Obesity manifests through both physical and psychological indicators:

• Physical:
  • High BMI (>30), excessive body fat (especially abdominal).
  • Shortness of breath, fatigue, or joint pain.
  • Skin issues (e.g., stretch marks, acanthosis nigricans).
• Psychological:
  • Low self-esteem, depression, or social isolation.
• Comorbid Symptoms:
  • Hypertension, insulin resistance, or sleep apnea (Mayo Clinic).

Note: Obesity often coexists with metabolic syndrome, a cluster of conditions increasing cardiovascular risk (Lippincott Review of Pathology).

1. Primary Causes:
   • Energy Imbalance: Consuming more calories than expended.
   • Sedentary Lifestyle: Lack of physical activity.
2. Genetic Factors:
   • Mutations in genes like FTO or MC4R influence appetite and fat storage (Lippincott Review of Pathology).
3. Environmental Triggers:
   • Ultra-processed diets, food marketing, and socioeconomic barriers.
4. Medical Conditions:
   • Hypothyroidism, PCOS, or Cushing’s syndrome (Lange Textbook of Clinical Pharmacology).
5. Medications:
   • Antidepressants, corticosteroids, or antipsychotics (BNF).

1. Dietary Modifications:
   • Emphasize whole foods (fruits, vegetables, lean proteins); limit sugars and saturated fats (WHO).
   • Follow the Mediterranean or DASH diet (Mayo Clinic).
2. Physical Activity:
   • Aim for ≥150 minutes/week of moderate exercise (e.g., cycling, swimming).
3. Behavioral Changes:
   • Mindful eating, stress management, and sleep hygiene.
4. Policy Interventions:
   • Sugar taxes, improved food labeling, and urban planning to promote activity (WHO).

1. Lifestyle Interventions:

• Structured Programs: Combine diet, exercise, and counseling (e.g., Weight Watchers).
• Caloric Deficit: Aim for a 500–750 kcal/day reduction for gradual weight loss (Mayo Clinic).

2. Pharmacotherapy (BNF Guidelines):

• Orlistat: Reduces dietary fat absorption.
• GLP-1 Agonists (e.g., Semaglutide, Liraglutide): Suppress appetite and improve glycemic control.
• Bupropion/Naltrexone: Reduces cravings.

3. Surgical Options:

• Bariatric Surgery:
  • Gastric Bypass or Sleeve Gastrectomy for BMI ≥40 or ≥35 with comorbidities.
  • Achieves 20–30% sustained weight loss (Lippincott Textbook of Pharmacology).

4. Psychological Support:

Cognitive-behavioral therapy (CBT) to address emotional eating

• Cardiovascular: Heart disease, stroke, hypertension.
• Metabolic: Type 2 diabetes, dyslipidemia.
• Musculoskeletal: Osteoarthritis, chronic back pain.
• Cancer: Increased risk of breast, colon, and endometrial cancers (WHO).

• Regular Monitoring: Track BMI, waist circumference, and metabolic markers.
• Support Networks: Join community programs or online groups for motivation.
• Avoid Weight Stigma: Seek healthcare providers who offer compassionate, evidence-based care (Mayo Clinic).

Obesity is a complex, multifactorial condition requiring a holistic approach. While prevention through lifestyle changes is ideal, advances in pharmacotherapy and surgery offer hope for those struggling with severe obesity. Early intervention can mitigate complications and improve quality of life.

Key Takeaways:

• Prioritize sustainable diet and exercise habits.
• Consult healthcare providers for personalized treatment plans.
• Advocate for policies addressing obesogenic environments.