Endocrinology & Metabolic

Obesity

Obesity is chronic excess adiposity that impairs health, shaped by biological, environmental, social and genetic factors; assess risk beyond BMI, treat complications and offer sustained behavioural support, escalating to NICE-approved medicines or bariatric services when eligible.

Definition

Obesity is chronic excess or abnormal adiposity that impairs health. BMI is used to classify weight status, but central adiposity and the person's ethnic and clinical context are also important when estimating health risk and selecting interventions.

First principles

Adiposity is biologically defended

Weight is regulated by appetite, satiety, energy expenditure, sleep, medicines, social context and genetic susceptibility. After weight loss, changes in appetite and energy expenditure can favour regain, so obesity behaves as a chronic relapsing disease rather than a short episode of poor willpower. Effective care therefore combines long-term support with treatment of complications and barriers.

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