What is obesity?
“Obesity” is a medical term used to describe extra body fat that affects a person’s health. Just like other health conditions, obesity is not a personal judgement or a reflection of someone’s character.
Diagnosis of obesity may occur with a health professional using the Body Mass Index (BMI) which assesses height and weight and/or waist circumference which measures weight gain around the belly. Some doctors may ask about personal health history or request for lab tests to help diagnose and identify health impacts of obesity.
The standard measure of BMI is a useful screening tool but has limitations on its own for the clinical diagnosis of obesity. This is for many reasons, including ethnicity, variations in body composition and metabolic risk levels among people.
Drivers of obesity
There are strong social, genetic, biological, historical and environmental influences on obesity.
The rise in obesity prevalence over the last 30 years is mainly a biological response to modern environments that promote unhealthier foods, stress, physical inactivity, and weight gain. Many people in Australia live in environments where energy-rich foods are abundant and easy to access, and not every Australian lives in conditions where they are able to safely exercise.
Progress in obesity research in recent years has shown why some people are more affected by obesity and why weight regain is a constant challenge for some, compared to others. For example, genetic factors can have a major influence on an individual’s susceptibility to weight gain. A genetic predisposition to fat accumulation, especially around internal organs and within muscle, can lead to dysregulation of important biological processes, including metabolism, appetite control and hormone functions. This causes the body to promote weight gain and fight weight loss, making it difficult for a person to lose weight and maintain that weight loss.
Unfortunately, many people aren’t aware of these complexities and consider obesity to be more of a personal choice which leads to harmful stigma, bias and discrimination.
The below Foresight obesity map highlights the complexity and some of the many drivers of obesity.
Impact of obesity
The condition of obesity can have serious impacts on people’s quality of life, and both their physical and mental health.
Everybody is different and obesity can affect someone’s health and wellbeing in different ways.
These can include:
- risks of developing diseases like diabetes, heart disease and cancer;
- challenges with mental health, mobility, fertility, and arthritis;
- harmful discrimination which can impact people’s mental health as well as education and employment opportunities.
The AIHW estimated that in 2018, 8.4% of the total burden of disease in Australia was due to overweight and obesity.[1] Overweight and obesity affects about two in three Australian adults and one in four Australian children. In the ten years to 2018, the number of adults in Australia living with obesity more than doubled.
Usually, health risks increase with the more weight that someone gains and the longer they have obesity. However, it is important to understand that everyone is different, and obesity will affect people in different ways. Not everyone with a higher weight or Body Mass Index will have serious health problems, but the risks are higher and accumulate over time.
Obesity affects people from all different backgrounds, areas of Australia and levels of education and wealth. However, some groups of people are more affected than others. For example, people living in remote and regional areas, Aboriginal and Torres Strait Islander people, and people living in low socio-economic areas are more likely to be affected.
[1]https://www.aihw.gov.au/reports/australias-health/overweight-and-obesity
Everybody is different and obesity can affect someone’s health and wellbeing in different ways.
These can include:
- risks of developing diseases like diabetes, heart disease and cancer;
- challenges with mental health, mobility, fertility, and arthritis;
- harmful discrimination which can impact people’s mental health as well as education and employment opportunities.
The AIHW estimated that in 2018, 8.4% of the total burden of disease in Australia was due to overweight and obesity.[1] Overweight and obesity affects about two in three Australian adults and one in four Australian children. In the ten years to 2018, the number of adults in Australia living with obesity more than doubled.
Usually, health risks increase with the more weight that someone gains and the longer they have obesity. However, it is important to understand that everyone is different, and obesity will affect people in different ways. Not everyone with a higher weight or Body Mass Index will have serious health problems, but the risks are higher and accumulate over time.
Obesity affects people from all different backgrounds, areas of Australia and levels of education and wealth. However, some groups of people are more affected than others. For example, people living in remote and regional areas, Aboriginal and Torres Strait Islander people, and people living in low socio-economic areas are more likely to be affected.
[1]https://www.aihw.gov.au/reports/australias-health/overweight-and-obesity
Collective action is needed
Because the development of obesity is so complex, there is no one solution that will reduce the risks and health impacts of obesity for everyone. Australia needs coordinated and sustained action across society, including local communities, business, non-profit organisations, health care, research, and government. Systems level thinking and a broad range of interventions are required such as policy changes, healthier environments, reducing stigma and access to quality care for those that experience the health impacts of obesity.
It is critical to invest in prevention and healthy environments for all and to invest in support, treatment, and care to help those who are living with obesity and want to do something about it.
Australia’s current policies prioritise the protection and profits of industry over the health and wellbeing of our communities. This needs to change. Our children shouldn’t be bombarded with marketing, people should be able to access affordable and healthy food options in their local area, we should have safe green spaces and opportunities for people to exercise. Our workplaces and schools should prioritise healthy environments.
People’s wishes and options for support in managing weight or any other condition needs to be met with a respectful, person-centred approach. Effective treatment and care options should be affordable for those that need it. Our healthcare teams need to be supported with education, guidelines, and toolkits to provide supportive and effective healthcare to people whose weight is potentially impacting their health.
Weight stigma
The word obesity is loaded with stigma, blame and shame. This stigma is unfair, a barrier to action and harmful.
Weight stigma, or weight bias, is the social devaluation and discriminatory actions and beliefs towards individuals due to their weight and size. These beliefs are typically informed by prevailing societal norms about acceptable body size and shapes and are perpetuated by media.
The stigma associated with obesity arises from the general misunderstanding of the drivers of obesity and the perception that it is only about a failure of personal responsibility. There are many drivers of obesity including strong social, biological, and environmental factors, which are outside of people’s control. People of course have a personal responsibility for their own health and wellbeing, but we need to recognise that many of the most powerful drivers of obesity lie outside of personal control. We all have a part to play in reducing the personal and societal burden of obesity.
Weight stigma and bias is harmful
Obesity stigma is associated with considerable physical and mental health consequences, including increased depression and anxiety, disordered eating and eating disorders, and decreased self-esteem.
Weight stigma can make it harder for a person to manage their weight as it can lead to unhealthy eating practices and avoidance of physical activity. A person with obesity may avoid healthcare appointments for fear of judgement. It can also lead to a lower quality of care for patients with obesity, ultimately leading to poorer health outcomes and increasing risk of mortality.
Weight bias is also associated with inequities in employment and education.