethnicity as suggested by previous studies raises the problem of applying WC for obesity assessment ( Table 3 ) [ 14 , 25 , 26 ].

Sex-specific WC and risk of metabolic complications associated with obesity in Caucasians.

Source: WHO (2000) [ 11 ].

Proposed WC for diagnosing the metabolic syndrome in selected country/ethnic groups.

Source: James (2005) [ 25 ].

WHtR has been proposed as another rapid and simple screening tool for assessing obesity [ 27 ]. WHtR values above 0.5 indicate increased risk and values above 0.6 indicate substantially increased risk [ 20 ]. Results of a meta-analysis showed that WHtR was better than WC, WHR, and BMI for detecting cardiovascular risk factors in both men and women [ 28 ]. The results were also supported by prospective studies [ 15 , 27 ]. An advantage of using WHtR over WC for assessing obesity is that the same cutoffs can be set for men and women, for children and adults, and for different ethnic groups [ 27 ].

There are ethnic variations in the association between adiposity and health, and Asian populations are generally more susceptible to the development of obesity-related illnesses and morbidity than Caucasian populations at any given level of BMI or WC [ 3 , 29 – 31 ]. A meta-analysis among different ethnic groups also showed that body fat percentage was 3−5% higher in Asian populations compared to Caucasian populations for the same BMI, and BMI was 3−4 units lower in Asian populations compared to Caucasian populations for the same body fat percentage [ 32 ]. These variations in the association between BMI or WC and risk of obesity-related illnesses and morbidity, and between BMI and body fatness have raised the need for population-specific BMI and waist classification cutoff points for defining obesity. A lower BMI cutoff points for overweight (≥23.0 kg/m 2 ) and obesity (≥25.0 kg/m 2 ) for Asians [ 11 ], and a series of ethnic-specific WC cutoff points to define abdominal obesity ( Table 3 ) [ 25 ] were proposed. However, the cutoff point for observed risk varies from 22.0 to 25.0 kg/m 2 in different Asian populations; and for high risk it varies from 26.0 to 31.0 kg/m 2 . Therefore, the WHO Expert Consultation recommended that the current WHO BMI cutoff points ( Table 1 ) should be retained as the international classification [ 33 ].

2.2. In Children and Adolescents

Defining overweight and obesity in children and adolescents is complicated as height is still increasing and body composition changes over time. Different measures and references such as weight-for-height, BMI percentiles, and skinfold thickness have been used [ 11 , 34 ]. Recently, BMI has been increasingly accepted as a valid indirect measure of adiposity in children and adolescents [ 35 , 36 ]. Cole et al. (2000) [ 35 ] published a set of smoothed sex-specific BMI cutoff values based on six nationally representative data sets from Brazil, Great Britain, Hong Kong, the Netherlands, Singapore and the United States. The proposed BMI cutoff value for overweight was 25 kg/m 2 and for obesity was 30 kg/m 2 at age 18 years averaged across the six populations. However, the reference data sets do not adequately represent non-Western populations, and little is known about whether or not BMIs above these cutoff points are related to health consequences for children across populations. Therefore, from 2006 onwards, the WHO released two new sets of growth standards for infants and young children [ 37 ], and school aged children and adolescents [ 38 ], respectively. The standards for infants and young children was developed based on healthy, breast-fed children from around the world [ 39 , 40 ]. The reference for school aged children and adolescents was developed from reconstructing the 1977 National Center for Health Statistics/WHO growth reference from 5 to 19 years, supplemented with data from the WHO Child Growth Standards, and applying the state-of-the-art statistical method [ 39 , 41 ]. A recent international survey also proposed a lower cutoff BMI value of 17 as definition of thinness in children and adolescents [ 42 ].

2.3. In Elderly

With aging, body composition changes and height decreases, affecting the interpretation of anthropometric data. Older persons generally have more fat than younger adults do at any given BMI, and absolute levels of WC indicate more visceral fat in older persons than in younger persons, because relatively more fat accumulates in the abdomen and less fat at the extremities as people age [ 43 ]. In general, BMI is a common method to diagnose obesity in older adults, but because of height and body composition changes with ageing, the cutoff values applied to adults might have to be reconsidered in old subjects [ 44 , 45 ]. In contrary to the young or middle-aged population, numerous studies have reported a J- or U-shaped relationship between BMI and mortality in older adults, and underweight is hazardous whereas mild-grade overweight, obesity and even central obesity might be protective for older adults [ 46 – 48 ].

Due to the progressive age-decline in stature, using BMI to classify obesity may overestimate adiposity in the elderly [ 49 ]. Furthermore, BMI cannot make a discrepancy between fat and muscle mass [ 45 ]. The reliability of BMI as an index of obesity is thus questionable, and therefore, other anthropometric indices are proposed to determine the degree of fatness in the elderly. These indices include WC, WHR, WHtR and sagittal abdominal diameter. However, the choice of measurement and the cutoff values in predicting mortality or other cardiovascular risks in the elderly population is still uncertain [ 50 – 53 ].

In summary, since the associations between adult values for overweight and obesity and certain adverse health outcomes in elderly populations show conflicting results with a suggestion that higher values may not result in adverse health outcomes, it may not be appropriate to apply existing adult values to elderly people aged 70 year and over. In view of the rapidly growing numbers of people in this age group in many developed countries with population ageing, this has important health implications in terms of health promotion and treatment targets. Further research is indicated in establishing criteria for a healthy weight in people aged 70 years and over, using relevant health outcomes such as functional independence in addition to disease occurrence. The emphasis may likely be on weight maintenance rather than reduction at the extreme of old age, when ability to modify lifestyle may be limited and quality of life may assume greater importance.

3. Health Consequences of Obesity

Numerous epidemiological studies have been conducted to show the relationship between excess weight, abdominal fatness and risk of a wide range of illnesses [ 6 , 54 – 56 ]. Table 4 summarizes the approximate relative risk of physical health problems associated with obesity [ 57 ].

Approximate relative risk of physical health problems associated with obesity.

Source: World Cancer Research Fund/American Institute for Cancer Research (2007) [ 57 ].

3.1. Diabetes

Of all physical health problems, type II diabetes has the strongest association with obesity. A meta-analysis examined the relative risk of incidence of various co-morbidities related to obesity and overweight from 89 studies [ 6 ]. Elevated BMI and WC were significantly associated with incidence of type II diabetes in men and women. Obesity, as defined by BMI, showed the strongest association with incidences of type II diabetes as compared to other co-morbidities. The pooled relative risks (95% confidence interval) across categories of BMI were 6.75 (5.55–8.19) in men and 12.41 (9.03–17.06) in women [ 6 ]. In the Nurses’ Health Study, which followed 78,419 apparently healthy women for 20 years, for each 5-unit increment in BMI, the multivariate relative risk (95% confidence interval) of diabetes was 2.36 (1.83–3.04) for Asians, 2.21 (1.75–2.79) for Hispanics, 1.96 (1.93–2.00) for whites, and 1.55 (1.36–1.77) for blacks [ 58 ].

3.2. Cardiovascular Diseases

Obesity predisposes an individual to a number of cardiovascular risks including hypertension, dyslipidemia and coronary heart disease [ 6 , 59 ]. In the Multi-Ethnic Study of Atherosclerosis, which assessed the association between obesity and cardiovascular risk factors and subclinical vascular disease in 6,814 persons aged 45 to 84 years, showed that a higher BMI was associated with more adverse levels of blood pressure, lipoproteins, and fasting glucose, and higher prevalence ratios of hypertension [ 60 ]. Another study in an Asia Pacific population reported that a one-standard deviation increase in index was associated with an increase in risk of ischemic heart disease of 17% (95% CI 7–27%) for BMI, 27% (95% CI 14–40%) for WC, 10% (95% CI 1–20%) for hip circumference, and 36% (95% CI 21–52%) for WHR [ 61 ].

3.3. Cancers

A number of reviews have considered the association of obesity and cancer [ 6 , 62 – 64 ]. Data from a meta-analysis showed that the pooled relative risks across categories of BMI for various cancers ranged from 1.05–2.29 in men and 1.13−3.22 in women [ 6 ]. The recent report by the World Cancer Research Fund and the American Institute for Cancer Research (2007) [ 57 ] also suggested that there was convincing evidence that overweight and obesity increased the risk of cancers of the esophagus, pancreas, colon and rectum, breast (postmenopausal), endometrium, and kidney. In addition, there was convincing evidence to support that abdominal fatness was a cause of colon cancer and may probably increase the risk of cancers of breast (postmenopausal) and endometrium.

3.4. Other Health Consequences of Obesity

There is a wealth of evidence to show that excess weight is an important risk factor in the development of other illnesses, including respiratory diseases [ 54 ], chronic kidney diseases [ 56 ], musculoskeletal disorders [ 65 , 66 ], gastrointestinal and hepatic disorders [ 67 , 68 ], lower physical functioning performance [ 69 ] and psychological problems [ 11 ].

4. Factors Contributing to the Development of Obesity

The etiology of obesity is multifactorial, involving complex interactions among the genetic background, hormones and different social and environmental factors, such as sedentary lifestyle and unhealthy dietary habits [ 11 ]. Table 5 lists the key factors that might promote or protect against weight gain and obesity as suggested by the WHO [ 70 ].

Summary of strength of evidence on factors that might promote or protect against weight gain and obesity.

Source: WHO (2003) [ 70 ].

Nutrition transition as a result of urbanization and affluence has been considered as the major cause for the obesity epidemic [ 70 ]. Numerous literatures have documented a marked shift in the dietary pattern worldwide [ 70 , 71 ]. Major dietary changes include a higher energy density diet with a greater role for fat and added sugars in foods, greater saturated fat intake (mostly from animal sources), marked increases in animal food consumption, reduced intakes of complex carbohydrates and dietary fiber, and reduced fruit and vegetable intake [ 70 – 73 ]. These dietary changes are compounded by lifestyle changes that reflect reduced physical activity at work and during leisure time [ 71 , 74 ]. Several studies have shown that insufficient physical activity is one of the important risk factors of obesity [ 75 – 77 ], and work-related activity has declined over recent decades in industrialized countries whereas leisure time dominated by television viewing and other physically inactive pastimes has increased [ 71 , 74 ].

Social inequality as a result of economic insecurity and a failing economic environment is also considered as one of the probable causes of obesity. A review by Drewnowski (2009) [ 78 ] indicates that inequitable access to healthy foods as determined by socioeconomic factors could influence the diet and health of a population. Energy-dense and nutrient-poor foods become the best way to provide daily calories at an affordable cost by the poor groups, whereas nutrient-rich foods and high-quality diets not only cost more but are consumed by more affluent groups. Lack of accessibility of healthy food choices [ 79 ] and the commercial driven food market environment [ 80 ] are also considered as other probable causes of obesity.

The interaction effects among environmental factors, genetic predisposition and the individual behavior on excess weight gain has received research interests in recent decades. “Gene-environment interaction” refers to a situation in which the response or the adaptation to an environmental agent, a behavior, or a change in behavior is conditional on the genotype of the individual [ 81 ]. Observational evidence has shown that susceptibility to obesity is determined largely by genetic factors, but the environment prompts phenotype expression. For instance, a study of 285 healthy Japanese men indicated that a missense variant in the interleukin 6 receptor gene interacted significantly with dietary energy intake levels in relation to the risk of abdominal obesity [ 82 ]. In a cross-sectional study of 632 men, it was found that intake of total fat and saturated fatty acids was significantly associated with WC in individuals with the PRARα Leu162/Leu162 genotype, but not in those with the Val162 allele [ 83 ]. Possible mechanisms by which genetic susceptibility may operate include low resting metabolic rate, low rate of lipid oxidation, low fat-free mass and poor appetite control [ 11 ].

An adverse environment during in utero or postnatal periods has also been suggested as one possible cause for the development of obesity, indicating that the mother’s nutrition or perinatal lifestyle could affect the developmental programming of the fetus. The concept of programming in fetal or postnatal life is firstly established from experimental animal studies. A wealth of evidence from animal studies has demonstrated that exposure to an elevated or excess nutrient supply before birth is associated with an increased risk of obesity and associated metabolic disorders in later life [ 84 ]. Results from epidemiological studies and experimental studies in human also supported that intrauterine or postnatal nutrition could predispose individuals to obesity in later life [ 84 , 85 ]. In a review by Martorell and colleagues (2001) [ 85 ], intrauterine over-nutrition as proxied by high birth weight or gestational diabetes is associated with subsequent fatness, and breastfeeding has a protective effect on the development of obesity. In contrast, the evidence that poor nutrition in early life is a risk factor for increased fatness later in life is still inconclusive.

5. Effectiveness of the Current Public Health Strategies for Risk Factor Reduction and Obesity Prevention

A public health approach to develop population-based strategies for the prevention of excess weight gain is of great importance and has been advocated in recent years [ 11 , 86 ]. The development and implementation of obesity prevention strategies should target factors contributing to obesity, should target barriers to lifestyle change at personal, environmental and socioeconomic levels, and actively involve different levels of stakeholders and other major parties. A proposed framework by Sacks (2009) [ 87 ] suggests that policy actions to the development and implementation of effective public health strategies to obesity prevention should (1) target the food environments, the physical activity environments and the broader socioeconomic environments; (2) directly influence behavior, aiming at improving eating and physical activity behaviors; and (3) support health services and clinical interventions. Examples of policies under each of these groups are reviewed in the following sections.

5.1. Food, Physical Activity, and Socioeconomic Environments

To alter the food environment such that healthy choices are the easier choices, and to alter the physical activity environment to facilitate higher levels of physical activities and to reduce sedentary lifestyle, are the key targets of obesity prevention policies. There are a wide range of policy areas that could influence the food environments. These areas include fiscal food policies, mandatory nutrition panels on the formulation and reformulation of manufactured foods, implementation of food and nutrition labeling, and restricting marketing and advertising bans of unhealthy foods [ 87 – 89 ]. For instance, some studies have demonstrated that food prices have a marked influence on food-buying behavior. A small study was done in a cafeteria setting and was designed to look at the effects of availability and price on the consumption of fruit and salad. It was shown that increasing variety and reducing price by half roughly tripled consumption of both food items, whereas returning price and availability to the original environmental conditions brought consumption back to its original levels [ 90 ]. A larger study designed to look at the effects of health education and pricing on the consumption of vending machine snacks also showed similar results, in which price reductions on low-fat items increased the proportional purchase of low-fat items by 9%, 39%, and 93% in the 10%, 25%, and 50% price reduction conditions, respectively [ 91 ].

Policy areas influencing physical activity environments include urban planning policies, transport policies and organizational policies on the provision of facilities for physical activity [ 87 , 92 ]. A recent review by Sallis and Glanz (2009) [ 93 ] summarized the impact of physical activity and food environments as solutions to the obesity epidemic. Living in walkable communities and having parks and other recreation facilities nearby were consistently associated with higher levels of physical activity in youth, adults, and older adults. Better school design, such as including basketball hoops and having a large school grounds, and better building design, such as signs promoting stair use and more convenient access to stairs than to elevators were associated with higher levels of physical activity in youth, adults and older adults [ 93 ].

As mentioned earlier, social inequality as a result of economic insecurity and a failing economic environment is also considered as one of the probable causes of obesity [ 78 ]. Therefore, policy areas covering the financial, education, employment and social policies could impact population health. As illustrated by Sacks (2009) [ 87 ], trade agreements between countries, personal income tax regimes and social security mechanisms are some potential policy areas that could be altered at international, national and state levels for the development of population-based strategies for obesity prevention.

5.2. Influencing Eating and Physical Activity Behaviors

According to Sacks’ framework (2009) [ 87 ], policies that directly influence behaviors need to have a direct effect in the settings in which people live their lives. There are many key settings, such as schools, home environment, workplaces and community, in which policies could target to directly influence the eating and physical activity behaviors.

A policy-based school intervention has been found to be effective for the prevention and control of obesity. The two-year School Nutrition Policy Initiative including components of school self-assessment, nutrition education, nutrition policy, social marketing, and parent outreach has been documented to be effective in reducing the incidence of overweight in school children [ 94 ]. A review examined the effectiveness of school-based strategies for obesity prevention and control based on results of nineteen included studies [ 95 ]. Pooled results of these studies showed that nutrition and physical activity interventions resulted in significant reductions in body weight compared with control (standardized mean difference (SMD) = −0.29, 95% confidence interval (CI) = −0.45 to −0.14). Parental or family involvement of nutrition and physical activity interventions also induced weight reduction (SMD = −0.20, 95% CI = −0.41 to 0.00). A study has evaluated the effectiveness of an intervention program, based on the Theory of Planned Behavior, on obesity indices and blood pressure in Ioannina, Greece [ 96 ]. In this study, 321 fifth grade students were assigned to the one-year school-based intervention focused on overcoming the barriers in accessing physical activity areas, increasing the availability of fruits and vegetables and increasing parental support, and 325 students served as control group. After the one-year follow up, a significantly higher consumption of fruits and lower consumption of fats/oils and sweets/beverages was observed in the intervention group compared with the control group. The intervention group also showed significantly lower BMI and blood pressure than the control group. The leadership role for schools in promoting physical activity in children and youth has also been advocated in a Scientific Statement from the American Heart Association Council [ 97 ]. The Statement points out that schools are potentially attractive settings in which to promote positive health behaviors because students spend large amounts of time in the school environment, elements of the traditional school curriculum relate directly to health, and schools typically provide extracurricular programs that can promote health.

The home environment is undoubtedly an important setting in preventing overweight and obesity. Television viewing has been identified as an independent risk factor for obesity [ 57 ]. Potential strategies to reduce television time include messages to parents about not having a television in children’s bedrooms, encouraging family rules restricting television viewing, and not having the television on during dinner [ 98 ]. Other potential areas to target in terms of the home food and physical activity environment include purchasing healthy foods, practicing regular meal times, allocating individual portions, creating opportunities for physical activities, and the parents as role models for healthy eating [ 99 ]. Other potential settings for interventions include restaurants, cafeterias and other food-service settings [ 100 ], supermarkets [ 101 ], and workplaces [ 102 ]. The constructs of interest include the availability and price of healthy food choices, quality of food, portion sizes, within-outlet promotions, and point-of-choice nutrition information [ 93 ].

5.3. Supporting Health Services and Clinical Interventions

A number of barriers to an effective obesity management program have been identified. At the physician practice level, a lack of time to address obesity during routine office visits, a lack of reimbursement, inadequate training and low self-efficacy in handling patients of excess weight are some barriers to an effective management [ 103 , 104 ]. At the patient level, stigmatization [ 105 ], a lack of financial incentive [ 106 ], difficulties in accessing weight management services [ 79 ] are identified as barriers to an effective management.

There are several potential policy areas in which the involvement of primary care in reducing overweight and obesity could be increased. These areas include increasing number of dietitians and nutritionists in hospitals and subsidization of weight-loss medication [ 87 ], providing professional and organizational support and training [ 104 ], and by offering financial incentives [ 106 ]. A systematic review was done to determine the existence and effectiveness of interventions to improve health professionals’ management of obesity or the organization of care for overweight and obese people [ 107 ]. Among the 18 studies involving 446 providers and 4,158 patients, no concrete conclusion could be drawn on how the management of obesity might be improved due to the heterogeneous nature of the studies. However, reminder systems, brief training interventions, shared care, inpatient care and dietitian-led treatments might all be worth further investigation.

5.4. Barriers to the Effectiveness of Reduction of Overweight and Obesity through a Policy Approach

Overweight and obesity prevention or reduction essentially involves lifestyle modification through behavioral change at the individual level. Policy alone is unlikely to achieve this, merely facilitating the process. However many factors act as barriers to change. For example the universal use of information technology in all settings, whether at home or work, greatly reduces physical activity [ 108 – 110 ]. Examples are the wide use of social networking websites such as Facebook, YouTube etc. ; school work dependent on the internet and computer; computer-based work dominating most occupations; entertainment dependent on information technology. Social networking and enjoyment would be strong motivation for computer use at home, while work demands would necessitate continual use at work. For the majority of people, it would be difficult to counterbalance this reduction in physical activity with the technology revolution. The habit of snack consumption at the same time also predispose to overweight and obesity [ 111 , 112 ].

As society becomes increasingly competitive, the resulting stress may contribute to excessive eating as some people turn to food for comfort [ 113 ]. It was hypothesized that the elevated cortisol secretion, caused by stress, might disrupt the food intake regulation in humans and could result in a long-term increased energy intake and fat accumulation [ 114 ]. Unhealthy lifestyles associated with poverty are difficult to tackle through policy, unless there is poverty reduction [ 78 ]. Finally, the goals of the food industry are to maximize profit, and this aim does not necessarily coincide with public health efforts for obesity control. The food industry strategies to maximize profits include promoting larger portions, frequent snacking and the normalization of sweets, soft drinks, snacks and fast food as daily fare [ 115 , 116 ]. A parallel may be drawn with the tobacco industry and the strategies used to promote their products.

Ultimately, the key to controlling the obesity epidemic lies at the level of individuals, since they have to act on health promotion advice and efforts. A recent qualitative study explored a lifestyle modification program from the clients’ perspective, showing the importance of client centered care in achieving lifestyle modification [ 117 ]. Further research is needed from the individual’s perspective. Questions to be addressed include: whether avoidance of overweight and obesity is viewed with as much concern as the prevention of diseases such as cancer or ischemic heart disease; what are factors that enable individuals to increase their physical activity level and adopt a healthy diet so that long-term behavior change is achieved; and more in depth understanding of individual, interpersonal, organizational and community factors that affect this behavior in the context of different ethnicity and culture.

6. Conclusions

The health risks and health care costs associated with overweight and obesity are considerable. The etiology of obesity is multifactorial, involving complex interactions among genetic background, hormones and different social and environmental factors. A public health approach to develop population-based strategies for the prevention of excess weight gain should target factors contributing to obesity, should be multifaceted, and actively involve different levels of stakeholders and other major parties. Potential policy areas to the development and implementation of such strategies should cross from the home environment to a broader policy level of socioeconomic environments. However, there is likely to be many barriers towards strategies based on policies alone. The prevention and reduction of overweight and obesity depend ultimately on individual lifestyle changes, and further research on motivations for behavior change would be important in combating the obesity epidemic.

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FDA Approves First Treatment to Reduce Risk of Serious Heart Problems Specifically in Adults with Obesity or Overweight

FDA News Release

Today, the U.S. Food and Drug Administration approved a new indication for use for Wegovy (semaglutide) injection to reduce the risk of cardiovascular death, heart attack and stroke in adults with cardiovascular disease and either obesity or overweight. Wegovy should be used in addition to a reduced calorie diet and increased physical activity. Cardiovascular disease is a group of diseases of the heart and blood vessels. 

“Wegovy is now the first weight loss medication to also be approved to help prevent life-threatening cardiovascular events in adults with cardiovascular disease and either obesity or overweight,” said John Sharretts, M.D., director of the Division of Diabetes, Lipid Disorders, and Obesity in the FDA’s Center for Drug Evaluation and Research. “This patient population has a higher risk of cardiovascular death, heart attack and stroke. Providing a treatment option that is proven to lower this cardiovascular risk is a major advance for public health.” 

Obesity or overweight affect approximately 70% of American adults. Obesity and overweight are serious health issues that increase the risk for premature death and a variety of health problems, including heart attack and stroke. 

Wegovy contains semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist. Therefore, Wegovy should not be used in combination with other semaglutide-containing products or other GLP-1 receptor agonists. 

Wegovy’s efficacy and safety for this new indication were studied in a multi-national, multi-center, placebo-controlled double-blind trial that randomly assigned over 17,600 participants to receive either Wegovy or placebo. Participants in both groups also received standard-of-care medical treatment (e.g., management of blood pressure and cholesterol) and healthy lifestyle counseling (including diet and physical activity). Wegovy significantly reduced the risk of major adverse cardiovascular events (cardiovascular death, heart attack and stroke), which occurred in 6.5% of participants who received Wegovy compared to 8% of participants who received placebo.

The prescribing information for Wegovy contains a boxed warning to inform health care professionals and patients about the risk of thyroid C-cell tumors. Because of this risk, Wegovy should not be used in patients with a personal or family history of medullary thyroid carcinoma or in patients with a rare condition called Multiple Endocrine Neoplasia syndrome type 2.

Wegovy should not be used in patients with a history of a severe allergic reaction to semaglutide or to any of the other ingredients. Patients should stop Wegovy immediately and seek medical help if a severe allergic reaction is suspected. 

Wegovy also contains warnings for inflammation of the pancreas (pancreatitis), gallbladder problems (including gallstones), low blood sugar, acute kidney injury, hypersensitivity reactions, diabetic retinopathy (damage to the eye's retina), increased heart rate and suicidal behavior or thinking. Patients should discuss with their health care provider if they have symptoms of pancreatitis or gallstones. If Wegovy is used with insulin or with a medication that causes insulin secretion, patients should speak to their health care provider about the risk of low blood sugar. Healthcare professionals should monitor patients for kidney disease, diabetic retinopathy and depression or suicidal behaviors or thoughts.

The most common side effects of Wegovy include nausea, diarrhea, vomiting, constipation, abdominal (stomach) pain, headache, fatigue, dyspepsia (indigestion), dizziness, abdominal distension, eructation (belching), hypoglycemia (low blood sugar) in patients with diabetes, flatulence (gas buildup) and gastroesophageal reflux disease (heartburn).

Wegovy received Priority Review designation for this indication.

The FDA granted the approval to Novo Nordisk A/S. 

Wegovy is also approved to reduce excess weight and maintain weight reduction long term in certain adults with obesity or overweight and certain children with obesity, for use in addition to a reduced calorie diet and increased physical activity.

Related Information

• NIH: Overweight & Obesity Statistics

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Boosting digital health can help prevent millions of deaths from noncommunicable diseases

An investment today of an additional US$0.24 per patient per year in digital health interventions, such as telemedicine, mobile messaging and chatbots, can help save more than 2 million lives from noncommunicable diseases over the next decade, says a new report released jointly by the World Health Organization (WHO) and ITU (International Telecommunication Union). This investment could also avert approximately 7 million acute events and hospitalizations, significantly reducing the strain on healthcare systems around the world.

The publication titled " Going digital for noncommunicable diseases: the case for action " has been launched at an event hosted by the Government of The Gambia during the 79 th United Nations General Assembly, in collaboration with the ITU and WHO.

“The future of health is digital. But to make this vision a reality, we need both resources and collaboration,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. No single organization can do it alone. We call on governments, partners, and donors to come together, invest strategically, and ensure that these life-saving innovations reach those who need them most.”

“The digital revolution has the potential to unleash a health revolution,” said ITU Secretary-General Doreen Bogdan-Martin. “At ITU, universal meaningful connectivity is a priority because digital is a catalyst for delivering targets in key sectors such as health and education. We call for greater collaboration between the health and tech sectors, including the development of strong digital public infrastructure, essential for the delivery of digital health services that can benefit people everywhere without leaving anyone behind.”

Noncommunicable diseases (NCDs), such as cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases, are responsible for over 74% of global deaths annually, many of which are preventable. While significant progress has been made in combating NCDs, the integration of digital health technologies into mainstream health systems remains a challenge. The report shows that there is an urgent need to harness these technologies to scale up effective interventions and mitigate the growing burden on healthcare systems worldwide.

Four major risk factors linked to our everyday environment – tobacco use, unhealthy diet, the harmful use of alcohol and physical inactivity – drive responses in our bodies that also increase NCD risk: raised blood pressure, obesity, raised blood glucose and raised cholesterol. Digital tools, including mobile messaging and chatbots, can support individuals to understand their modifiable risk factors and encourage them to develop healthier habits.

People living with NCDs require regular monitoring and continuous management, and many need long term and specialized care. Digital tools such as telemedicine can help them to overcome barriers to accessing healthcare. Real-time data and tools for health care professionals can also help them make informed decisions about their patients. 

While over 60% of countries have developed a digital health strategy, there is often a lack of integration of new technologies into the existing health infrastructure. The report calls for countries to invest in digital public infrastructure, and promote standards and interoperability which can overcome critical barriers to realizing the full potential of digital health.

The report serves as a blueprint for action, complementing the WHO Global Initiative on Digital Health and Global Strategy on Digital Health 2020-2025. The United Nations Inter-Agency Task Force for the prevention and control of NCD s (UNIATF) Secretariat, in collaboration with WHO and ITU, including through the Be He@lthy, Be Mobile programme are committed to providing tailored strategic planning and advocacy support to governments.

Note to editors: 

• In Senegal, the integration of an mHealth solution has brought numerous benefits to diabetes prevention and control. The "mRamadan" campaign, a part of the Be He@lthy, Be Mobile programme launched in 2014, uses mobile technology to provide preventive advice and promote a healthy lifestyle during Ramadan. By leveraging a cultural tradition that is deeply significant for Senegal's Muslim population, the campaign has achieved greater popular engagement, reaching more than 200 000 users. The initiative has contributed to advancing technical capabilities and cross-sectoral partnerships to promote public health outcomes.
• WHO’s prototype of a digital health promoter, S.A.R.A.H., started off as a chatbot to fight misinformation around COVID-19 and offered information on living healthily during the pandemic. The platform has since been expanded to provide messages for individuals at risk of hypertension and diabetes, offering accessible health information in multiple languages via messaging apps like WhatsApp.
• In Zambia, the Be He@lthy, Be Mobile programme, a joint WHO-ITU initiative, leverages telemedicine and mobile technology to promote NCD prevention and management. The initiative connects patients in remote areas with healthcare professionals for real-time consultations and monitoring of NCD risk factors, such as obesity and high blood pressure, helping to improve health outcomes.
• Kyrgyzstan has made significant progress in developing its digital health infrastructure, driven by the national digital transformation concept "Digital Kyrgyzstan 2019-2023". The country has focused on creating a unified health information system, establishing the national e-Health Centre and promoting ICT-based solutions. This effort has led to the pilot-testing of electronic health record platforms, capacity-building for medical personnel, and the introduction of e-clinical information forms in primary healthcare. The strategic benefits of this transformation were evident during the COVID-19 pandemic, when Kyrgyzstan rapidly developed a digital register for vaccination certificates, eliminating the need for paper forms and saving approximately 850 000 hours of work by health workers and public employees.

About UN NCD Task Force

The United Nations Interagency Task force on the Prevention and Control of Noncommunicable Diseases (UN NCD Task Force) was established in 2013 by the UN Secretary-General to provide support to Member States in scaling up action on NCDs. Its role is to bring the United Nations system together to tackle NCDs and mental health conditions. It uses its networks and expertise to help governments develop and introduce effective responses to prevent and control NCDs. Bringing together over 46 UN agencies, as well as the World Bank and regional development banks, the UN NCD Task Force promotes a whole-of-government and whole-of-society approach.

More information about UNIATF is available here https://uniatf.who.int/

For more information, please contact:

Alexey Kulikov [email protected]

Neneh Sallah  [email protected]

Digital copies of the report are available online .

Media Contacts

WHO Media Team

World Health Organization

Going digital for noncommunicable diseases: the case for action

WHO Global Initiative on Digital Health