Over recent decades, obesity has been increasing in epidemic proportions around the globe. We need certain calories every day to carry out daily activities. But when we eat more calories than we burn in daily activity and exercise, this can lead to weight gain and obesity. It is not only just about calorie intake and calorie expenditure, or having a sedentary lifestyle that causes overweight or obesity. However, those are causes of obesity, but there are some other causes that we cannot control.
Let us begin with the terms 'overweight' and 'obesity' first. A body mass index (BMI) over 25 is considered overweight, over 30 is obese and if it is more than 40 is termed as severe obesity. In 2017, according to the global burden of disease, over 4 million people died as a result of being overweight or obese (WHO, 2023). More than 1.9 billion adults of 18 years and older were overweight in 2016 and over 650 million were obese (WHO, 2021). The Nepal Demographic and Health Survey (NDHS) highlighted that among men and women aged 15–49 years, women had a higher prevalence of both overweight (22 per cent vs. 17 per cent) and obesity (5 per cent vs. 3 per cent).
Moreover, the environment at home, at school, at the workplace, and in the community can all influence eating behaviour, and how active we are. Therefore, being overweight and obese is the result of complex conditions of multiple yet heterogenic factors. In most cases, it is associated with eating patterns, physical activity, and energy expenditure. There are specific causes of obesity that include genetics, which can affect how our body processes food into energy and how fat is stored in our body. People of older age usually have less muscle mass and a slower metabolic rate, making it easier to gain weight.
Another cause may be lack of enough sleep which in turn makes us feel hungrier and crave certain high-calorie foods. Pregnancy is also linked to weight gain and weight gained during pregnancy may be difficult to lose and might eventually lead to obesity. The changing lifestyle and environment mingled with better socioeconomic conditions have been implicated in the obesity epidemics in low- and middle-income countries. There are many items that tend to increase the risk of weight gain that include fast foods, fried foods, fatty and processed meats, many dairy products, foods with added sugar, such as baked goods, readymade breakfast cereals, and cookies.
Similarly, foods containing hidden sugars, such as ketchup and many other canned and packaged food items, sweetened juices, sodas, and alcoholic drinks, processed, high carbohydrate foods, such as bread also are responsible for weight gain. Eating too much food with high calories and a lack of sufficient exercise can result in weight gain and obesity. Many people nowadays lead a much more sedentary lifestyle than their ancestors. People often have sedentary habits such as working in an office, playing games on a computer, and using transportation than walking or cycling.
As we know that the less a person moves around, the fewer calories they burn. There is a relationship between physical activity and hormones in our body, and hormones have an impact on how the body processes food. Several researches have suggested that physical activity is needed to keep insulin levels stable and that unstable insulin levels may lead to weight gain. The data on the global burden of disease has shown a dramatic increase in obesity and obesity-related diseases in the last couple of decades. The direct effects of the high ratio of body fat to muscle strain not only our bones but also other internal organs. It also increases inflammation in the body, a known risk factor for cancer.
Obesity is also a major risk factor for the development of type 2 diabetes. Besides diabetes, obesity has been linked to a number of other health complications, some of which can be life-threatening if not treated in time. Heart disease, high blood pressure, certain cancers (breast, colon, and endometrial), stroke, gallbladder disease, fatty liver disease, high cholesterol, sleep apnea and other breathing problems, arthritis, and infertility have been found to have a strong link with overweight and/or obesity.
Change in lifestyle
However, there are methods with the help of which we can control body weight. A healthy eating plan and structured exercise programme are the best methods to maintain normal body weight. Lifestyle and behavioural changes are the preferred weight loss methods for everyone with overweight and obesity. On a personal level, one can help prevent weight gain and obesity by making healthier lifestyle choices such as moderate exercise like walking, swimming, or biking for 20 to 30 minutes every day, eating well by choosing nutritious foods, like fruits, vegetables, whole grains, and lean protein, avoid too much high-fat, high-calorie foods.
We should keep in mind that the longer a person has obesity, the harder it may be for them to lose weight. Governments in many countries are putting an emphasis on healthier food choices and activities to help turn the tide of the burden of obesity. Lastly, it is not too late to impose restrictions on the limit of sugar, salt, and trans fat content in fast foods besides mass awareness of the effects of high-calorie diets on the rapid rise in non-communicable diseases.
(Dr. Lohani is the clinical director at the Nepal Drug and Poison Information Centre. email@example.com)