Tackling obesity: Time to move beyond “eat less and exercise more” approach - CNBCTV18

Obesity, a complex disorder is caused by multiple factors, both environmental and genetic. Obesity has been identified by the American Medical Association as a chronic medical condition, and not just a lifestyle disease. Being obese is not a result of being lazy. It is an actual medical condition that warrants just as much attention, consideration, and care as any other medical condition such as diabetes or heart disease.

Yet, most of the obese people are blamed and shamed for their condition by society without understanding the root cause. Not just the society, some physicians also have a misplaced understanding of this chronic condition. They must move past the basic and generally futile endorsement of "eat less and exercise more". It is critical to investigate and address the causes of amplified energy intake, diminished metabolic rate, and reduced activity.

Obesity reduces life expectancy by increasing the risk of type-2 diabetes, heart attack, heart failure, high blood pressure, stroke, non-alcoholic liver disease, and several types of cancer. Not every obese person faces these problems. The risk intensifies if there is a family history of one of those conditions. Many experts believe that obesity is a common underlying factor leading to hospitalisation due to severe COVID-19 infection. According to a study by CDC, obese people have thrice the risk of hospitalisation due to a COVID-19 infection.

Several pieces of evidence have shown that obesity results in substantial changes in both innate and adaptive immune response and people with obesity are in a state of chronic inflammation. Two things happen in obese patients—firstly, the quantity of fat increases, and secondly, fat gets accumulated in the wrong places. If fat is accumulated in the liver and skeletal muscle, it disturbs metabolism resulting in high levels of insulin in the blood.

The sad reality is that overweight and obesity are connected to more deaths worldwide than undernutrition. Globally today, there are also more people who are obese than undernourished—this occurs in every region. We often neglect childhood obesity by treating it as a mere lifestyle issue. Childhood obesity is sadly linked to a higher chance of obesity, type 2 diabetes, cardiovascular disease and debility and even early death in adulthood.

However, in addition to future risks, obese children face breathing problems, a higher risk of fractures, hypertension, early signs of cardiovascular disease, insulin resistance, type 2 diabetes and even depression. Several types of cancers are also connected to being obese, such as cancer of the uterus, gallbladder, liver, kidney, breast, and colon. Common causes of obesity include unhealthy diet, lack of exercise, genetics, lack and inadequate sleep. Some health conditions can also lead to weight gain, and further leading to obesity. These include PCOS, osteoarthritis, hypothyroidism, environment, and psychological factors such as depression. People with a genetic predisposition may find it tougher to maintain a healthy weight.

Medical practitioners usually gather family health history to help detect people at high risk of obesity-related diseases. There are medical help and treatment options available for obese individuals struggling to lose weight on their own. One can start with a primary care physician, who can diagnose the condition and may refer the patient to an obesity specialist. There are dedicated medical teams including obesity specialists, dietitians, and therapists to support during the treatment journey. Sometimes, medications or a weight loss surgery will be recommended based on the individual's health and body type.

The main aim of weight-loss medications, or anti-obesity medications, is to help strictly follow a low-calorie diet by reducing hunger and the feeling of not being 'full' that often arise when trying to lose weight. Weight-loss surgery for obesity may be considered if other weight loss methods have failed. It helps some people lose roughly about 35 percent or more of their excess body weight. We should remember that it isn't a miracle obesity cure and certainly not scalable to be done in millions of people.

Obesity and its related health problems have a significant economic impact on the country's health care system—including direct and indirect costs. Direct medical costs comprise of precautionary, diagnostic, and treatment services. Indirect costs are related to sickness and death, lost productivity etc.

Productivity actions contain employees being absent from work for obesity-related health reasons, declined productivity even though at work durability, and untimely death. In the last couple of decades, we have seen a dramatic increase in obesity and obesity-related diseases. It is advisable to seek expert opinion from your doctor to address obesity at an early stage to have a healthier life and improve quality of life.

—The author, Dr V Mohan is Chairman and Managing Director at Dr. Mohan's Diabetes Specialities Centre, Director and Chief of Diabetes Research, Madras Diabetes Research Foundation. The views expressed are personal