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April 20, 2022/Health Conditions

IS OBESITY A DISEASE?

What we often get wrong and how it can be managed

Mention the word “obesity,” and the opinions — and misconceptions — start
flying. But obesity isn’t the result of a lack of willpower or not caring about
appearance. Obesity is a condition that affects about 42% of the U.S.
population.

Cleveland Clinic is a non-profit academic medical center. Advertising on our
site helps support our mission. We do not endorse non-Cleveland Clinic products
or services. Policy

WHAT IS OBESITY?

Obesity is a disease where an abnormal or excess accumulation of fat causes harm
to one’s health. So, what causes it and how can it be managed? Psychologist and
weight management specialist Leslie Heinberg, PhD, MA, offers some helpful
insight for navigating this complex disease.

WHAT WE OFTEN GET WRONG ABOUT OBESITY

“The most common misconception about obesity is that it is simply a ‘lifestyle’
disorder — that people have obesity simply because of their diet or physical
activity. Obesity is very complex and is caused by a lot of factors,” explains
Dr. Heinberg.

IS OBESITY AN ILLNESS OR A DISEASE?

The American Medical Association (AMA) officially recognized obesity as a
chronic disease back in 2013. The AMA also states that it’s a disease state with
multiple functional changes that require a range of treatment and prevention
options.

SYMPTOMS OF OBESITY

While obesity is considered a disease, there aren’t any true symptoms for it.

“Just like high blood pressure, obesity is ‘silent.’ It doesn’t have specific
symptoms,” says Dr. Heinberg. “Obesity is defined by body mass index (BMI),
which is a ratio of height and weight, but that’s a pretty blunt
instrument. What’s more important is the percentage of fat mass to lean muscle
mass and where people hold their weight (for example, abdominal obesity).”

CAUSES OF OBESITY

The following factors can contribute to obesity.

AN IMBALANCE BETWEEN FOOD AND ACTIVITY

If you’re eating a lot of calories but not burning more through physical
activity, that can cause you to gain weight. Try to watch your portion sizes and
start moving if you don’t already exercise regularly.

YOUR ENVIRONMENT

When you don’t have access to fresh food, it can be harder to make healthy
choices. It’s also tough if you live in an area that doesn’t have nice parks,
sidewalks or affordable fitness options. And believe it or not, ads for junk
food could even be influencing how you eat.

YOUR GENES

Yes, they can affect how you gain weight. They can also increase your risk for
obesity. Scientists have discovered that genes can cause obesity that occurs
with conditions like Prader-Willi syndrome, which is a common genetic disorder
that causes life-threatening obesity in kids. Variations in some genes may also
contribute to obesity by causing you to feel hungrier so you eat more.

OTHER MEDICAL CONDITIONS

Hormonal conditions such as an underactive thyroid, Cushing’s
syndrome and polycystic ovary syndrome (PCOS) can lead to obesity. Some
medications can trigger it as well. They include corticosteroids (steroids),
antidepressants and seizure medicines.

“More than 100 possible causes or risk factors for obesity have been identified.
Some relate to our environment (for example, agricultural policies or how our
neighborhoods are built) and there has been recent interest in the impact of our
gut microbial community and how gut hormones play a role in driving our
metabolism,” notes Dr. Heinberg.

TREATMENT OPTIONS FOR OBESITY

Dr. Heinberg says there are a variety of treatment options for
obesity. Lifestyle interventions that focus on changing a person’s diet and
level of physical activity, while empowering them with behavioral tools and
skills, can help increase success. Medical interventions are also beneficial.

“Several prescription medications are now available to help with weight loss and
medically supervised diets can be helpful. Endoscopic and bariatric surgical
procedures are associated with the greatest amount of weight loss but are
reserved for more severe obesity or for those who are living with significant
health problems,” says Dr. Heinberg.

OBESITY IS A RISK FACTOR FOR THESE HEALTH CONDITIONS

As obesity is a multifactorial disease, if you’re living with it, your
healthcare provider will also check for other medical conditions. Dr. Heinberg
says that more than 220 conditions have been linked to obesity, including:

TYPE 2 DIABETES

Living with obesity can make you more likely to develop Type 2 diabetes. Obesity
also causes diabetes to progress much faster.

CARDIOVASCULAR DISEASE

When your body fat increases, it can increase your risk for heart failure,
coronary artery disease, atrial fibrillation or even sudden cardiac death.

LIVER DISEASE

Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis have been
linked to obesity. Obesity, combined with high blood sugar, insulin resistance
and high levels of triglycerides and other fats in your blood, can cause fat to
build up in your liver. This buildup can lead to inflammation or scar tissue in
your liver as well.

OBSTRUCTIVE SLEEP APNEA

While weight isn’t the only reason why people develop sleep apnea, extra weight
can make it hard to breathe while sleeping. Fat deposits in your neck can block
your upper airway. And excess fat around your midsection can make it harder for
your lungs to work properly, or your lungs are more likely to collapse. And the
risk for obstructive sleep apnea increases as your BMI goes up.

CERTAIN TYPES OF CANCER

According to the National Cancer Institute, there’s evidence that higher levels
of body fat can increase risks for certain cancers. These cancers include
endometrial, liver, kidney, breast, ovarian and thyroid.

WHY IT’S IMPORTANT TO REMEMBER THAT OBESITY IS A CHRONIC DISEASE

“People assume that once they’ve lost weight, they’re ‘done’ or that the obesity
is ‘cured,’” notes Dr. Heinberg. “Unfortunately, after weight loss comes the
much more difficult challenge of weight loss maintenance. Like many chronic
diseases, obesity tends to recur and can worsen over time. Long-term treatment
options are best for chronic diseases like this one.”

HOW WE CAN BE BETTER ADVOCATES FOR OURSELVES OR OUR LOVED ONES WHO ARE LIVING
WITH OBESITY

Dr. Heinberg says one of the best things that we can do is seek out healthcare
providers who understand that obesity is a disease. “Find providers who
understand that it isn’t an issue of willpower and take this condition
seriously. No one should feel stigmatized in healthcare due to their weight.”

Learn more about our editorial process.

Cleveland Clinic is a non-profit academic medical center. Advertising on our
site helps support our mission. We do not endorse non-Cleveland Clinic products
or services. Policy

April 19, 2024/Mental Health

THE INTERSECTION OF OBESITY AND EATING DISORDERS

Having overweight and disordered eating is a high-risk combination that often
gets dismissed or overlooked

February 19, 2024/Heart Health

HOW WEIGHT AFFECTS YOUR HEART

Having underweight, having overweight and having obesity can be dangerous for
your heart

February 14, 2024/Digestive

HOW TO KNOW WHICH TYPE OF BARIATRIC SURGERY IS RIGHT FOR YOU

Gastric bypass and sleeve gastrectomy are different procedures that offer
similar benefits, including significant weight loss

October 24, 2023/Weight Loss

HOW MOUNJARO IS HELPING PEOPLE WITH OBESITY LOSE WEIGHT

This diabetes drug is quickly gaining attention for weight loss potential

September 10, 2023/Diet, Food & Fitness

IS IT HEALTHY TO BE ‘FAT AND FIT’?

Having obesity brings long-term health risks no matter your fitness level

March 29, 2023/Weight Loss

IS OZEMPIC THE ANSWER FOR YOUR WEIGHT LOSS?

This diabetes med can treat obesity, but it’s not for people who just want to
drop a few pounds

January 16, 2023/Weight Loss

THE NEW ANTI-OBESITY DRUGS: WHAT YOU SHOULD KNOW

You can lose 15% of your body weight, plus lower your heart disease and diabetes
risks

January 13, 2023/Wellness

WHAT DOES YOUR BODY SHAPE SAY ABOUT YOUR HEALTH?

Any body shape can be a healthy one, but a thicker midsection can be a red flag

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