
The evolving landscape of obesity: a journey to disease acceptance
The World Obesity Federation starts ‘World Obesity Day’, to provide a global platform for raising awareness, promoting research, and advocating for those impacted by obesity.
Despite progress in long-term weight management options, 51% of people are expected to be living with obesity or overweight by 2035. To effectively address obesity, long-term weight management strategies must work hand in hand with obesity prevention and early intervention strategies. However, several barriers to prevention and early intervention exist. This article explores the difference between obesity prevention and intervention, the unique barriers they face and most importantly, how can we overcome these barriers to turn the tide on obesity?
Obesity is associated with an increased risk of many diseases and health problems such as heart disease, type 2 diabetes and certain types of cancer.
The aim of prevention is to stop obesity and its related health risks from developing in the first place. Obesity prevention strategies can be particularly effective when introduced before the development of obesity. Action at this stage is important because living with obesity can generally increase the risk of developing obesity-related health complications.
The aim of early intervention is to reduce the long-term health impact of obesity in those already living with the disease. Early intervention strategies can be particularly effective when introduced in people living with obesity without complications. Action at this stage is important because obesity-related health complications can become long-term and more severe as obesity persists.
Let’s use the link between obesity and heart health as an example to show the difference between prevention and early intervention strategies.
Obesity prevention strategies in those not yet diagnosed in people living with obesity without health complications can help reduce the risk of developing heart disease risk-factors, such as high blood pressure.
Early intervention strategies in those already living with an increased risk of heart disease can help reduce the long-term impact of obesity on the heart, such as heart attack or stroke.
Barriers to obesity prevention exist at an individual, healthcare and government level. Although factors differ from level to level, they tend to fall under 3 key themes: education, cost and environment.
Barrier | Individual | Healthcare professional | Government |
Education | Lack of recognition of obesity as a chronic and relapsing disease | Insufficient training and counselling skills in obesity | Lack of awareness around the seriousness of obesity as a disease, its rising prevalence, and the urgent need for action |
Cost | Difficulty affording a range of nutritious food options and costs related to physical activity e.g. memberships | In some countries, doctors’ appointments or prescriptions can be too expensive | Lack of funding for healthier (low fat, low sugar, unprocessed) food options and exercise |
Environment | Lack of time after work | Insufficient time to provide holistic support during time-limited appointments | Lack of green spaces |
Another key barrier to obesity prevention is the lack of clinical trials that examine the effectiveness of obesity prevention. This makes building successful obesity prevention strategies more challenging.
A key barrier to early intervention is how obesity can be surprisingly hard to recognise without objective assessments. This challenge is made more difficult by the average BMI for populations in many countries now being within the ‘overweight’ range. As a result, healthcare professionals and the general public may not recognise the need for early interventions until it’s too late. This highlights the importance of understanding and using measurements other than BMI to diagnose obesity, such as the Waist-to-Height Ratio or Waist-to-Hip Ratio.
Obesity prevention can be accomplished at an individual- and population-level. Due to the increasing prevalence of obesity, prevention strategies that target entire populations may be more effective than those focused on individuals.
Population-level strategies | Individual-level strategies |
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However, personalised strategies to prevent obesity on an individual basis are also important. Obesity is a complex disease, caused by many factors which differ from person to person. Although poor nutrition and a lack of adequate physical activity are widely known as causes of obesity, there are many lesser-known factors at play. For example, poor sleep could cause increased dietary intake, or depression could lead to decreased physical activity. This highlights the importance of working with a healthcare professional that understands your individual needs to find a weight management approach that works best for you.
Early intervention can be accomplished by early detection and managing obesity as soon as possible in order to slow its progression. This can be achieved through regular screening and using measurements of obesity in addition to BMI, such as the Waist-to-Height Ratio or Waist-to-Hip Ratio. Regular assessments by healthcare professionals can also help to identify patterns and factors contributing to weight gain early.
Obesity prevention and early intervention are key steps in helping to reduce the global burden of obesity, yet both remain underused due to a range of barriers at every level. By recognising the difference between obesity prevention and early intervention, and tailoring strategies accordingly, we can act earlier and more effectively. Together, tackling obesity through prevention, detection and long-term weight management strategies could be the most effective way to reduce the global burden of obesity.
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