What is obesity?
In 2022, over 890 million adults, representing 16% of adults worldwide, were living with obesity. The World Health Organization (WHO) defines obesity as a complex chronic disease characterised by excessive body fat that can harm health. Body mass index (BMI) and waist circumference measurements are commonly used tools for diagnosing obesity. However, while diagnosing obesity may be straightforward, its causes are often misunderstood and framed as solely personal lifestyle choices. In reality, obesity is influenced by many factors beyond individual behaviour, including genetic, environmental and societal determinants. For example, an individual’s genetic makeup accounts for 40-70% of the likelihood of developing obesity. Additionally, structural factors, such as food systems, work environments and urban planning, exacerbate the risk of obesity by shaping the conditions in which people live, work and make daily choices.
The interconnected challenge of obesity and type 2 diabetes
Obesity significantly increases the risk of developing other non-communicable diseases (NCDs), particularly type 2 diabetes (T2D) and hypertension (HTN). Globally, obesity is responsible for approximately 43% of type 2 diabetes cases, and in some countries, such as the UK, it contributes to 80-90% of cases. Excess body fat, particularly visceral fat (fat stored around the abdomen and vital organs), is associated with insulin resistance, a key driver of T2D. Insulin resistance can lead to glucose intolerance, increasing the likelihood of developing T2D. Not only is obesity a key risk factor for T2D, but both conditions arise from a similar interplay of genetic, environmental and societal factors. Given this close relationship, tackling obesity is essential to halting the rise of T2D. Additionally, prevention strategies should address both conditions simultaneously for maximum impact.
Obesity: a systemic issue
To effectively address the rising burden of obesity and T2D, it is crucial to focus on their root causes. Structural factors play a fundamental role in shaping health outcomes and influencing obesity risk. Some key contributors include:
- Unhealthy diets: global food systems priortise efficiency and profit resulting in the mass production of food. This has increased the availability of ultra-processed foods, high in sugar, unhealthy fats and calories, and are cheaper and more accessible than fresh, nutritious food options.
- Sedentary lifestyles: economic development has led to changes in workplaces, transportation patterns and urban environments, reducing opportunities for physical activity.
- Commercial determinants of health: economic factors provide incentives for market actors to create food environments that make it difficult for people to access and afford healthy foods. The marketing of unhealthy foods has been directly linked to an increase in overweight and obesity in children.
- Healthcare access: many individuals face stigma when seeking medical care for obesity-related conditions, and there is a widespread lack of specialised obesity services.
More solutions that go beyond behaviour change are needed
Addressing obesity and T2D requires systemic change - policies that promote healthier food environments, investment in urban planning that supports physical activity, and healthcare approaches that provide equitable, stigma-free support. DigiCare4You is an example of an initiative working to improve the early prevention and management of T2D and HTN through a community-based, person-centred approach that integrates both social and healthcare systems, supported by digital tools. Key components of this initiative extend beyond the individual to address structural factors contributing to the risk of obesity and diabetes. For example, making green spaces and playgrounds in schools more accessible to families encourages physical activity, while establishing a social collaboration platform fosters healthy societal norms and supports behaviour change. Initiatives like DigiCare4You, which take into account the complex interplay of multiple determinants of health, represent the kind of paradigm shift necessary to effectively address the rising prevalence of NCDs. DigiCare4You echoes the calls of World Obesity Day that the spotlight must be put on the system – not people – that need to change.
Sources:
- IDF Policy Brief – Obesity and Type 2 Diabetes: a Joint Approach to Halt the Rise
- https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
- https://www.diabetes.co.uk/body/visceral-fat