Obesity and its effect on us

Author: Lesley Smyth (Obesity tutor/presenter/expert)

Obesity is defined as a ‘medical condition in which excess body fat has accumulated to the extent that it may harm health’ (NHS, 2012). It is a complex multifactorial chronic disease that develops from an interaction of genotype and the environment. Preventing and managing obesity is a complex problem with no easy straightforward answer.

Obesity has a severe impact on the health of individuals both physiologically and psychologically, with the risk of complications from secondary conditions a major concern. It’s also linked to Metabolic Syndrome (also known as syndrome X), which is a medical term for clustering of symptoms/medical disorders that, when presented together increase the risk of developing diabetes type 2 or cardiovascular disease.

In 2006 International Diabetes Federation (IDF) consensus worldwide definition is central obesity defined by waist circumference AND any two of the following…

• Raised triglycerides
• Reduced HDL cholesterol
• Raised blood pressure (BP)
• Raised fasting plasma glucose (FPG)

Classification	BMI (KG/M2)	Risk of secondary conditions
Underweight	<18.5	Low (other health risks may be associated with low BMI)
Healthy weight	18.5 - 24.9	Average
Overweight (pre-obese)	25 - 29.9	Increased
Obesity, class 1	30 - 34.9	Moderate
Obesity, class 2	35 - 39.9	Severe
Obesity, class 3	>40	Very severe

Assessment of the health risks associated with overweight and obesity in adults should be based on BMI and waist circumference as follows…

Weight classification	BMI (Kg/M2)	Men > 102cm (40’) Women > 88cm (35’)
Underweight	<18.5	-
Normal	18.5 - 24.9	-
Overweight	25 - 29.9	High
Obesity class
1	30 - 34.9	Very high
2	35 - 39.9	Very high
3	>40	Extremely high
Disease risk* relative to normal weight and waist circumference *Increased waist circumference also can be a marker for increased risk, even for individuals of normal weight.

Further metabolic risks associated with Obesity:

• Hypertension - 5 fold risk in obesity (Foresight Report, 2007)
• Coronary Heart Disease
• Stroke - up to 6x more likely in an obese person (Lancet, 2009)
• Certain cancers - up to 6x more likely in an obese person (Lancet, 2009)
• Non-alcoholic fatty liver
• Polycystic ovaries
• Skin complications
• Dementia
• Respiratory disease
• Osteoarthritis (The risk increases by 35% for every 5kg of weight. Obese individuals are 14 x more likely to have this (Grotle et al. 2008) 
• Lower back pain 
• Sleep apnoea
• Stress incontinence
• Varicose veins
• Hernia
• Oedema
• Depression

Obesity not only affects our bodies but also our society.

• It is the fifth leading risk for global deaths
• 2.8 million adults die each year from these conditions and it’s associated comorbidities
• 44% of diabetes type 2, 23% of coronary heart disease and 41% of cancers can be attributed to obesity (WHO, 2013)
• More than half of the adult UK population are overweight and one-third of people between 55 and 74 years old are classed as obese (NHS, 2012)
• In 2012, an estimated 62% of adults (aged 16 years and over) were overweight or obese in England (BMI>25), 24.7% were obese (BMI>30) and 24% were severely obese (BMI>40). (PHE, 2014)
• Adult obesity increased from 13% of men in 1993 to 24% in 2012 and from 16% of women in 1993 to 25% in 2012. (PHE, 2014)
• According to a four-year study concluded in 2013 from the Health & Social Care Information Centre (HSCIC) nearly 1 in 4 adults are obese
• The 2009 Health Survey for England (HSE) found that 1 in 6 children aged 2-10 are obese
• The 2007 Foresight report, Tackling Obesities: Future Choices predicted that if no action was taken 60% of men, 50% of women and 25% of children will be obese by 2050
• Obesity has a severe impact on the health of individuals both physiologically and psychologically, with the risk of complications from secondary conditions a major concern
• Direct costs caused by obesity were estimated to be £15.8 billion in 2007 with a cost of £4.2 billion to the NHS. Predictions suggest this figure could rise to £27 billion in 2015 and forecast to more than double to £50 billion by 2050 if we carry on as we are (Foresight Report, 2007)
• Heart and circulatory disease costs the economy £18.9 billion every year (BHF, 2013)

Use the online BMI calculator to check your BMI