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obesity

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"Obesity"[MeSH Terms] AND "Weight Loss"[MeSH Terms]

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WHO obesity fact sheet definition BMI adults obesity

Obesity is a chronic disease in which excess body fat increases health risks. In adults, it is commonly classified using body mass index (BMI):
  • Overweight: BMI 25.0-29.9 kg/m²
  • Obesity: BMI ≥30 kg/m²
    • Class I: 30.0-34.9
    • Class II: 35.0-39.9
    • Class III: ≥40
BMI is a screening measure, not a direct measure of body fat. Waist circumference and an individual's health conditions also matter. The WHO definition and classification uses weight, height, and BMI, while recognizing age-specific criteria for children.

Causes

Obesity usually results from a long-term mismatch between energy intake and expenditure, influenced by:
  • Genetics and family history
  • Highly processed, calorie-dense foods and sugary drinks
  • Low physical activity and sedentary time
  • Poor sleep, stress, alcohol use
  • Some medicines, such as glucocorticoids, certain antipsychotics, and some antidepressants
  • Medical conditions, less commonly, including hypothyroidism or Cushing syndrome

Health effects

It raises the likelihood of type 2 diabetes, high blood pressure, abnormal cholesterol, fatty liver disease, sleep apnea, osteoarthritis, infertility, cardiovascular disease, and several cancers.

Management

Treatment is individualized and is not about willpower alone:
  1. Lifestyle and behavioral support: a sustainable calorie deficit, higher-fiber and minimally processed foods, activity, sleep improvement, and regular follow-up.
  2. Physical activity: aim progressively toward at least 150 minutes weekly of moderate activity, plus resistance training when feasible.
  3. Medication: may be considered alongside lifestyle treatment for eligible adults, particularly with BMI ≥30 or BMI ≥27 plus weight-related conditions. A clinician should assess risks, contraindications, and long-term use.
  4. Metabolic/bariatric surgery: may be appropriate for selected people with severe obesity or obesity with major complications.
Even sustained loss of 5%-10% of starting weight can improve blood sugar, blood pressure, lipids, and sleep-apnea risk. A 2024 systematic review comparing Mediterranean, low-carbohydrate, and low-fat diets found weight loss can occur with several dietary patterns, supporting selection of a pattern a person can maintain (PubMed 39255914).
Seek medical assessment sooner if there is rapid unexplained weight change, symptoms of sleep apnea such as loud snoring with daytime sleepiness, or obesity with diabetes, hypertension, pregnancy, or medication concerns.
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