Is obesity really a health condition?

Obesity is a term used to describe people who are carrying excess weight. It affects 1 in 4 adults in the UK.

It is a serious health condition. It can affect your physical and mental wellbeing and is closely linked to a variety of health conditions, including heart disease, stroke, diabetes and depression¹

Although excessive eating is often associated with obesity, there are lots of reasons why you might live with it. The use of medication, your mobility, or your genetics may also contribute to your size. But this doesn’t mean that you cannot achieve a healthy weight.

Obesity is avoidable and reversible.

In the UK, weight is classified under different categories. The terms that are often used are:

• Underweight
• Healthy weight
• Overweight
• Obese

If you are unsure whether you are obese, there are many ways to check. You can measure your waist-to-hip ratio, use skinfold callipers (if they’re accessible to you) or use a smart scale.

But your GP will likely measure your BMI. This is the ratio between your height to your weight. This measurement is recommended by the NHS because it allows for easy identification of patients who are either overweight or obese.

You can also check your BMI at home so long as you have a pair of accurate scales and a tape measure. If you don’t feel confident doing it yourself, you can ask your doctor or pharmacist for help. ²

You are considered to be obese if you have a BMI of 30 to 39.9. Anything over this range is considered severely obese.²

BMI is not a perfect indicator of your body composition as it doesn’t account for all of your proportions. You may be very tall and muscular, meaning that you will have a high BMI but are healthy. Your GP will take this into account when they take your body measurements.²

If you are from Asian, Middle Eastern, Black African or African-Caribbean heritage, your BMI obesity threshold will be slightly different. This is because fat is distributed differently in your body. For example, you may be more naturally inclined to have more visceral fat (harmful fat wrapped around your organs) than people of White backgrounds. This can also make you more prone to health conditions like type 2 diabetes.²

Yes. Obesity increases your risk of developing metabolic, cardiovascular, sexual health, and mental health conditions. It can also make it more likely that you live with pain or mobility challenges. Some conditions commonly associated with obesity include:

• Heart disease
• Stroke
• Metabolic syndrome
• High blood pressure
• Type 2 diabetes
• Cancer
• Liver disease
• Asthma
• Bone and joint problems like arthritis and gout
• Kidney disease
• Pregnancy problems and fertility issues.⁴

Obesity isn’t just caused by eating too much and not exercising enough. There are many different reasons for weight gain, which is why some people may find they still carry excess weight even though they eat well and exercise.⁶

Genetics can also play a part in obesity. It is possible to inherit certain traits from your parents that make it more likely for you to be overweight. Genetic conditions, like Prader-Willi syndrome, can also make you more susceptible to weight gain.⁶ Cushing’s syndrome, which affects thyroid function, can cause you to lose weight over time because your body isn’t producing enough of the thyroid hormones it needs for normal function.

Obesity can also be caused by taking medication to treat other illnesses. Some types of antidepressants, can cause temporary weight gain. Steroids, which are used to treat a range of conditions including epilepsy and diabetes, can also affect your body mass.⁶

Excessive weight gain can also happen in response to giving up smoking. This is because nicotine is an appetite suppressant. It makes you feel like eating less throughout the day. Often, people report turning to food in response to cravings when they try to quit smoking.⁶

Lifestyle changes

Eating a more balanced diet, cutting down on alcohol and exercising more frequently can help you reach a healthy weight. There’s a lot of support you can access with the help of a GP. They may refer you to a dietician, physiotherapist or recommend NHS resources to help you make a start. This help can be tailored to your individual needs.⁷

Medicated weight loss treatments

Your GP might also recommend medicated weight loss treatments. They are most effective when you adopt a healthy lifestyle alongside their use.⁷

Medicated weight loss isn’t for everyone. There is a set of eligibility criteria that you must meet for it to be prescribed for you. Your GP or pharmacist will let you know if you qualify for any of these medications. They will also regularly check in with you to monitor your progress.

Surgery

Surgery for weight loss may only be considered if you have:

• A BMI over 40
• A BMI over 35 and a serious medical condition like heart disease or liver disease that could be improved with weight loss.⁷

If your GP believes surgery is the right thing for you, you will be referred to a specialist who will discuss it with you. They’ll also talk to you about recovery times.⁷

Weight loss surgery is always optional. You will be given all the information you need to make an informed decision about your health. If you have any questions, you can ask your healthcare team.⁷