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Factors that contribute to obesity

A condition known as over-nutrition develops when essential nutrients are ingested in excess via a particular kind of diet. It is categorised as a kind of malnutrition, and, like a deficit of nutrients in a certain diet, it results in health problems in the person who is affected with the condition. Over-nutrition may be caused by either a restricted diet or an excessive amount of food consumption. Over-nutrition is referred to as hyperalimentation in another context. Over-nutrition may be generalised or specific to a particular nutrient or combination of nutrients, depending on the situation. Over-nutrition, in general, is caused by an excessive intake of any and all foods, which leads in obesity and the associated health problems. Specific over-nutrition is defined as an excess of a single vitamin or mineral, and the health consequences of this overabundance differ depending on which vitamin or mineral is oversupplied. To dive deeper into this topic and address its critical components, this paper seeks to understand its root cause and epidemiology while also providing measures via which this health condition can be avoided or managed. The graphs below provide the nations having highest and lowest levels of obesity in the world.

Numerous variables contribute to an individual's overnutrition or obesity, and the following are covered in detail:

Inheritance and its familial ramifications

An individual’s parents' genes may have an effect on the amount and distribution of body fat one keeps. Additionally, genetics may also influence how effectively one’s body turns food into energy, how well an individual can control his hunger, and how many calories one burns during exercise. Thus, obesity is a can be hereditary trait (Setywati et al., 2020).

Choices in lifestyle

Weight gain is a consequence of a calorie-dense diet that is deficient in fruits and vegetables, heavy on fast food, and high in high-calorie drinks and big portions (Sainsbury et al., 2019). Liquids have a calorie content. Numerous calories, particularly those originating from alcohol, may be consumed without experiencing satiety. Additionally, beverages high in calories, such as sugared soft drinks, may lead to weight gain.

Inactive Lifestyle

It's more probable for a sedentary person to overeat than someone who is active and engaged in their daily lives. Staring at computer, tablet, or smartphone screens is one kind of sedentary behaviour. Weight gain is significantly linked to the amount of time spent in front of a screen (Sainsbury et al., 2019).

Additional factors to consider

Numerous medical conditions and drugs side effects.

It is possible that in certain individuals, obesity is linked to medical illnesses including Prader-Willi syndrome, Cushing syndrome, and others (Singhal et al., 2021). Additionally, medical diseases such as arthritis may result in a decrease in physical activity, which may result in weight gain. If one does not adopt lifestyle changes, such as a change in food or activity, many medications may lead to weight gain. There are antidepressants, seizure pills, diabetes medications, antipsychotics and beta-blockers included in this list of drugs for depression (Williams et al., 2020).

Factors pertaining to socioeconomic aspects

Obesity has been linked to a number of different social and economic aspects. Because of the lack of safe walking and exercise places, obesity is difficult to avoid (Corsi & Subramaniam, 2019). Similarly, one may lack enough culinary training or have limited access to nutritious foods.

Age

Obesity may strike anybody at any age, even children. On the other hand, hormonal changes and a sedentary lifestyle raise an individual’s risk of obesity as one ages. Additionally, as one ages, the muscular mass in his body diminishes. A lack of muscle mass is associated with a lower metabolic rate. Additionally, these changes diminish calorie requirements, making weight reduction more difficult. If one does not maintain a healthy diet and improve physical activity as he ages, it will be very hard to combat obesity.

Pregnancy weight gain: Pregnant women frequently gain weight. Some women struggle to lose excess weight after the birth of their child. As a result of this weight gain, women's obesity may be exacerbated.

Smoking cessation: It is common for people to equate stopping smoking with weight gain. And for others, it may result in a gain in weight sufficient to qualify as obese. This often occurs when individuals turn to food to help them deal with the withdrawal symptoms associated with smoking cessation. However, quitting smoking is a better long-term health option than continuing to smoke. Following your smoking cessation, one’s doctor may be able to assist in preventing weight gain.

Inadequate sleep: Sleep deprivation or excessive sleep may cause changes in hormones that stimulate hunger. Additionally, one may seek meals that are rich in calories and carbs, which may result in weight gain.

Anxiety: Obesity may be influenced by a variety of extrinsic variables that affect an individual's mood and well-being. When people are concerned, they want more calorie-dense foods.

Obesity Epidemiology

Consumption alters the microbiota, which may result in weight gain or difficulty reducing weight.

Chooi et al. (2019) state that,  according to World Health Organization (WHO) criteria, BMI is used to define and diagnose obesity. Adults with a BMI of 25.0–29.9 are classified as overweight, while those with a BMI of more than 30.0 are classified as obese. Obesity is classified as class I if the BMI is between 30.0 and 34.9, class II if the BMI is between 35.0 and 34.9, and class III if the BMI is between 35.0 and 34.9.(BMI 35.0–34.9). (40.0 BMI). Individual variances in body fat percentage for a particular BMI score, on the other hand, may be related to sex, ethnic origin, and age. Obesity in the abdominal area is defined as an abnormal accumulation of fat that is related to an increased risk of illness. Each organisation, including the WHO, the IDF, and the AHA, has its own definitions and measuring criteria for abdominal obesity (American Heart Association). However, there is no widely accepted norm.

In the past decade, obesity rates have climbed dramatically across the board for men and women of all ages, with the elderly and women experiencing a proportionately greater rate. While there is a worldwide trend, absolute rates of incidence differ by region, country, and ethnic group. Prevalence of obesity varies by socioeconomic class, with higher-income and certain middle-income countries seeing a slower rise in BMI. Previously, it was considered that obesity was an issue peculiar to nations with a high standard of living. In high-income nations such as the United States, Sweden, Denmark, Norway, France, Australia, and Japan, the proportion of obese or overweight children began to decline or plateau in the early 2000s (Jackson Leach et al., 2020).

In low- and middle-income nations, particularly in metropolitan areas, obesity and being overweight are on the rise. In a study conducted in  China by Zhang et al. (2020) during a 22-year period, the prevalence of age-adjusted obesity increased from 3.15 percent to 14 percent in both sexes, with girls rising from 3 percent to 12.23 percent and boys increasing from 2.36 percent to 15  percent. In Africa, the prevalence of overweight children under the age of five has grown by 26 percent since 2000 (Oloyumbo et al., 2021). In 2019, more than half of Asian children below the age of 5 were classified as overweight or obese. Adult obesity and being overweight are inversely related to juvenile stunting, being underweight, and wasting, according to Oluyombo et al. (2021) from the statistics concerning Sub-Saharan Africa.

Making changes in one’s  lifestyle

Due to a scarcity of specialised pharmaceutical agents, "lifestyle modification" continues to be the cornerstone of obesity treatment. Individuals who are obese are advised to reduce at least 10% of their body weight using a mix of diet, exercise, and behavioural treatment (or lifestyle modification)(Kasila et al., 2020). In the short run, consumption of portion-controlled diets has been stated to aid in weight loss by Enkhma et al. (2018). High-intensity physical exercise and regular patient–provider interaction may result in long-term weight management. Changing one's lifestyle may often result in a large reduction in body weight and a reduction in cardiovascular risk.

Medications for Obesity

Pharmacotherapy is indicated for those with a BMI of 30 (or 27 with co-morbid illnesses) who are unable to reduce weight with lifestyle changes alone (Srivastava & Apovian, 2018). The FDA has authorised numerous novel pharmacological agents for short-term obesity treatment, but only four have been licenced for long-term use [Naltrexone-Bupropion (Contrave), Orlistat (Xenical, Alli), Liraglutide (Saxenda), and Phentermine-Topiramate (Qsymia), with Gelesis being the fifth] (Srivastava & Apovian, 2018).

 Additionally Xu et al. (2018) in their research have also stated that, 11 distinct components from 54 distinct plant groupings have been discovered as having anti-obesity properties. Celastraceae, Zingiberaceae, Theaceae, Magnoliaceae, and Solanaceae are only a few of these families. Traditional Chinese medicine offers a variety of treatments for obesity control, including fat metabolism regulation, hormone supplementation, and gut flora maintenance.

Bariatric surgery, more often referred to as weight loss surgery, is a procedure available to individuals with a BMI of 40 or 35 who are unable to reduce weight through lifestyle changes or medication (Le Roux & Heneghan, 2018). SG (sleeve gastrectomy), RYGB (Roux-en-Y gastric bypass), and AGB (adjustable gastric banding) are all examples of common bariatric procedures that alter metabolic profiles dramatically. According to the study, there are various other advantages of undertaking this surgery. For instance, Bariatric surgery decreases chronic inflammation associated with obesity, as well as biomarkers, the gut microbiome, and long-term type 2 diabetes remission (Ciobarca et al., 2020).

In recent years, FMT has reawakened scientific interest in the treatment of obesity. There are intriguing signs that FMT may benefit weight loss and maintenance by transferring microorganisms from healthy to obese people. She et al. (2021) pointed out that Ridaura et al. pioneered the transplantation of faecal slurries from obese human twins into germ-free mice. Mice infected with the microbiota of fat individuals acquired obesity, but mice infected with the microbiome of healthy individuals stayed trim. Findings from the sequencing of post-procedure faecal samples from mice suggest that the human microbiomes were effectively injected, indicating the transfer of functionalities associated with fat or lean microbiomes, respectively. According to promising human investigations, Lee et al. (2019) were able to significantly improve microbial diversity and insulin sensitivity in obese, diabetic adult men after taxonomic transplantation from lean donors. However, butyrate-producing bacteria and Bacteroidetes were found to be on the rise, suggesting a move toward a leaner phenotype-related microbial population. While research is ongoing, FMT may offer a viable alternative to obesogenic microbial communities.

Conclusion

Despite of the various awareness programs generated by nations to curtail overweights and obesity, this problem still remains the number one issue in almost all areas of the world. Further, this report also discussed the various risk factors that contributed towards the issue and the extent of the problem. However, it also provides solutions pertaining to the problem towards the end.

References

Chooi, Y. C., Ding, C., & Magkos, F. (2019). The epidemiology of obesity. Metabolism, 92, 6-10.

Ciobârc?, D., C?toi, A. F., Cop?escu, C., Miere, D., & Cri?an, G. (2020). Bariatric surgery in obesity: effects on gut microbiota and micronutrient status. Nutrients, 12(1), 235.

Corsi, D. J., & Subramanian, S. V. (2019). Socioeconomic gradients and distribution of diabetes, hypertension, and obesity in India. JAMA network open, 2(4), e190411-e190411.

Enkhmaa, B., Surampudi, P., Anuurad, E., & Berglund, L. (2018). Lifestyle Changes: Effect of Diet, Exercise, Functional Food, and Obesity Treatment on Lipids and Lipoproteins. Endotext [Internet].

Jackson Leach, R., Powis, J., Baur, L. A., Caterson, I. D., Dietz, W., Logue, J., & Lobstein, T. (2020). Clinical care for obesity: A preliminary survey of sixty?eight countries. Clinical obesity, 10(2), e12357.

Kasila, K., Vainio, S., Punna, M., Lappalainen, P., Lappalainen, R., Kaipainen, K., & Kettunen, T. (2020). Individual differences in processes of lifestyle changes among people with obesity: an acceptance and commitment therapy (ACT) intervention in a primary health care setting. Primary Health Care Research & Development, 21.

le Roux, C. W., & Heneghan, H. M. (2018). Bariatric surgery for obesity. Medical Clinics, 102(1), 165-182.

Lee, P., Yacyshyn, B. R., & Yacyshyn, M. B. (2019). Gut microbiota and obesity: An opportunity to alter obesity through faecal microbiota transplant (FMT). Diabetes, Obesity and Metabolism, 21(3), 479-490.

Oluyombo, R., Oguntade, H. B., Soje, M., Obajolowo, O., & Karim, M. (2021). Obesity and CKD in Sub-Saharan Africa: A Narrative Review. Kidney Medicine.

Sainsbury, K., Evans, E. H., Pedersen, S., Marques, M. M., Teixeira, P. J., Lähteenmäki, L., ... & Sniehotta, F. F. (2019). Attribution of weight regain to emotional reasons amongst European adults with overweight and obesity who regained weight following a weight loss attempt. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 24(2), 351-361.

Setyawati, A. D., Padila, P., & Andri, J. (2020). Obesity and Heredity for Diabetes Mellitus among Elderly. JOSING: Journal of Nursing and Health, 1(1), 26-31.

She, J., Wong, C. C., & Yu, J. (2021). Targeted prebiotics alter the obese gut microbiome in humans. Signal Transduction and Targeted Therapy, 6(1), 1-2.

Singhal, V., Sella, A. C., & Malhotra, S. (2021). Pharmacotherapy in pediatric obesity: current evidence and landscape. Current opinion in endocrinology, diabetes, and obesity, 28(1), 55.

Srivastava, G., & Apovian, C. M. (2018). Current pharmacotherapy for obesity. Nature Reviews Endocrinology, 14(1), 12-24.

Williams, D. M., Nawaz, A., & Evans, M. (2020). Drug therapy in obesity: a review of current and emerging treatments. Diabetes Therapy, 11(6), 1199-1216.

World Health Organization, 2020. Overweight and obesity.

Xu, L., Zhao, W., Wang, D., & Ma, X. (2018). Chinese medicine in the battle against obesity and metabolic diseases. Frontiers in physiology, 9, 850.

Zhang, L., Wang, Z., Wang, X., Chen, Z., Shao, L., Tian, Y., ... & Gao, R. (2020). Prevalence of overweight and obesity in China: results from a cross-sectional study of 441 thousand adults, 2012–2015. Obesity research & clinical practice, 14(2), 119-126.

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