30/07/2025
Definition and Causes:
🔴 Obesity is a chronic, progressive disease involving excess body fat.
🔴 It raises the risk of serious health problems across multiple systems.
🔴 Causes include:
🔴 Genetics, environment, medications, medical conditions, and lifestyle
🔴 Key contributors: poor diet, low activity, stress, and hormonal factors
Limitations of BMI:
🟠 BMI alone doesn’t measure fat distribution or metabolic risk.
🟠 Use BMI+ for better risk assessment, including:
🟠 Waist circumference
🟠 Waist-to-hip ratio (≥0.85 women, ≥0.90 men)
🟠 Waist-to-height ratio (>0.5)
🟠 These help detect central obesity and predict cardiometabolic risk
Complications of Obesity:
🟡 Increases risk of:
🟡 Type 2 diabetes – due to insulin resistance
🟡 Obstructive sleep apnea – fat narrows airway
🟡 Cardiovascular disease – heart attack, stroke, hypertension
🟡 MASLD – liver fat accumulation, inflammation, fibrosis
🟡 Osteoarthritis – joint stress from excess weight
🟡 Also linked to infertility, GERD, cancer, and depression
Approach to Obesity Care:
🟢 Use respectful, person-centered care free from weight stigma
🟢 Follow the 5 A’s framework:
🟢 Ask – get permission to discuss weight
🟢 Assess – BMI+, complications, and behaviors
🟢 Advise – explain risks and benefits clearly
🟢 Agree – set shared, realistic goals
🟢 Assist – provide tools, referrals, and follow-up
Treatment Options by BMI Category:
🔵 25–26.9 kg/m²: Lifestyle therapy
🔵 27–29.9 kg/m²: Add meds if complications exist
🔵 30–34.9 kg/m²: Lifestyle + pharmacotherapy
🔵 35–39.9 kg/m²: Add surgery if complications
🔵 ≥40 kg/m²: Lifestyle, pharmacotherapy, and surgery recommended.
