Obesity is a disease in which excess accumulated body fat causes negative

effects on health. Obesity continues to accelerate. Elevated body mass index

(BMI) is a risk factor for noncommunicable diseases such as diabetes,
cardiovascular disease, and musculoskeletal disorders, leading to decreased
quality and life expectancy. The main cause of obesity is the long-term energy
imbalance between calories consumed and calories expended. Treating these
conditions can place an additional burden on healthcare systems: for example,
obese people are estimated to have a 30% higher medical cost than those with
a normal BMI. With total health care-related costs doubling every decade,
treating the consequences of obesity poses a costly challenge for patients.
Obesity increases the likelihood of several diseases and conditions that are
linked to increased mortality. These include type 2 diabetes mellitus (T2DM),
cardiovascular disease (CVD), metabolic syndrome (MetS), chronic kidney
disease (CKD), hyperlipidemia,
hypertension, nonalcoholic fatty liver
disease (NAFLD), certain types of cancer,
obstructive sleep apnea, osteoarthritis,
and depression. There are several
possible mechanisms that lead to
obesity. The most popular mechanism is
usually that the main cause is an excess
of energy greater than the energy that Figure 1. Lopez, P. G.. Obesity today
the body uses. Excess energy is stored in
fat cells, thus developing the characteristic pathology of obesity. More and
more etiologies or defects leading to obesity can be identified in the context
of the struggle between nurturing and nature, genetics and epigenetics, the
environment and the microenvironment. Epigenetic studies have provided
very useful tools for understanding the global rise in obesity. Studies have
looked at the relationships between genetics, epigenetics and the
environment in obesity and explored the roles of epigenetic factors in
regulating metabolism and obesity risk, as well as its complications.

Epidemiology of Obesity
BMI is used to define and diagnose obesity according to World Health
Organization (WHO) guidelines. In adults, the WHO defines "overweight" as a
BMI of 25.0 to 29.9 and "obese" as a BMI ≥ 30.0. Obesity is also classified into
three levels of severity: class I (BMI 30.0-34.9), class II (BMI 35.0-39.9) and class
III (BMI ≥ 40.0). However, there are large individual differences in body fat
percentage for the given BMI value, which can be attributed to sex, ethnicity,
and age. The prevalence of excessive weight gain has doubled worldwide since
1980, and about one-third of the world's population has been determined to
be obese or overweight. The obesity rate has increased quite a bit in both men
and women, and at all ages, with a proportionately higher prevalence in older
people and women. The prevalence of obesity also varies by socioeconomic
status, with slower rates of BMI increase in high-income and some middle-
income countries. In low- and middle-income countries, rates of overweight
and obesity are increasing, especially in urban areas.

Pathogenesis of obesity
The pathogenesis of obesity involves the regulation of calorie utilization,
appetite, and physical activity, but it has complex interactions with the
availability of health care systems, the role of socioeconomic status, and
underlying environmental and hereditary factors. Current health
recommendations for controlling obesity are based on the underlying
physiological property that fat accumulation is driven by an energy imbalance
between calories consumed and expended. The obesity epidemic has been
fueled in large part by increased energy due to increased availability of highly
rewarding, energy-rich foods. Diet and various social, economic and
environmental factors related to the food supply have a significant effect on
the patient's ability to achieve balance.
Obesogenic marketing to promote beverages or foods high in sugar and fat
negatively modulates human behavior. These ads can increase the preference
for energy-rich foods and beverages. The analysis showed that African-
American programs had more food ads than other general market
programs. More food ads were for meat, sweets, soft drinks and fast food than
for grains, pasta, cereals, vegetables and fruits. The advertised products were
designed to be cheap, have a long shelf life and an 'irresistible' taste.
Family history, lifestyle, and psychological factors influence the propensity for
obesity. The likelihood of becoming obese can be affected by nature and
parenting, enhanced by family genetics (propensity to accumulate fat or
lifestyle (poor diet or exercise habits). A child with an obese parent has three
times the risk of becoming obese as an adult, while when a child's parents are
obese, this child has a 10-fold increased risk of obesity in the future.

Obesity Therapeutics
Since food choices are primarily determined by people's environment, it is
imperative that governments improve policies and the environment to reduce
the availability of unhealthy food and make healthy food more
accessible. Policies must be changed to increase the development of foods low
in sugar, fat and salt and decrease the availability of obesogenic foods for
children. Pharmacotherapy is recommended for those whose BMI ≥30 (or a
BMI ≥27 with comorbid conditions) and who cannot lose weight with lifestyle
modification alone. The U.S. Food and Drug Administration (FDA) approved
some new pharmacotherapy drugs for the treatment of obesity in the short
term. Traditional Chinese medicine offers unique solutions to treat obesity,
such as regulating fat metabolism, improving hormone level, regulating
intestinal microflora, among other pathways.
Conclusion
As a conclusion, it is necessary to implement many prevention measures in
countries where obesity is very advanced since that can be a factor that puts
the health of the country at risk, also invite parents to be aware of what their
children may present if they take a poor diet and the risk factors that this
disease can bring. In addition, we must devote greater efforts and resources
to the prevention of obesity in both children and adults.

References:
Lin, X., & Li, H. (2021). Obesity: Epidemiology, pathophysiology, and
therapeutics. Frontiers in Endocrinology, 12, 706978.
https://doi.org/10.3389/fendo.2021.706978
López, P. G. (2022, June 18). Obesidad en la actualidad. PonteMASfuerte.
https://www.pontemasfuerte.com/bePMF/cuidado-con-la-obesidad/