Obesity

Overview

Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. A body mass index (BMI) over 25 is considered overweight, and over 30 is obese. In 2019, an estimated 5 million noncommunicable disease (NCD) deaths were caused by higher-than-optimal BMI.

Rates of overweight and obesity continue to grow in adults and children. From 1990 to 2022, the percentage of children and adolescents aged 5–19 years living with obesity increased four-fold from 2% to 8% globally, while the percentage of adults 18 years of age and older living with obesity more than doubled from 7% to 16%.

Obesity is one side of the double burden of malnutrition, and today more people are obese than underweight in every region except the South-East Asia Region. Once considered a problem only in high-income countries, today some middle-income countries have among the highest prevalence of overweight and obesity worldwide.

Complication :

Overweight and obesity are major risk factors for a number of chronic diseases, including cardiovascular diseases such as heart disease and stroke, which are the leading causes of death worldwide. Being overweight can also lead to diabetes and its associated conditions, including blindness, limb amputations, and the need for dialysis. Rates of diabetes have quadrupled since around the world since 1980. Carrying excess weight can lead to musculoskeletal disorders including osteoarthritis. Obesity is also associated with some cancers, including endometrial, breast, ovarian, prostate, liver, gallbladder, kidney and colon. The risk of these noncommunicable diseases increases even when a person is only slightly overweight and grows more serious as the body mass index (BMI) climbs.

Obesity in childhood is associated with a wide range of serious health complications and an increased risk of premature onset of related illnesses. Studies have found that without intervention, children and adolescents with obesity will likely continue to be obese into adulthood.

Prevention & Control

Many of the causes of overweight and obesity are preventable and reversible. Although other factors are involved, the fundamental cause of obesity is an imbalance of calories consumed and calories expended. As global diets have changed in recent decades, there has been an increase in the consumption of energy-dense foods high in fat and free sugars. There has also been a decrease in physical activity due to the changing nature of many types of work, more access to transportation and increased urbanization.

Lowering the risk of overweight and obesity includes reducing the number of calories consumed from fats and sugars, increasing the portion of daily intake of fruit, vegetables, legumes, whole grains and nuts, and engaging in regular physical activity (60 minutes per day for children and 150 minutes per week for adults). In babies, studies have shown that exclusive breastfeeding from birth to 6 months of age reduces the risk of infants becoming overweight or obese.

Risk factors

Risk factors for diabetes depend on the type of diabetes. Family history may play a part in all types. Environmental factors and geography can add to the risk of type 1 diabetes.

Sometimes family members of people with type 1 diabetes are tested for the presence of diabetes immune system cells (autoantibodies). If you have these autoantibodies, you have an increased risk of developing type 1 diabetes. But not everyone who has these autoantibodies develops diabetes.

Race or ethnicity also may raise your risk of developing type 2 diabetes. Although it’s unclear why, certain people — including Black, Hispanic, American Indian and Asian American people — are at higher risk.

Prediabetes, type 2 diabetes and gestational diabetes are more common in people who are overweight or obese.

Complications

Long-term complications of diabetes develop gradually. The longer you have diabetes — and the less controlled your blood sugar — the higher the risk of complications. Eventually, diabetes complications may be disabling or even life-threatening. In fact, prediabetes can lead to type 2 diabetes. Possible complications include:

Heart and blood vessel (cardiovascular) disease.Diabetes majorly increases the risk of many heart problems. These can include coronary artery disease with chest pain (angina), heart attack, stroke and narrowing of arteries (atherosclerosis). If you have diabetes, you’re more likely to have heart disease or stroke.
Nerve damage from diabetes (diabetic neuropathy).Too much sugar can injure the walls of the tiny blood vessels (capillaries) that nourish the nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward.

Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhea or constipation. For men, it may lead to erectile dysfunction.

Kidney damage from diabetes (diabetic nephropathy).The kidneys hold millions of tiny blood vessel clusters (glomeruli) that filter waste from the blood. Diabetes can damage this delicate filtering system.
Eye damage from diabetes (diabetic retinopathy).Diabetes can damage the blood vessels of the eye. This could lead to blindness.
Foot damage.Nerve damage in the feet or poor blood flow to the feet increases the risk of many foot complications.
Skin and mouth conditions.Diabetes may leave you more prone to skin problems, including bacterial and fungal infections.
Hearing impairment.Hearing problems are more common in people with diabetes.
Alzheimer’s disease.Type 2 diabetes may increase the risk of dementia, such as Alzheimer’s disease.
Depression related to diabetes.
Depression symptoms are common in people with type 1 and type 2 diabetes.

Complications of gestational diabetes

Most women who have gestational diabetes deliver healthy babies. However, untreated or uncontrolled blood sugar levels can cause problems for you and your baby.

Complications in your baby can be caused by gestational diabetes, including:

Excess growth.Extra glucose can cross the placenta. Extra glucose triggers the baby’s pancreas to make extra insulin. This can cause your baby to grow too large. It can lead to a difficult birth and sometimes the need for a C-section.
Low blood sugar.Sometimes babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth. This is because their own insulin production is high.
Type 2 diabetes later in life.Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
Untreated gestational diabetes can lead to a baby’s death either before or shortly after birth.

Complications in the mother also can be caused by gestational diabetes, including:

Preeclampsia.Symptoms of this condition include high blood pressure, too much protein in the urine, and swelling in the legs and feet.

Gestational diabetes. If you had gestational diabetes in one pregnancy, you’re more likely to have it again with the next pregnancy

Prevention

Type 1 diabetes can’t be prevented. But the healthy lifestyle choices that help treat prediabetes, type 2 diabetes and gestational diabetes can also help prevent them:

Eat healthy foods.Choose foods lower in fat and calories and higher in fiber. Focus on fruits, vegetables and whole grains. Eat a variety to keep from feeling bored.
Get more physical activity.Try to get about 30 minutes of moderate aerobic activity on most days of the week. Or aim to get at least 150 minutes of moderate aerobic activity a week. For example, take a brisk daily walk. If you can’t fit in a long workout, break it up into smaller sessions throughout the day.
Lose excess pounds.If you’re overweight, losing even 7% of your body weight can lower the risk of diabetes. For example, if you weigh 200 pounds (90.7 kilograms), losing 14 pounds (6.4 kilograms) can lower the risk of diabetes.

But don’t try to lose weight during pregnancy. Talk to your provider about how much weight is healthy for you to gain during pregnancy.

To keep your weight in a healthy range, work on long-term changes to your eating and exercise habits. Remember the benefits of losing weight, such as a healthier heart, more energy and higher self-esteem.

Sometimes drugs are an option. Oral diabetes drugs such as metformin (Glumetza, Fortamet, others) may lower the risk of type 2 diabetes. But healthy lifestyle choices are important. If you have prediabetes, have your blood sugar checked at least once a year to make sure you haven’t developed type 2 diabetes.