Obesity

Obesity is a chronic, multifactorial disease that does not depend on individual willpower. It is not a single condition, but rather encompasses a range of chronic diseases that share an excess and/or dysfunction of body fat, which negatively impacts health.

In Spain, 19% of the adult population has obesity and 37% is overweight. In children, the situation is no better: up to 40.6% are overweight, placing Spain among the highest in Europe. This condition is associated with more than 200 diseases, including diabetes, cancer, and cardiovascular diseases. Obesity and overweight represent one of the greatest health and social challenges.

This condition is not merely a risk factor, but a chronic disease with genetic, epigenetic, behavioral, socioeconomic, and environmental roots. It results from an imbalance between caloric intake and energy expenditure, often worsened by obesogenic environments.

Disease impact

Obesity and overweight are not just anthropometric categories, but conditions with clinical significance. They are associated with:

• Increased risk and severity of cardiometabolic diseases, including type 2 diabetes, hypertension, atherogenic dyslipidemia, and cardiovascular disease.
• Respiratory conditions such as sleep apnea and hypoventilation.
• Metabolic liver disease (non-alcoholic fatty liver disease).
• Musculoskeletal disorders, including chronic pain, functional limitations, and osteoarthritis.
• Psychosocial and mental health impact.
• Higher risk of perioperative complications and increased use of healthcare resources.

Prevention

Prevention is essential and requires a comprehensive approach that considers biological, genetic, psychological, and environmental factors. While some forms of obesity are not driven by environmental factors and cannot be prevented solely by addressing social determinants of health, in many cases these factors play a key role, contributing to the development of obesity and/or worsening its severity and associated complications.

Physical activity and nutrition

One of the key elements for maintaining a good quality of life is a balanced diet combined with regular physical activity, both for preventing and managing obesity. Beyond advances in research, successful management of this disease relies on adopting sustainable lifestyle changes tailored to the needs and circumstances of each individual.

Treatment

In recent years, new medications for the treatment of obesity have been developed based on its underlying physiological mechanisms, showing highly promising results, not only in achieving weight loss (in some cases exceeding 20%), but also in improving obesity-related complications.

These medications are currently not publicly funded and require a multidisciplinary approach, both for appropriate prescription and long-term follow-up.

It is important to note that these treatments target only some of the mechanisms involved in obesity, and not all of them. Therefore, response to treatment may vary depending on each patient’s characteristics.

For this reason, maintaining healthy eating habits and regular physical activity remains essential to preserve overall health and quality of life.