Treating obesity as a disease

Obesity is often misunderstood as simply a result of poor lifestyle choices. However, leading health organisations recognise it as a chronic and complex medical condition.

In this article a nutrition and dietetics specialist explains why obesity should be viewed and treated as a disease, and explores the effective medical and surgical treatments available.

What is obesity?

Obesity is defined as having a body mass index (BMI) of 30 or above. It involves excessive accumulation of body fat that may negatively affect one’s health.

Why obesity is considered a disease

Many still view obesity as simply the result of overeating or inactivity. While these play a role, in reality, it is caused by a combination of genetic, hormonal, environmental, and psychological factors. Like other chronic conditions, such as asthma or hypertension, obesity requires ongoing medical care, rather than just willpower or temporary lifestyle changes.

Physical health complications of obesity

Obesity significantly increases the risk of developing:

• Type 2 diabetes.
• Hypertension (high blood pressure).
• Heart disease and stroke.
• Obstructive sleep apnoea.
• Osteoarthritis and joint problems.
• Fatty liver disease (non-alcoholic steatohepatitis).

Mental health impact

Obesity can also have a profound impact on mental health. It is linked to depression, anxiety, and low self-esteem. In addition, the social stigma attached to obesity can make it even more difficult for people to seek help.

Non-surgical treatment options for obesity

Initial treatment includes a multi-disciplinary approach, involving:

• Nutritional support from specialist dietitians.
• Physical activity programmes.
• Psychological or behavioural therapy.
• Medications approved for weight loss, such as GLP-1 agonists, which help regulate appetite and glucose levels.

These measures can be highly effective, particularly in the early stages. However, for patients with more severe obesity, further intervention may be needed.

When bariatric surgery is recommended

For individuals with a BMI ≥ 40, or a BMI ≥ 35 with obesity-related health problems, bariatric (weight loss) surgery may be considered. The most common procedures include gastric bypass and sleeve gastrectomy.

These surgeries work by reducing the size of the stomach and altering gut hormone levels, leading to reduced hunger, better blood sugar control, and sustainable weight loss. Bariatric surgery is not a shortcut, it is a clinically proven, long-term treatment that significantly improves health outcomes and can even reverse conditions like type 2 diabetes in many patients.

Changing the way we view obesity

Treating obesity as a disease helps to reduce stigma and encourage appropriate medical care. It enables more people to access treatments that are safe, effective, and evidence-based. It also highlights the need for improved public health policy and education to support individuals affected by this condition.

Obesity is a chronic disease, not a personal failing. It deserves the same level of understanding and medical attention as any other long-term condition.