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Understanding Obesity: A Complex, Chronic Condition

Obesity is a serious, multi-faceted condition impacting physical, mental, and social health. Its effects extend far beyond just weight.

What is Obesity?

A Complex, Chronic Disease Beyond Calories

Obesity results from an imbalance between energy intake and energy expenditure. When the number of calories consumed consistently exceeds the amount the body uses, excess energy is stored as fat, eventually leading to obesity. This condition is not simply a matter of willpower, but rather a complex interplay of genetic, metabolic, behavioural, and environmental factors. The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) aptly summarised this in its 1996 Prague statement: “Obesity is a chronic, lifelong, multifactorial, genetically-related, life-threatening disease of excessive fat storage with highly significant medical, psychological, social, physical and economic co-morbidities.”

Obesity has long been a global health concern, and its rising prevalence is driven by both clinical and lifestyle-related factors. Genetic predisposition plays a significant role by influencing metabolism and fat storage, while conditions such as insulin resistance and diabetes further compound the risk. However, modern lifestyle habits, including the consumption of calorie-dense, nutrient-poor foods and increasingly sedentary behaviour, have accelerated the crisis. Social, emotional, and psychological influences are also important contributors, as food can become a coping mechanism or even a form of addiction, making long-term change difficult without structured support.

So how do we define when someone has moved from being overweight to being classified as obese? That’s what we’ll explore in the next section, along with a closer look at the health impacts and treatment options for this chronic condition.

What does it mean to be overweight?

It’s important to understand that a person can be overweight without being obese, but not the other way around. Obesity is not defined by weight alone; the key indicator used globally is Body Mass Index (BMI). BMI is a standardised calculation that assesses a person’s weight relative to their height, and it provides a simple, objective way to classify weight status. While factors such as age and sex may influence body composition, BMI remains a widely used clinical tool for identifying increased health risks.

Normal

A BMI between 18.5 and 24.9 is considered within the normal range. Various online BMI calculators are available to help you assess your own risk category.

Overweight

A BMI of 25 to 29.9 falls into the overweight category. While not a perfect measure, BMI provides a useful starting point for understanding your weight in the context of health, and can help guide decisions about when to seek further medical support.

Obese

while a BMI of 30 or higher is classified as obese.

Let’s now take a closer look at some key facts and figures related to obesity.

Global Obesity: A Growing Epidemic

The scale of the global obesity crisis is staggering. According to World Health Organization (WHO) data, more than 650 million people worldwide were classified as obese in 2016, and the global prevalence of obesity has more than tripled since 1975. Once considered a problem confined to high-income countries, obesity is now a widespread public health challenge in low- and middle-income nations as well. Perhaps most concerning is the rise in childhood obesity, with 39 million children under the age of five classified as overweight or obese in 2020.

 

These figures are not just numbers – they reflect a major shift in global health trends, driven by changes in diet, lifestyle, and urbanisation. The impact of obesity is far-reaching, affecting not just individual health but also healthcare systems, economies, and communities. To better understand the relevance of these statistics in our own context, let’s take a closer look at obesity in South Africa.

Obesity in South Africa

Obesity in South Africa has reached alarming levels, reflecting both global trends and unique local challenges. A recent national survey revealed several key insights into the shifting landscape of obesity across the country. One of the most concerning findings was that the highest rate of increase in obesity occurred among women aged 45 to 55, highlighting a demographic that may be particularly vulnerable due to hormonal, metabolic, and lifestyle changes during midlife.

Equally troubling is the rise in childhood obesity, with 18% of pre-school children now classified as obese, a figure that raises serious concerns about long-term health outcomes. Among school-aged children, poor dietary habits are a major contributor, with over 50% purchasing food at school rather than bringing nutritious meals from home. This reflects broader issues such as limited access to healthy food, lack of nutritional education, and socioeconomic inequality. In a country with significant income disparity and varying access to healthcare and lifestyle support, tackling obesity requires coordinated, multisectoral strategies.

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