Obesity: A Chronic Health Reality

The misconception that obesity is a lifestyle choice that can be reversed by willpower has been fixed in the minds of the general public for a long time. But in the last decade, the conclusion has emerged that obesity is not just a risk factor for diseases like type 2 diabetes, but is a disease in itself.

Manuela Băbuș
Medical Writer
Obesity: A Chronic Health Reality
source: source: Freepik

Obesity was first listed in the International Classification of Diseases in 1948.

According to the World Health Organization (WHO), the number of obese people has tripled in the last 20 years, the main reasons being bad eating habits and a sedentary lifestyle. Currently, more than 1.9 billion adults are overweight and more than 600 million are obese. Obesity is not just a weight issue; it's a chronic disease with deep-rooted causes and far-reaching consequences. It's a health crisis that demands attention and understanding.

What is Obesity?

Obesity is a medical condition characterised by an excessive accumulation of body fat. It's typically measured using the Body Mass Index (BMI), where a BMI of 30 or above indicates obesity. However, BMI is not a perfect tool. It doesn't differentiate between muscle and fat, or consider fat distribution.

The Causes of Obesity

Genetic factors play an important role in the appearance of obesity and are considered to be responsible for 40-70% of obesity cases. But also non-genetic factors, such as unhealthy eating habits and lack of physical activity, play an essential role in the generation of obesity. 

The number of calories consumed, the type of diet, the frequency and timing of meals have an important impact on the development of obesity and related metabolic disorders. In addition, the duration and quality of sleep influence excess weight.

  • Genetic Predisposition: Genetics can influence body weight by affecting metabolism, fat storage, and hormone regulation. However, it's not destiny; lifestyle choices play a crucial role too.
  • Lifestyle Choices: Diet and physical activity are pivotal. High-calorie, low-nutrient foods and sedentary lifestyles contribute significantly to obesity.
  • Environmental Factors: Socioeconomic status, access to healthy foods, and safe environments for physical activity can impact weight.

Psychological Factors: Emotional well-being is crucial. Stress, anxiety, and other emotional issues can lead to overeating as a coping mechanism.

Diagnosing Obesity -The Role of Body Mass Index (BMI)

BMI is a widely used method for diagnosing obesity. It's calculated by dividing a person's weight in kilograms by the square of their height in metres. The resulting categories are:

  • Underweight: BMI less than 18.5
  • Normal weight: BMI 18.5 to <25
  • Overweight: BMI 25 to <30
  • Obesity: BMI 30 or higher

Limitations of BMI

While BMI is a useful screening tool, it has limitations:

  • Does Not Measure Body Fat Directly: BMI doesn't differentiate between muscle and fat mass.
  • Does Not Account for Fat Distribution: Fat distribution, like abdominal fat, can be a better indicator of health risks than BMI alone.

The Significance of Abdominal Fat

Abdominal obesity is characterised by the accumulation of excess fat around the stomach and abdomen. Unlike subcutaneous fat, which is located just under the skin, abdominal fat includes visceral fat, which is found deeper in the abdomen, surrounding internal organs. This visceral fat is particularly concerning because of its association with numerous health risks.

Abdominal obesity, commonly referred to as "belly fat," is a significant health concern that goes beyond aesthetic considerations, posing serious risks to overall health. This type of obesity is not just about carrying extra weight; it's specifically about where this weight is located and how it impacts the body's normal functioning.

Risks Associated with Abdominal Obesity

The presence of excess abdominal fat is linked to a range of serious health issues, including: Heart Disease, Type 2 Diabetes, Metabolic Syndrome, Certain Cancers, Sleep Apnea.

Abdominal obesity is strongly linked to cardiovascular diseases, such as heart attacks and strokes, due to its association with high cholesterol, high blood pressure, and insulin resistance. 

People with abdominal obesity are at a higher risk of developing type 2 diabetes, as visceral fat affects the body's ability to use insulin effectively.

Abdominal obesity is also a key component of metabolic syndrome. This is a cluster of conditions that occur together (abdominal obesity, dyslipidemia, hypertension), increasing the risk of heart disease, stroke, and type 2 diabetes. 

Excess belly fat has been linked to an increased risk of certain cancers, including breast and colon cancer.

The Link Between Sleep Apnea and Obesity

Obesity is one of the primary risk factors for the development of obstructive sleep apnea. Excess body weight, particularly around the neck, can compress the upper airway, especially when lying down, leading to obstructed breathing.

Increased Abdominal Fat can reduce lung capacity and increase the likelihood of airway collapse during sleep.

source: freepik

Measuring Abdominal Obesity

One of the simplest ways to determine abdominal obesity is by measuring waist circumference. This measurement is a more accurate indicator of health risks than Body Mass Index (BMI) alone, as it specifically targets abdominal fat.

Normal Waist Circumference Values

  • For men, a waist circumference below 94cm (37in) is ‘low risk’, 94–102 cm (37-40in) is ‘high risk’ and more than 102cm (40in) is ‘very high’. 
  • For women, below 80cm (31.5in) is low risk, 80–88cm (31.5-34.6in) is high risk and more than 88cm (34.6in) is very high. 

These are the guidelines for people of white European, black African, Middle Eastern and mixed origin.

Managing Obesity

Managing obesity involves a combination of lifestyle changes:

Dietary Adjustments: Adopting a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats can help reduce abdominal fat. It's also important to limit the intake of processed foods, sugary beverages, and high-fat items. 

The Dietary Approaches to Stop Hypertension (DASH) Eating Plan is an excellent guide. It emphasises:

  • Limiting Foods High in Saturated Fat: Choosing lean meats and dairy alternatives.
  • Reducing Sugar-Sweetened Beverages and Sweets: Opting for water or unsweetened beverages.
  • Cutting Down on Sodium: Choosing fresh, unprocessed foods.

Regular Physical Activity: Engaging in regular physical activity, including both aerobic exercises like walking, running, and swimming, and strength training, can significantly reduce abdominal fat.

Stress Management: Chronic stress can contribute to abdominal obesity by triggering the release of cortisol, a hormone that can promote fat storage in the abdominal area. Techniques such as meditation, yoga, and deep breathing can be effective in managing stress.


Obesity is a pathological growth of adipose tissue, which increases the risk of cardiovascular disease, some types of cancer and type 2 diabetes. 

Complications resulting from overweight and obesity represent the fifth most common cause of death worldwide. 

Obesity is a serious health concern that requires attention and action. By understanding its risks and implementing lifestyle changes focused on diet, exercise, and stress management, individuals can significantly reduce their waist circumference and associated health risks. 

Regular monitoring of waist circumference can serve as a motivational tool and a way to track progress in managing abdominal obesity.

Disclaimer: This article provides general information and should not replace individualised medical advice. If you have concerns about your health, consult with a healthcare professional.

Talk to your doctor to determine an appropriate diet, physical activity level or medications for your specific condition!

Article Citations & Bibliography
  1. https://www.nhlbi.nih.gov/health/overweight-and-obesity, accessed on February 11th 2024
  2. Nutrition in the prevention and treatment of abdominal Obesity, https://www.sciencedirect.com/book/9780128160930/nutrition-in-the-prevention-and-treatment-of-abdominal-obesity 
  3. Burki T. European Commission classifies obesity as a chronic disease. Lancet Diabetes Endocrinol. (2021) 9(7):418. doi: 10.1016/S2213-8587(21)00145-5
  4. Chait A, den Hartigh LJ. Adipose tissue distribution, inflammation and its metabolic consequences, including diabetes and cardiovascular disease. Front Cardiovasc Med. (2020) 7:22. doi: 10.3389/fcvm.2020.00022 
  5. Goodarzi, M.O. Genetics of obesity: What genetic association studies have taught us about the biology of obesity and its complications. Lancet Diabetes Endocrinol. 2018, 6, 223–236. 
  6. Agodi, A.; Maugeri, A.; Kunzova, S.; Sochor, O.; Bauerova, H.; Kiacova, N.; Barchitta, M.; Vinciguerra, M. Association of Dietary Patterns with Metabolic Syndrome: Results from the Kardiovize Brno 2030 Study. Nutrients 2018, 10, 898. 
  7. https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/measuring-your-waist, accesed on February 11th 2024

Please note that the information provided on this blog is for educational and informational purposes only. It is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.

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Manuela Băbuș.
Medical Writer