Obesity

Obesity develops for more than one reason, and it usually isn't down to a single cause. In simple terms, it happens when your body takes in more calories than it uses, and the extra amount is stored as fat.

This problem has become far more common because of the way daily life is set up around us. It often isn't easy to choose healthy food, and finding time or space for physical activity can be just as hard. Several everyday pressures play a part in this, including:

• the cost of healthy food
• the cost of exercise or gym facilities
• time pressures from work and family life
• the area you live in and what it offers

Certain underlying health conditions can also lead to weight gain. These include:

• an underactive thyroid gland (hypothyroidism), where the thyroid doesn't produce enough hormones
• Cushing's syndrome, a rare condition in which the body produces too much steroid hormone

If a condition like this is properly diagnosed and treated, it will no longer stand in the way of your efforts to lose weight.

Genes can also play a role, since they influence how your body stores and uses fat. Even so, there is still a great deal you can do to work toward and maintain a healthy weight.

Diagnosing obesity

The most common way to tell if you’re at risk of obesity is by calculating your body mass index (BMI). Measuring your waist to height ratio can also be helpful.

Body Mass Index (BMI)

BMI is widely used as a simple way of finding out whether a person is a healthy weight for their height.

For most white adults, having a BMI of 18.5 to 24.9 means your weight is in a healthy range. A person with a BMI of 25 to 29.9 would be in the overweight range. Someone with a BMI of over 30 is considered to be have obesity.

Health risks can begin at 23 and at a higher risk from 27.5 for people who have these family backgrounds:

• Asian
• Chinese
• Middle Eastern
• Black African
• African-Caribbean

Waist to height ratio

If your BMI is below 35 it can also be useful to measure your waist to height ratio. This helps you understand if you’re carrying too much weight around your tummy.

Ideally your waist size should be less than half your height.

More information on BMI and waist to height ratio

Diagnosing obesity in children

Diagnosing obesity in children and young people under 18 is slightly different. BMI measurements alone are not suitable. It’s difficult to measure at home.

Your healthcare professional may want to do other tests and check their overall health.

Speak to your child’s healthcare professional if you’re worried about their weight.

Treating obesity

The most important ways of treating obesity are to:

• eat a healthy, reduced-calorie diet
• exercise regularly

To do this you can:

• eat a balanced, calorie-controlled diet as recommended by your health care professional
• try to be more active — any increase in your current activity levels will help towards you achieving a health weight

Your GP may also recommend you join your local health board’s weight management programme. These are designed to help you move towards being a healthy weight.

They can also provide support for weight-related health conditions like:

• type 2 diabetes
• cardiovascular disease (CVD)

More information on how to lose weight safely

Weight loss medicines

You may also need medicines that can help with weight loss. There are a number of different types of medications available that can help you lose weight. The ones that have been proven to be safe and effective and are used by the NHS are:

• semaglutide
• liraglutide
• tirzepatide
• orlistat

Semaglutide, liraglutide and tizepatide work in different ways to help you achieve a healthy weight.

More information on weight loss medications

Orlistat works by reducing the amount of fat you absorb during digestion. Your GP will know whether orlistat is right for you.

More information on orlistat

Weight loss surgery

Weight loss surgery is sometimes used to treat people who are living with complex obesity. It’s also known as metabolic and bariatric surgery.

Read more about weight loss surgery

Treating obesity in children

If your child has obesity, treatments include:

• making their diet healthier
• making sure they get more exercise

It can be hard to do this, but, there are things you can do.

The amount of calories your child should eat each day will depend on their age and height. Your GP should be able to advise you about a how many calories they should eat in a day. They may also be able to refer you to your local family healthy lifestyle programme.

Read more about the physical activity guidelines for children and young people

Your child may be referred to a specialist in childhood obesity if:

• they develop an obesity-related complication
• there’s an underlying condition which is causing their obesity

The specialist will recommend which treatment options would be right for them.

Conditions related to obesity

There are a range of conditions that are related to obesity and excess weight around your tummy. These include:

• type 2 diabetes
• cardiovascular disease
• fatty liver disease
• stroke
• obstructive sleep apnoea
• polycystic ovary syndrome (PCOS) and infertility
• some types of cancer, such as breast cancer and bowel cancer
• depression
• low self-esteem

People with obesity may be more likely to also have eating disorders like:

• binge eating disorder
• avoidant restrictive food intake disorder (ARFID)

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