1. Polycystic Ovarian Syndrome (PCOS)

2. Obesity

3. Mental health conditions

4. Early onset of menstruation

5. Early menopause

6. Endometriosis

7. Infertility

8. Metabolic disorders

The way forward: A collective effort for ‘Women’s Health’

Dr. Sudeshna Ray , Additional Director, Obstetrics & Gynaecology- Jaslok Hospital & Research Centre

Lifestyle-related health issues among women are on the rise, driven by factors such as a sedentary lifestyle, irregular meal timings, unmindful junk food consumption, and, most importantly, stress. As the world grows more complex, so do health concerns, particularly for women, whose well-being is intricately linked to hormonal balance, menstrual health, mental health, and fertility.Let’s explore some of the key lifestyle-related health concerns affecting women today:PCOS is the most common hormonal disorder in women, characterized by irregular menstrual cycles (missed or frequent periods), excessive facial and body hair, scalp hair loss, and unexplained weight gain or difficulty in losing weight. While genetic predisposition plays a role, lifestyle factors such as unhealthy eating habits, physical inactivity, and poor sleep patterns can exacerbate PCOS symptoms.Obesity is a growing concern among urban women due to a lack of exercise, poor dietary habits, and late sleeping hours. Irregular meal timings and an unbalanced diet further contribute to weight gain. While genetics influence body weight, adopting a healthy lifestyle from an early age can help regulate genetic expression and prevent obesity-related complications.Anxiety, overthinking, fear, and depression are common mental health concerns among women. Stress is a major contributing factor, but other influences, such as body image issues, low self-confidence, fatigue, and hormonal imbalances, also play a role. Addressing mental well-being is crucial for overall health.In recent years, the average age of menarche (the onset of menstruation) has shifted from 11–13 years to as early as 9–11 years. This trend is linked to decreased physical activity and unhealthy eating habits, highlighting the role of lifestyle in early puberty.A woman’s menopausal age is largely influenced by her mother’s menopausal history. However, modern lifestyles are causing many women to experience menopause in their early 40s, regardless of family history. Studies suggest that chronic stress and unhealthy living conditions contribute to this early transition.Endometriosis affects approximately 1 in 10 women worldwide. It causes severe period pain, painful intercourse, bloating, digestive issues, irregular bleeding, and heavy menstrual flow, significantly impacting a woman’s quality of life. While endometriosis is not directly caused by lifestyle factors, lifestyle modifications—such as a balanced diet, regular exercise, and stress management—play a crucial role in its management.Infertility is defined as the inability of a couple to conceive after actively trying for six months to a year. Both male and female factors contribute to infertility, with environmental and lifestyle influences playing a significant role. Even when fertility treatments are required, maintaining a healthy lifestyle improves the chances of success.Women are increasingly susceptible to metabolic conditions such as diabetes, high blood pressure, coronary artery disease, and cholesterol imbalances. These issues are linked to lifestyle choices from adolescence onward. Factors such as family history, PCOS, early menopause, sedentary habits, and addictions increase the risk of developing metabolic disorders.The solution to lifestyle-related health concerns among women can be summed up in two words: healthy lifestyle. However, implementing this is easier said than done. It cannot be an individual effort alone; it requires a collective approach involving families, educational institutions, workplaces, and government policies.Every small step taken toward promoting a healthier lifestyle will contribute to improving women’s overall well-being. Investing in women’s health today ensures a healthier nation tomorrow.

Obesity Should obesity be treated as a disease? (more)

Obesity Should Obesity Be Treated as a Disease? Ask the Chatbot a Question Ask the Chatbot a Question

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Obesity is the “abnormal or excessive fat accumulation that presents a risk to health. Obesity has long caused debate, from historical views that obesity was a result of the greed and sloth of the rich to the “fat acceptance” or “body positivity” movement that began in the 1960s to promote the idea that fatness should be accepted and celebrated by society. [1][2][5][6][7]

Obesity Defined as a Disease By 2013, most major health organizations and agencies had defined obesity as a disease, including American Academy of Family Physicians, American College of Cardiology, American College of Gastroenterology, American Heart Association, American Medical Association (AMA), Food and Drug Administration (FDA), National Institutes of Health (NIH), and Obesity Society. Even the Internal Revenue Service (IRS) allows Americans who are medically diagnosed as obese to claim tax deductions for doctor-prescribed treatments. [16][17][18] [19][20][21][22][23] However, as recently as January 2025, the definition of obesity as a disease was not put into practice widely. An international commission of 58 experts by the The Lancet Diabetes & Endocrinology journal found Despite evidence that some people with excess adiposity have ill health due to obesity, obesity is generally considered a harbinger of other diseases, not a disease in itself. The idea of obesity as a disease remains therefore highly controversial. In addition, current BMI-based measures of obesity can both underestimate and overestimate adiposity and provide inadequate information about health at the individual level. [54][55] Few observers now doubt that obesity is a global epidemic. The question more frequently debated is whether obesity should be treated as a disease. Is treating obesity as a “disease” a good thing for the patient? A good thing for society? And the best way to address this global epidemic?

Pros and Cons at a Glance PROS CONS Pro 1: Obesity is medically defined as a disease. Read More. Con 1: Medicalizing obesity discourages people from taking responsibility for unhealthy choices. Read More. Pro 2: Obesity is a disease that increases the risk for other diseases. Read More. Con 2: Obesity alone is not an indicator of ill health. Read More. Pro 3: Treating obesity as a disease has social value by lowering the stigma associated with being “fat.” Read More. Con 3: Treating obesity as a disease irresponsibly glorifies unhealthiness. Read More.

Pro Arguments (Go to Con Arguments) Pro 1: Obesity is medically defined as a disease. The FDA, the American Medical Association (AMA), the National Institutes of Health (NIH), American Heart Association, American College of Cardiology, the Obesity Society, the World Health Organization (WHO), the American College of Gastroenterology, the American Academy of Family Physicians (AAFP), and other medical organizations have all defined obesity as a disease. [16][17][18][19][20] [21][22][23] “Individuals with obesity have an increased accumulation of fat not always attributable to eating too many calories or lacking physical activity. They experience impaired metabolic pathways along with disordered signaling for hunger, satiety (the feeling of fullness), and fullness (the state of fullness),” according to the Obesity Medicine Association. “For many, efforts to lose weight are met with unyielding resistance or disappointing weight regain…. [In fact,] 90% of people who lose weight will regain most of it.” [24] Some 42% of Americans, according to the WHO, suffer from obesity, and yet only 4% of people with the disease seek treatment. Treating obesity as a disease like cancer or diabetes would increase recourse to needed medical treatment. [25] Further, “the rise of new obesity medicines … helps to frame it more as a disease. The general public tends to think of a disease as having a corresponding medication to treat it. As more patients come in asking about these medications, it can help to explain to them that this disease warrants a multi-pillared approach, which can mean addressing lifestyle factors too,” according to the Obesity Medicine Association. [24] “We need to accept that obesity is a disease. And since it’s a chronic disease, every person with obesity has to be diagnosed, and in each case a treatment needs to be defined. This is the future,” says Daniel Weghuber of the Paracelsus Medical University in Salzburg. [26] Pro 2: Obesity is a disease that increases the risk for other diseases. “Obesity is an inflammatory disease in which adipose tissue, or fat cells, release toxins known as cytokines into the bloodstream. These toxins can damage critical organs, contributing to conditions like fatty liver disease, diabetes and heart disease,” according to Christopher C. Thompson, a Harvard professor of medicine. Obesity is linked to 30-53% of new diabetes cases in the U.S. every year, reports the Journal of the American Heart Association. [10][29] Obesity also increases the risk for around 200 other diseases, including arthritis, asthma, cancer, gallstones and gallbladder disease, high blood pressure, high cholesterol, osteoarthritis, and sleep apnea. Obesity triples the likelihood that COVID-19 will be severe. Mental illnesses including anxiety and depression are also linked to obesity, and obesity was a factor in almost 12% of American deaths in 2019 (the most recent data available). [26][27] Approaching obesity as a disease that deserves treatment can lower the risk of other diseases. New prescription weight-loss drugs, such as Ozempic, Wegovy, and Zepbound, effectively treat obesity, thus lowering the risk of and damage done by other diseases. [28] Doctors and researchers are also finding that patients are more compliant in taking new drugs specifically targeting weight, unlike single-use drugs like statins targeted to reduce cholesterol. Further, the drugs are showing promise in treating related diseases like arthritis, fatty liver disease, high cholesterol, high blood pressure, kidney disease, and sleep apnea. [28] By treating obesity like the disease it is, patients can benefit from better health care, better health, and fewer related diseases, which can improve quality of life and lengthen their lifespans. Pro 3: Treating obesity as a disease has social value by lowering the stigma associated with being “fat.” “The societal stigma of being seen as ‘fat’ is a paralyzing barrier. So many still view obesity as a character flaw, or the result of someone not having enough willpower or being lazy. As best-selling author and social researcher Brene Brown explains, ‘shame is the most powerful, master emotion.’ Shame is killing people,” explains Christopher C. Thompson, a Harvard professor of medicine. [29] The idea that a person’s caloric consumption and physical activity are solely responsible for their weight is outdated and incorrect. Further, the idea that weight-loss management drugs and other interventions are “vanity medication” or “the easy way out,” is “rooted in weight bias and the principle that people with obesity are solely responsible for reversing their condition,” says William H. Dietz of George Washington University. [30] Dietz continues, “imagine, for any other chronic disease, foregoing medications that could spare a patient the risks and complications of major surgery, increase mobility, improve mental health, ease physical pain and financial burden, and begin to relieve the harms of that disease –all due to a bias that isn’t supported by the research or medical literature, but is held at every level of society.” [30] Treating obesity as a disease gives more patients access to interventions. As family doctor Mara Gordon explains, drugs like Ozempic may help “if you’re facing hatred and fatphobia on a daily basis, if you can’t do the things you need to do because the chair at your office isn’t the correct size…. I wish we lived in a less superficial society. But my job is to take care of the patient right in front of me.” [31] Treating obesity medically can not only help the patient but help minimize the stigma associated with being overweight.

Con Arguments (Go to Pro Arguments) Con 1: Medicalizing obesity discourages people from taking responsibility for unhealthy choices. Our increasingly sedentary lifestyles have contributed greatly to the obesity epidemic, and treating obesity as a disease – as something out of our control – simply encourages many patients to ignore responsibility for choices contributing to their ill-health. Clearly, now that much of our work, school, and interpersonal relationships have gone digital, we have a reduced societal need to move our bodies. Unsurprisingly, a study found “a causal relationship” between four sedentary behaviors – leisure screen time, watching TV, computer use, and driving – and obesity. [32][33] A correlation between digital gaming addiction, decreased physical activity, and obesity has also been found. As the study’s authors noted, “regular physical activity should be encouraged, digital gaming hours can be limited to maintain ideal weight. Furthermore, adolescents should be encouraged to engage in physical activity to reduce digital game addiction.” [34] Similar results, revealing a positive correlation between digital addiction and obesity among college students, was confirmed by a separate study. And yet another study found a correlation between Internet addiction, obesity, and sleep disorders in children aged 7-10. [35][36] Treating obesity as a disease often back-fires. Obesity treatments and drugs are expensive and not covered by some insurances; their long-term effects are not known, and stopping the drugs can have immediate consequences including regaining the lost weight. Common-sense changes like increasing physical activity, monitoring our choices, and improving access to healthier food options can go a long way toward improving health, regardless of weight. [37] Con 2: Obesity alone is not an indicator of ill health. “We can be obese but remain healthy,” says Ruth Loos, an epidemiologist who studies the genetics of obesity at the University of Copenhagen. [38] Automatically treating obesity as a disease can mean both over- and under-diagnosing patients. As physiologist Lindo Bacon explains, “it’s very clear that there are a lot of people in that category called obese [who] don’t have any signs of disease and live long, healthy lives.” Without ill-health, obesity doesn’t necessarily need to be treated. [38] Bacon recounts “my father and I both went to orthopedic surgeons because we were having bad knee pain…. My father went to his death with knee problems” because he was diagnosed as obese and only told to lose weight rather than receiving treatment for knee pain. Bacon’s father “could have benefited from stretching, strengthening, [and] knee surgery. He didn’t get that.” Lindo Bacon, however, was of “normal” weight and thus offered surgery to correct the knee problems. [38] When there is ill-health, obesity is frequently only the side-effect of another disease or medical condition that should be treated. In these cases, treating obesity as the primary problem could result in doctors missing underlying problems like arthritis causing decreased mobility and exercise or polycystic ovary syndrome (PCOS) causing hormonal imbalances. Automatically treating obesity as a disease can mean treatments capable of relieving pain and helping patients get frequently overlooked and under-considered. [38][39] Con 3: Treating obesity as a disease irresponsibly glorifies unhealthiness. Treating obesity as a disease has had unintended consequences. Not only have people been discouraged from thinking about how their lifestyles may be unhealthy, but obesity and unhealthiness have now been glorified. The “fat acceptance” movement has encouraged people, especially kids and teens, to be pleased with their weight no matter what, which is “toxic positivity.” The movement has encouraged people to suppress negative emotions about weight and to pretend to be happy with extra pounds and the related physical and mental health issues. “Toxic positivity is toxic! To deny and avoid acknowledging and expressing our authentic negative emotions, including fear, disappointment, anger, betrayal, etc. keeps us in a world of illusion and fantasy and inevitably harms our physical, emotional, and mental wellbeing,” explains therapist Beatty Cohan. [41] “No one should be subject to ridicule or teasing because of her weight,” says journalist Danielle Crittenden. “But it’s one thing to be compassionate, [and] quite another to glamorize what amounts to a dangerous health epidemic. In many ways, the current campaign to endorse female heaviness reminds me of the old smoking advertisements. Even as evidence accumulated that smoking could cause cancer and other diseases, tobacco companies continued to push their products as tickets to coolness, sophistication, and even a great way to get sex. Then, as now, they were not beneath marketing to children.” [42] Journalist Lizzie Cernik agrees, saying, “suggesting that being a size 30 is just as healthy as being a size 12 isn’t a body-positive message either – it’s an irresponsible form of denial.” [43] Treating obesity as a disease out of an individual’s control and the body-positivity efforts have not yielded good results. Rates of mental and physical health issues related to obesity have not decreased. [40] Overweight and obese people deserve good healthcare, but that healthcare will not be sought without honest assessments of their true medical condition and how it arose.

U.S. Obesity Levels by State Obesity is usually determined by BMI (body mass index) measurements. Someone with a BMI of 30 or more is considered obese. According to the State of Childhood Obesity, adult obesity rates exceeded 35% in 17 states in 2022, the most recent data available. Between 2021 and 2022, adult obesity rates rose in 21 states and fell in none. 2022 Rank % of Population That Was Obese in 2022 State % Change from 1990 to 2022 % of Population That Was Obese in 1990 1990 Rank State of Childhood Obesity, “Adult,” stateofchildhoodobesity.org, 2023 1 41.60% West Virginia 204% 13.70% 4 2 38.70% Kentucky 205% 12.70% 9 3 38.40% Oklahoma 273% 10.30% 31 4 38.00% Wisconsin 222% 11.80% 14 5 37.60% Louisiana 206% 12.30% 10 6 37.20% Ohio 229% 11.30% 17 7 37.00% Mississippi 147% 15.00% 1 7 37.00% North Dakota 219% 11.60% 15 9 36.60% Indiana 175% 13.30% 6 9 36.60% South Dakota 242% 10.70% 26 11 35.80% Alabama 220% 11.20% 21 11 35.80% Iowa 193% 12.20% 11 13 35.30% Arkansas n/a n/a n/a 13 35.30% Delaware 145% 14.40% 2 15 35.20% Missouri 212% 11.30% 17 15 35.20% Nebraska 212% 11.30% 17 17 35.10% Tennessee 216% 11.10% 23 18 34.70% Kansas n/a n/a n/a 19 34.60% Minnesota 236% 10.30% 31 20 34.40% Texas 221% 10.70% 26 21 34.20% Virginia 203% 11.30% 17 21 34.20% Wyoming n/a n/a n/a 23 34.10% Georgia 238% 10.10% 33 24 33.40% Michigan 153% 13.20% 8 24 33.40% Idaho 259% 9.30% 3 26 32.80% South Carolina 173% 12.00% 13 27 32.70% Arizona 208% 10.60% 29 28 32.60% Maine 199% 10.90% 24 29 32.40% New Mexico 300% 8.10% 44 29 32.40% Florida 184% 11.40% 16 31 32.40% Pennsylvania 136% 13.70% 4 32 32.10% North Carolina 141% 13.30% 6 33 31.90% Nevada n/a n/a n/a 34 31.70% Utah 252% 9.00% 41 35 31.60% Washington 213% 10.10% 33 36 31.50% Maryland 192% 10.80% 25 37 31.20% Alaska n/a n/a n/a 38 31.00% Illinois 156% 12.10% 12 39 30.70% New Jersey n/a n/a n/a 40 30.50% Oregon 172% 11.20% 21 41 30.40% Connecticut 192% 10.40% 30 42 30.30% Montana 261% 8.40% 43 43 30.20% New Hampshire 205% 9.90% 37 44 29.90% New York 222% 9.30% 39 45 29.80% Rhode Island 195% 10.10% 33 46 28.40% California 187% 9.90% 37 47 28.00% Massachusetts 177% 10.10% 33 48 27.10% Hawaii 204% 8.90% 42 49 26.00% Vermont 143% 10.70% 26 50 24.90% Colorado 261% 6.90% 45 51 21.50% DC 49% 14.40% 2

Global Obesity Levels The United States territory American Samoa was the most obese jurisdiction in the world with obesity affecting 75.21% of the adult population in 2022, according to the most recent data available from the World Health Organization (WHO). Vietnam is the least obese country with 2.02% of the adult population classified as obese. Global Rank Country % of Adult Population That Is Obese 1 American Samoa 75.21 2 Tonga 71.65 3 Nauru 69.92 4 Tokelau 69.82 5 Cook Islands 68.92 6 Niue 66.58 7 Tuvalu 64.2 8 Samoa 62.43 9 French Polynesia 48.09 10 Bahamas 47.26 11 Micronesia (Federated States of) 47.1 12 Kiribati 46.3 13 Marshall Islands 45.9 14 Saint Kitts and Nevis 45.64 15 Egypt 44.27 16 Qatar 43.14 17 Belize 42.32 18 United States of America 41.99 19 Kuwait 41.42 20 Palau 41.14 21 Puerto Rico 41.13 22 Saudi Arabia 40.6 23 Iraq 40.49 24 Chile 38.91 25 Jordan 38.51 26 Barbados 38.02 27 occupied Palestinian territory, including east Jerusalem 37.56 28 Libya 36.71 29 Bahrain 36.13 30 Panama 36.07 31 Mexico 36.03 32 Argentina 35.36 33 Georgia 34.66 34 Romania 34.04 35 Syrian Arab Republic 33.94 36 Fiji 33.84 37 Jamaica 33.81 38 Nicaragua 33.63 39 New Zealand 33.62 40 Saint Lucia 33.47 41 Uruguay 33.34 42 Türkiye 33.3 43 Antigua and Barbuda 33.25 44 Saint Vincent and the Grenadines 33.25 45 Bermuda 32.99 46 Paraguay 32.96 47 Malta 32.29 48 United Arab Emirates 32.08 49 Brunei Darussalam 31.71 50 Hungary 31.7 51 Costa Rica 31.39 52 Dominica 31.34 53 Oman 31.1 54 El Salvador 30.88 55 South Africa 30.82 56 Croatia 30.62 57 Grenada 30.25 58 Australia 30.24 59 Eswatini 30.09 60 Uzbekistan 30.03 61 Lebanon 29.78 62 Honduras 29.49 63 Seychelles 29.36 64 Dominican Republic 29.34 65 Suriname 29.02 66 Bolivia (Plurinational State of) 28.68 67 Guyana 28.46 68 Ireland 28.35 69 Brazil 28.14 70 Trinidad and Tobago 28.05 71 Greece 27.98 72 North Macedonia 27.54 73 Poland 27.5 74 Ecuador 27.38 75 Peru 27.29 76 Greenland 27.04 77 Tunisia 26.83 78 Slovakia 26.82 79 United Kingdom of Great Britain and Northern Ireland 26.82 80 Guatemala 26.81 81 Kyrgyzstan 26.6 82 Azerbaijan 26.55 83 Canada 26.23 84 Czechia 25.98 85 Lithuania 25.36 86 Armenia 24.51 87 Iran (Islamic Republic of) 24.27 88 Latvia 24.27 89 Russian Federation 24.19 90 Mongolia 24.11 91 Algeria 23.81 92 Tajikistan 23.79 93 Ukraine 23.63 94 Colombia 23.62 95 Albania 23.36 96 Pakistan 23.01 97 Republic of Moldova 22.97 98 Cyprus 22.94 99 Venezuela (Bolivarian Republic of) 22.72 100 Mauritania 22.69 101 Solomon Islands 22.6 102 Serbia 22.51 103 Israel 22.49 104 Estonia 22.16 105 Malaysia 22.1 106 Portugal 21.79 107 Morocco 21.78 108 Cuba 21.76 109 Finland 21.51 110 Turkmenistan 21.4 111 Belarus 21.37 112 Vanuatu 21.28 113 Iceland 21.23 114 Bosnia and Herzegovina 21.19 115 Gabon 21.02 116 Lesotho 21 117 Bulgaria 20.59 118 Papua New Guinea 20.52 119 Germany 20.4 120 Belgium 20.03 121 Slovenia 19.44 122 Mauritius 19.23 123 Afghanistan 19.22 124 Norway 19.15 125 Luxembourg 18.43 126 Kazakhstan 18.38 127 Botswana 18.29 128 Andorra 18.1 129 Montenegro 18 130 Equatorial Guinea 17.67 131 Maldives 17.3 132 Italy 17.29 133 Liberia 17.01 134 Sudan 17.01 135 Namibia 16.97 136 Sao Tome and Principe 16.46 137 Comoros 16.28 138 Cabo Verde 15.77 139 Spain 15.67 140 Thailand 15.38 141 Austria 15.37 142 Sweden 15.27 143 Gambia 14.93 144 Cameroon 14.88 145 Somalia 14.61 146 Netherlands (Kingdom of the) 14.54 147 Zimbabwe 14.21 148 Singapore 13.88 149 Yemen 13.65 150 Denmark 13.28 151 Ghana 12.93 152 United Republic of Tanzania 12.58 153 Kenya 12.41 154 Nigeria 12.36 155 Bhutan 12.18 156 Switzerland 12.11 157 Cote d’Ivoire 11.64 158 Togo 11.56 159 Angola 11.47 160 Guinea-Bissau 11.47 161 Mali 11.37 162 Djibouti 11.35 163 Indonesia 11.23 164 Benin 11.17 165 Zambia 11.08 166 Democratic People’s Republic of Korea 10.8 167 Haiti 10.69 168 Sri Lanka 10.56 169 Mozambique 10.26 170 Senegal 10.21 171 France 9.7 172 Guinea 9.53 173 Central African Republic 9.3 174 Philippines 8.74 175 South Sudan 8.6 176 Congo 8.54 177 China 8.28 178 Lao People’s Democratic Republic 8.01 179 Uganda 7.9 180 Malawi 7.74 181 Myanmar 7.43 182 Republic of Korea 7.33 183 India 7.27 184 Sierra Leone 7.13 185 Nepal 6.99 186 Burkina Faso 6.75 187 Chad 6.69 188 Democratic Republic of the Congo 6.64 189 Niger 5.97 190 Japan 5.54 191 Bangladesh 5.3 192 Burundi 5.02 193 Rwanda 4.92 194 Eritrea 4.83 195 Cambodia 4.36 196 Madagascar 4.26 197 Ethiopia 2.82 198 Timor-Leste 2.35 199 Vietnam 2.02

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Discussion Questions Should obesity be treated as a disease? Why or why not? Should obesity be treated with medication? Why or why not? How can we treat obesity socially? Consider transportation seat sizes, meal portions, and clothing size availability, among other factors that make navigating the world difficult for some. Explain your answer.C

Take Action Consider the pro position of the Obesity Society Explore the topic of obesity at the World Health Organization (WHO) website. Analyze the con position of Dr. D.L. Katz Consider how you felt about the issue before reading this article. After reading the pros and cons on this topic, has your thinking changed? If so, how? List two to three ways. If your thoughts have not changed, list two to three ways your better understanding of the “other side of the issue” now helps you better argue your position. Push for the position and policies you support by writing U.S. senators and representatives

Obesity has long been a topic of discussion. While it is often portrayed as a result of poor lifestyle choices, in recent years, it has increasingly been marketed as a medical condition that warrants pharmaceutical intervention. Recently, a front-page ad in a leading newspaper and on several billboards has raised several questions about obesity management and treatment. The advertorial promotes obesity as a disease and encourages individuals to resort to medical interventions. Several doctors and experts have expressed their concerns about this advertisement and highlighted how the weight loss market has changed the whole narrative surrounding obesity.

Rise of the weight loss market

With the launch of Mounjaro and Wegovy (weight loss drugs) in India, the biological and genetic components of obesity have gained evident recognition. The portrayal of obesity as solely a medical condition further overshadows the importance of preventive measures and lifestyle modifications. This marketing shift also raises questions about the commercialisation of health issues and the profit-driven motives of pharmaceutical giants.

Lifestyle modifications over weight loss drugs: The choice matters

The reliance on weight loss medications can fuel a misconception that obesity can be resolved without addressing the underlying lifestyle issues.

Obesity management is more than just shedding kilos. Obesity is a common risk factor for several serious health conditions like diabetes, heart disease, hypertension, fatty liver and others. Obesity management must focus on a diverse approach that improves overall health, reducing the risk of related conditions rather than depending on temporary fixes.

“Dependence on weight loss drugs is not the healthiest way to lose weight. Also, using weight loss drugs is not an easy approach as these medications are strictly available on prescription. There is a classical criterion, whether you have diabetes, arthritis or if your BMI is more than 30. ”

“These weight loss drugs are not a replacement for lifestyle choices. One should primarily focus on preventing obesity by restricting fat and sugar content and exercising regularly,” said Dr. Ashish Gautam, Senior Robotic, Bariatric, and Gastrointestinal Surgeon at Max Hospital.

On the other hand, Dr. Vaibhav Singhal, Consultant – Endocrinology at Max Hospital suggests that a combination of both might help. “Obesity can be genetic or a result of some health condition. A combination of both, weight loss medication nd healthy lifestyle choices might help achieve effective results, especially when diet and exercise become ineffective or when the BMI is severely high.”

“These drugs do have side effects like nausea, vomiting, and digestive issues but can be easily managed. Also, weight loss drugs should be coupled with diet and lifestyle modifications to shed weight and reduce the overall risk of diseases associated with obesity,” he added.

What are the healthiest ways to reverse obesity?

The classification of obesity can impact an individual’s approach to treatment. While using injectables for weight loss can seem appealing due to their convenience, they often come with risks and side effects. The foundation of effective weight management lies in adopting a balanced diet and healthy lifestyle choices.

1. Eat a well-balanced diet

A well-rounded diet rich in whole grains, lean proteins, healthy fats, fruits, and vegetables can not only promote weight loss but also nourish the body. Portion control, understanding serving sizes and mindful eating can help individuals become more aware of their eating habits.

2. Stay physically active

Engaging in regular exercise, whether through structured workouts or simply finding ways to be active throughout the day, can significantly aid weight loss efforts. Regular physical activity also improves mood and energy levels.

3. Behavioural changes

Small behavioural changes such as setting realistic goals, tracking progress, and seeking social support can maximise the effect of your weight loss efforts. Stress management also plays a key role in weight management.

4. Stay consistent

Weight loss does not happen overnight. Continuous efforts can make it easier to sustain habits that support weight loss over the long term.

Additionally, surgical options, such as bariatric surgery, can be effective for certain individuals, however, they do not replace the need for lifestyle changes that support overall well-being.

“Obesity reversal is possible with diet and lifestyle modifications. However, it is a very demanding task involving eating right and exercising regularly without fail. Also, it is important to achieve these results sustainably,” Dr. Gautam added.

Obesity is a complex condition which can be effectively addressed by focusing on nutritious eating, regular physical activity, and staying consistent. A holistic approach centred on healthy lifestyle choices can help individuals achieve sustainable results.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

The study used a model based on cardiac magnetic resonance imaging (MRI), and found that certain health conditions, such as obesit y and AFib, and leading an unhealthy lifestyle, can increase the functional age of the heart.

To do that, a recent study examined a way to calculate the functional age of people’s hearts compared to their biological age.

Evaluating how well the heart is doing and what changes have occurred can help doctors and people make informed decisions about heart health.

The final model researchers used considered left atrial end-systolic volume and left atrial ejection fraction, which both evaluate the function of the left upper chamber of the heart. These two factors were functional parameters significantly related to age among 169 healthy participants.

There were distinct heart differences between the healthy and unhealthy groups. For example, the unhealthy group had a higher median stroke volume , which involves how much blood the left ventricle is pumping out when it contracts.

Participants were from five different locations across three countries. Researchers were able to look at several components of heart structure and function. They then developed a model to help determine the age of participants’ hearts and also did statistical analyses.

Researchers used a healthy reference population of 191 participants and compared them to a testing population of 366 participants who had at least one comorbidity, such as high blood pressure, diabetes, or obesity. Researchers also used another group of 25 people as a “preliminary external validation” cohort.

Researchers of this retrospective observational study wanted to explore a way to measure the age of people’s hearts and what happens in healthy versus unhealthy aging. They note that certain modifiable risk factors, like high blood pressure, can speed up how fast the heart ages. One potential tool to look at how the heart looks and functions is cardiac magnetic resonance imaging.

“We have discovered an equation—a simple math formula—that uses movies from heart MRI scans to figure out how old your heart looks. For healthy folks, their heart age matches their real age. But if someone has [conditions] like high blood pressure, diabetes, a wonky heartbeat, or extra weight, their heart can look way older—about 4.6 years older on average. For people with a lot of extra weight, their hearts looked up to 45 years older!” — Pankaj Garg, MD, PhD

Similarly, diabetes increased functional heart age for participants between 30 and 69, with the greatest increase seen in the 40 to 49-year-old group. But in the seventy to 85-year-old group, participants with diabetes and high blood pressure actually had lower functional heart ages than healthy participants of the same age.

Functional heart age was sometimes higher for other comorbidities in certain age groups. In participants between the ages of 30 and 69, participants with high blood pressure had increased functional heart age compared to healthy participants who were in the same age category.

Obesity appeared to increase functional heart age, with more weight increasing heart years. Participants with a body mass index of 40 or higher had a functional heart age 45 years higher than their chronological age. For participants with atrial fibrillation, heart functional age was also higher than it was for healthy participants.

Researchers found that healthy participants’ heart ages were about the same as how old they were. Unhealthy participants saw heart ages higher than their chronological age. The cardiac magnetic resonance-derived heart ages were almost five years older than the chronological age of these participants.

This research is a great possible step towards more effective cardiac health monitoring, but it also has limitations. First, this work involved estimations and estimated the functional age of the heart. Second, since the study was not long-term, there’s a higher risk for survivor bias. This could then minimize how comorbidities truly affect older people. Thirdly, researchers did not measure how long participants had had the measured comorbidities. So, it’s possible that there was variety among unhealthy participants regarding how long they had comorbidity exposure. Bias is noted in some of the calculations. Researchers also noted the possibility of selection bias. This study did not assess certain factors like exercise and diet.

Researchers also acknowledge that there could have been variation in the unhealthy group because of medical treatments.

Researchers had certain exclusion and inclusion criteria in place, which impacted who they could include in the study. For example, they excluded people with severe chronic kidney disease, which is a contraindication for the MRI scans they used. Development of the age calculation model involved making a number of decisions, and researchers may find areas for refinement.

Patrick Kee, MD, PhD, a cardiologist at Vital Heart & Vein who was not involved in the study, noted several potential limitations of the study, including its inability to examine long-term data, lack of other measurements that could have been helpful, and use of a simple model that focused on left atrium end-diastolic volume and left atrium ejection fraction.

Long-term studies will likely be beneficial, as well as seeing how changing factors like lifestyle could help alter outcomes.

Key facts

In 2022, 1 in 8 people in the world were living with obesity.

Worldwide adult obesity has more than doubled since 1990, and adolescent obesity has quadrupled.

In 2022, 2.5 billion adults (18 years and older) were overweight. Of these, 890 million were living with obesity.

In 2022, 43% of adults aged 18 years and over were overweight and 16% were living with obesity.

In 2024, 35 million children under the age of 5 were overweight.

Over 390 million children and adolescents aged 5–19 years were overweight in 2022, including 160 million who were living with obesity.

Overview

Overweight is a condition of excessive fat deposits.

Obesity is a chronic complex disease defined by excessive fat deposits that can impair health. Obesity can lead to increased risk of type 2 diabetes and heart disease, it can affect bone health and reproduction, it increases the risk of certain cancers. Obesity influences the quality of living, such as sleeping or moving.

The diagnosis of overweight and obesity is made by measuring people’s weight and height and by calculating the body mass index (BMI): weight (kg)/height² (m²). The body mass index is a surrogate marker of fatness and additional measurements, such as the waist circumference, can help the diagnosis of obesity.

The BMI categories for defining obesity vary by age and gender in infants, children and adolescents.

Adults

For adults, WHO defines overweight and obesity as follows:

overweight is a BMI greater than or equal to 25; and

obesity is a BMI greater than or equal to 30.

For children, age needs to be considered when defining overweight and obesity.

Children under 5 years of age

For children under 5 years of age:

overweight is weight-for-height greater than 2 standard deviations above WHO Child Growth Standards median; and

obesity is weight-for-height greater than 3 standard deviations above the WHO Child Growth Standards median.

Charts and tables: WHO child growth standards for children aged under 5 years

Children aged between 5–19 years

Overweight and obesity are defined as follows for children aged between 5–19 years:

overweight is BMI-for-age greater than 1 standard deviation above the WHO Growth Reference median; and

obesity is greater than 2 standard deviations above the WHO Growth Reference median.

Charts and tables: WHO growth reference for children aged between 5–19 years

Facts about overweight and obesity

In 2022, 2.5 billion adults aged 18 years and older were overweight, including over 890 million adults who were living with obesity. This corresponds to 43% of adults aged 18 years and over (43% of men and 44% of women) who were overweight; an increase from 1990, when 25% of adults aged 18 years and over were overweight. Prevalence of overweight varied by region, from 31% in the WHO South-East Asia Region and the African Region to 67% in the Region of the Americas.

About 16% of adults aged 18 years and older worldwide were obese in 2022. The worldwide prevalence of obesity more than doubled between 1990 and 2022.

In 2024, an estimated 35 million children under the age of 5 years were overweight. Once considered a high-income country problem, overweight is on the rise in low- and middle-income countries. In Africa, the number of overweight children under 5 years has increased by nearly 12.1% since 2000. Almost half of the children under 5 years who were overweight or living with obesity in 2024 lived in Asia.

Over 390 million children and adolescents aged 5–19 years were overweight in 2022. The prevalence of overweight (including obesity) among children and adolescents aged 5–19 has risen dramatically from just 8% in 1990 to 20% in 2022. The rise has occurred similarly among both boys and girls: in 2022 19% of girls and 21% of boys were overweight.

While just 2% of children and adolescents aged 5–19 were obese in 1990 (31 million young people), by 2022, 8% of children and adolescents were living with obesity (160 million young people).

Causes of overweight and obesity

Overweight and obesity result from an imbalance of energy intake (diet) and energy expenditure (physical activity).

In most cases obesity is a multifactorial disease due to obesogenic environments, psycho-social factors and genetic variants. In a subgroup of patients, single major etiological factors can be identified (medications, diseases, immobilization, iatrogenic procedures, monogenic disease/genetic syndrome).

The obesogenic environment exacerbating the likelihood of obesity in individuals, populations and in different settings is related to structural factors limiting the availability of healthy sustainable food at locally affordable prices, lack of safe and easy physical mobility into the daily life of all people, and absence of adequate legal and regulatory environment.

At the same time, the lack of an effective health system response to identify excess weight gain and fat deposition in their early stages is aggravating the progression to obesity.

Common health consequences

The health risks caused by overweight and obesity are increasingly well documented and understood.

In 2021, higher-than-optimal BMI caused an estimated 3.7 million deaths from noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes, cancers, neurological disorders, chronic respiratory diseases, and digestive disorders (1).

Being overweight in childhood and adolescence affects children’s and adolescents’ immediate health and is associated with greater risk and earlier onset of various NCDs, such as type 2 diabetes and cardiovascular disease. Childhood and adolescent obesity have adverse psychosocial consequences; it affects school performance and quality of life, compounded by stigma, discrimination and bullying. Children with obesity are very likely to be adults with obesity and are also at a higher risk of developing NCDs in adulthood.

The economic impacts of the obesity epidemic are also important. If nothing is done, the global costs of overweight and obesity are predicted to reach US$ 3 trillion per year by 2030 and more than US$ 18 trillion by 2060 (2).

Finally, the rise in obesity rates in low-and middle-income countries, including among lower socio-economic groups, is fast globalizing a problem that was once associated only with high-income countries.

Facing a double burden of malnutrition

Many low- and middle-income countries face a so-called double burden of malnutrition.

While these countries continue to deal with the problems of infectious diseases and undernutrition, they are also experiencing a rapid upsurge in noncommunicable disease risk factors such as obesity and overweight.

It is common to find undernutrition and obesity co-existing within the same country, the same community and the same household.

Children in low- and middle-income countries are more vulnerable to inadequate pre-natal, infant, and young child nutrition. At the same time, these children are exposed to high-fat, high-sugar, high-salt, energy-dense, and micronutrient-poor foods, which tend to be lower in cost but also lower in nutrient quality. These dietary patterns, in conjunction with lower levels of physical activity, result in sharp increases in childhood obesity while undernutrition issues remain unsolved.

Prevention and management

Overweight and obesity, as well as their related noncommunicable diseases, are largely preventable and manageable.

At the individual level, people may be able to reduce their risk by adopting preventive interventions at each step of the life cycle, starting from pre-conception and continuing during the early years. These include:

ensure appropriate weight gain during pregnancy;

practice exclusive breastfeeding in the first 6 months after birth and continued breastfeeding until 24 months or beyond;

support behaviours of children around healthy eating, physical activity, sedentary behaviours and sleep, regardless of current weight status;

limit screen time;

limit consumption of sugar sweetened beverages and energy-dense foods and promote other healthy eating behaviours;

enjoy a healthy life (healthy diet, physical activity, sleep duration and quality, avoid tobacco and alcohol, emotional self-regulation);

limit energy intake from total fats and sugars and increase consumption of fruit and vegetables, as well as legumes, whole grains and nuts; and

engage in regular physical activity.

Health practitioners need to

assess the weight and height of people accessing the health facilities;

provide counselling on healthy diet and lifestyles;

when a diagnosis of obesity is established, provide integrated obesity prevention and management health services including on healthy diet, physical activity and medical and surgical measures; and

monitor other NCD risk factors (blood glucose, lipids and blood pressure) and assess the presence of comorbidities and disability, including mental health disorders.

The dietary and physical activity patterns for individual people are largely the result of environmental and societal conditions that greatly constrain personal choice. Obesity is a societal rather than an individual responsibility, with the solutions to be found through the creation of supportive environments and communities that embed healthy diets and regular physical activity as the most accessible, available and affordable behaviours of daily life.

Stopping the rise in obesity demands multisectoral actions such as food manufacturing, marketing and pricing and others that seek to address the wider determinants of health (such as poverty reduction and urban planning).

Such policies and actions include:

structural, fiscal and regulatory actions aimed at creating healthy food environments that make healthier food options available, accessible and desirable; and

health sector responses designed and equipped to identify risk, prevent, treat and manage the disease. These actions need to build upon and be integrated into broader efforts to address NCDs and strengthen health systems through a primary health care approach.

The food industry can play a significant role in promoting healthy diets by:

reducing the fat, sugar and salt content of processed foods;

ensuring that healthy and nutritious choices are available and affordable to all consumers;

restricting marketing of foods high in sugars, salt and fats, especially those foods aimed at children and teenagers; and

ensuring the availability of healthy food choices and supporting regular physical activity practice in the workplace.

WHO response

WHO has recognized the need to tackle the global obesity crisis in an urgent manner for many years.

The World Health Assembly Global Nutrition Targets aiming to ensure no increase in childhood overweight, and the NCD target to halt the rise of diabetes and obesity by 2025, were endorsed by WHO Member States. They recognized that accelerated global action is needed to address pervasive and corrosive problem of the double burden of malnutrition.

At the 75th World Health Assembly in 2022, Member States demanded and adopted new recommendations for the prevention and management of obesity and endorsed the WHO Acceleration plan to stop obesity. Since its endorsement, the Acceleration plan has shaped the political environment to generate impetus needed for sustainable change, created a platform to shape, streamline and prioritize policy, support implementation in countries and drive impact and strengthen accountability at national and global level.

References

1. GBD 2021 Risk Factor Collaborators. “Global Burden of 88 Risk Factors in 204 Countries and Territories, 1990–2021: a systematic analysis for the Global Burden of Disease study 2021”. Lancet. 2024; 403:2162-2203.

2. Okunogbe et al., “Economic Impacts of Overweight and Obesity.” 2nd Edition with Estimates for 161 Countries. World Obesity Federation, 2022.