Obesity: Burden, epidemiology and priority interventions

Abstract

Obesity (or more generally being overweight), which is generally assessed on elevated body mass index (BMI) or waist circumference, results in many complications, including diabetes, hypertension, dyslipidaemias, cardiovascular disease and some cancers. The prevalence of obesity is increasing in most countries, including in children. Its cause is multifactorial and includes the increasingly obesogenic environment (e.g. commercial, societal and physical environment factors) and neuroendocrine mechanisms (which favour weight gain, particularly in response to ultraprocessed foods). The multifactorial nature of obesity and the high disease burden related to high BMI emphasize the need for macro-policy interventions across multiple sectors to modify the obesogenic environments targeting the whole population. At the individual level, counselling to encourage the adoption of a healthy diet and lifestyle is important but has often limited efficacy in the long term. Where resources are available, a number of medications are available, particularly the newer ones that act on satiety, and bariatric surgery is an extreme but highly effective measure that can largely reduce or avert metabolic complications of obesity. Effective long-term care requires partnerships between patients and multiple healthcare professionals.