A chronic disease: The health impacts of obesity

Obesity: a chronic disease

Obesity affects 650 million adults worldwide – that’s approximately 13% of the world’s population.1 It is recognised by healthcare professionals, organisations and people across the world as a chronic disease which requires long-term management.2-6 The Awareness, Care and Treatment in Obesity MaNagement – an International Observation (ACTION IO) Study* found that 68% of people with obesity and 88% of healthcare professionals believe that obesity is a chronic disease. 7

Although both people with obesity and healthcare professionals recognise obesity as a chronic disease, it remains underdiagnosed and undertreated:8-10

What factors influence obesity as a disease?

Perhaps one of the reasons obesity continues to be poorly understood, underdiagnosed and undertreated, is that its causes are multifactorial. These causes can be physiological, psychological, genetic, environmental or socioeconomic. Many of these factors are outside of an individual’s control.11,12


Many aspects of our environment can contribute to the development of obesity, including exposure to oversized food portions, lack of physical activity due to high amounts of screen usage and easy access to unhealthy food13


Some people are genetically predisposed to developing obesity, depending on their family history. 13


Energy balance is a complex mechanism centrally regulated by the brain, with input from peripheral hormonal signals released from the gastrointestinal tract, pancreas and adipose tissue, which are integrated to regulate appetite and energy expenditure14


Stress,13 boredom13 and psychological disorders15 are linked to overeating and can contribute to the development of obesity13,15


Where a person lives, the society in which they live and their income can also influence their chances of developing obesity12,16

*The Awareness, Care and Treatment In Obesity MaNagement – an International Observation (ACTION IO) Study is the first international study to investigate barriers to obesity management among people with obesity and healthcare professionals in 11 countries worldwide (Australia, Chile, Israel, Italy, Japan, Mexico, Saudi Arabia, South Korea, Spain, UAE, UK). A total of 14,502 people with obesity and 2,785 healthcare professionals completed the survey.7


1.     World Health Organization. Obesity and Overweight Factsheet no. 311. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/. Last accessed: October 2020.

2.     Mechanick JI, Garber AJ and Garvey WT. American Association of Clinical Endocrinologists’ Position Statement on Obesity and Obesity Medicine. Endocrine Practice. 2012;18:642–648.

3.     Allison DB, Downey M, Atkinson RL, et al. Obesity as a Disease: A White Paper on Evidence and Arguments Commissioned by the Council of The Obesity Society. Obesity. 2008;16:1161–1177.

4.     Frühbeck G, Sbraccia P and Nisoli E. 2015 Milan Declaration: A Call to Action on Obesity - an EASO Position Statement on the Occasion of the 2015 EXPO. Obesity Facts. 2016;9:296–298.

5.     American Medical Association. A.M.A Adopts New Policies on Second Day of Voting at Annual Meeting. Obesity as a Disease. Available at: http://news.cision.com/american-medical-association/r/ama-adopts-new-policies-on-second-day-of-voting-at-annual-meeting,c9430649. Last accessed: October 2020.

6.     Bray GA, Kim KK, Wilding JPH, et al. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev. 2017;18:715–723.

7.     Caterson ID, Alfadda AA, Auerbach P, et al. Gaps to bridge: Misalignment between perception, reality and actions in obesity. Diabetes Obes Metab. 2019; 21:1914-1924

8.     Colby SL and Ortman JM. Projections of the Size and Composition of the U.S. Population: 2014 to 2060, Current Population Reports, P25-1143, U.S. Census Bureau, Washington, DC, 2014. Available at: https://www.census.gov/content/dam/Census/library/publications/2015/demo/p25-1143.pdf. Last accessed: October 2020.

9.     Centers for Disease Control and Prevention. Obesity and Overweight. Available at: https://www.cdc.gov/nchs/fastats/obesity-overweight.htm. Last updated on June 13, 2016. Last accessed: October 2020.

10.  Ma J, Xiao L, Stafford R. Adult Obesity and Office-based Quality of Care in the U.S. Obesity (Silver Spring). 2009;17(5):1077–1085.

11.  Wright SM and Aronne LJ. Causes of obesity. Abdominal Imaging. 2012;37:730–732.

12.  National Institutes of Health. Clinical Guidelines On The Identification, Evaluation, And Treatment Of Overweight And Obesity In Adults. Available at: http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf. Last accessed: October 2020.

13.  NIH. What causes overweight and obesity? Available at: https://www.nhlbi.nih.gov/health/health-topics/topics/obe/causes . Last accessed: October 2020.

14.  Sumithran P, Prendergast LA, Delbridge E, et al. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011;365:1597–1604.

15.  Collins J and JE B. Behavioral and Psychological Factors in Obesity. The Journal of Lancaster General Hospital. 2009;4:124–127.

16.  Pampel FC, Denney JT and PM K. Obesity, SES, and economic development: a test of the reversal hypothesis. Soc Sci Med. 2013;74:1073–1081.

HQ20OB00143, Approval date: December 2020

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