Obesity: Symptoms, Causes & Treatment

Obesity is a complex chronic disease resulting from interactions between genetic, environmental, social, and economic factors. It is defined by a body mass index (BMI) of 30 or higher. The condition develops when a person consumes more calories than their body burns, leading to excessive fat accumulation under the skin and around vital organs.

Obesity is one of the most prevalent diseases globally, affecting over one billion people worldwide. In the Arab region and Jordan specifically, obesity rates have risen significantly in recent decades due to lifestyle changes, dietary shifts, increased consumption of fast food, and reduced physical activity. Obesity represents a major health and social burden because it is linked to serious diseases such as type 2 diabetes, hypertension, cardiovascular disease, cancer, joint disorders, infertility, and depression.

It is important to understand that obesity is not merely a cosmetic issue, but a serious medical condition requiring specialized medical intervention. Its treatment requires a comprehensive approach that combines lifestyle and dietary changes, modern medications, and sometimes surgical intervention.

Mild obesity may not show obvious symptoms initially, but as weight increases, various health problems emerge. Symptoms vary among individuals depending on obesity severity, overall health, and other factors. Women may experience additional symptoms due to hormonal effects, while children and adolescents may present different signs.

• Persistent fatigue and tiredness even with rest.
• Shortness of breath, asthma, and wheezing, especially during physical exertion.
• Joint pain in knees, ankles, back, and hips.
• Heaviness and general discomfort in the body.
• Snoring, sleep disturbances, and sleep apnea.
• Skin problems such as infections and excessive sweating in skin folds.
• Psychological distress, depression, and low self-esteem.
• Fertility problems and infertility in both men and women.
• Indigestion and acid reflux.
• High blood pressure (may be detected only upon measurement).
• Elevated blood sugar levels without obvious early symptoms.
• Movement difficulties and reduced ability to perform daily activities.

• Excessive calorie intake: Consuming foods rich in calories, fats, and sugars more than the body needs leads to fat accumulation.
• Lack of physical activity: Sedentary lifestyles, desk jobs, and prolonged screen time reduce calorie burning.
• Genetic factors: Genes significantly influence how the body regulates appetite, metabolism, and fat storage.
• Hormonal disorders: Thyroid problems, polycystic ovary syndrome, and other hormonal imbalances increase obesity risk.
• Medications: Certain drugs such as antidepressants and beta-blockers can cause weight gain as a side effect.
• Psychological stress: Mental stress, anxiety, and depression may drive overeating.
• Sleep disorders: Poor sleep or sleep disturbances affect hormones that regulate hunger and satiety.
• Social and economic factors: Availability of cheap unhealthy foods, marketing, and social pressures increase obesity risk.

• Age: Obesity is most common in middle age but can occur at any age.
• Gender: Women are more prone to obesity than men in many countries, including Jordan.
• Genetic and family factors: A family history of obesity increases individual risk.
• High-calorie diet: Foods rich in fats and sugars, processed foods, and fast food promote weight gain.
• Lack of exercise: Absence of regular physical activity is a major risk factor.
• Psychological disorders: Depression, anxiety, and chronic stress.
• Certain medications: Such as corticosteroids and antipsychotics.
• History of childhood obesity.
• Social and cultural eating habits.
• Limited economic resources in some communities.

Obesity diagnosis is primarily based on measuring body mass index (BMI), but comprehensive assessment requires a complete clinical examination, blood tests, and additional investigations to ensure no complications exist.

• Body Mass Index (BMI) calculation: Calculated by dividing weight in kilograms by height in meters squared. BMI 18.5-24.9 is normal, 25-29.9 is overweight, 30 and above is obesity. Values above 35 indicate severe obesity.
• Waist circumference measurement: Reflects fat distribution. Waist circumference greater than 102 cm for men and 88 cm for women indicates higher health risks.
• Comprehensive clinical examination: Includes checking blood pressure, heart, lungs, and joints.
• Blood tests: Measuring glucose, cholesterol, triglycerides, liver, and kidney function.
• Glucose tolerance test: To detect type 2 diabetes or prediabetes.
• Ultrasound: To examine the liver, kidneys, and other internal organs.
• Lifestyle and medical history assessment: Questions about eating habits, physical activity, medications, and past diseases.
• Psychological evaluation: Assessment for depression, anxiety, and behavioral eating disorders.

Medications

• Semaglutide (Ozempic, Wegovy): A modern drug that mimics the natural GLP-1 hormone, reducing appetite and increasing satiety. Very effective and safe for long-term use.
• Tirzepatide (Zepbound, Mounjaro): A newer drug that mimics GLP-1 and GIP hormones, showing better weight loss results than semaglutide.
• Orlistat (Xenical): A drug that reduces fat absorption from food by 25-30%. Available over-the-counter.
• Phentermine: A stimulant that reduces appetite, used for short-term periods (12 weeks or less).
• Naltrexone/Bupropion (Contrave): A combination drug that works on appetite and hunger centers in the brain.

Surgical Interventions

• Gastric Sleeve Surgery: Removal of part of the stomach to reduce its size and capacity. The most common bariatric surgery.
• Gastric Bypass: Redirecting food to bypass part of the stomach and intestines, reducing calorie absorption.
• Gastric Band: Placing an adjustable band around the stomach to reduce its size.
• Duodenal Switch: A complex surgery combining gastric sleeve with intestinal bypass.
• Vagal Nerve Stimulation: A device implanted under the skin that sends electrical pulses to reduce hunger.
• Gastric Balloon: A temporary balloon filled with fluid inserted into the stomach to reduce capacity.

Lifestyle Changes

• Dietary improvements: Eat a healthy, balanced, low-calorie diet rich in vegetables, fruits, and lean proteins. Avoid processed foods, fast food, and sugary beverages.
• Regular exercise: Perform brisk walking, running, swimming, or cycling for at least 150 minutes weekly, plus muscle-strengthening exercises twice per week.
• Adequate sleep: Getting 7-9 hours of sleep daily helps regulate hormones affecting weight.
• Stress management: Practice yoga, meditation, and enjoyable activities to reduce stress and emotional eating.
• Behavior modification: Work with a behavioral specialist or nutrition counselor to understand and change poor eating habits.
• Regular follow-up: Visit your doctor every 1-3 months to monitor progress and ensure treatment safety.
• Social support: Join support groups or group therapy programs to increase success rates.

• Type 2 Diabetes: Obesity is the primary risk factor for diabetes. Excess fat reduces insulin sensitivity, elevating blood sugar. Diabetes increases risk of heart disease, kidney damage, and blindness.
• Hypertension: Excess weight increases strain on the heart and blood vessels. Chronic high blood pressure causes strokes and heart attacks.
• Cardiovascular disease: Obesity increases cholesterol, inflammation, and atherosclerosis, leading to heart attacks, strokes, and thrombosis.
• Osteoarthritis and bone disease: Excess weight increases pressure on joints, especially knees, hips, and ankles, causing inflammation and cartilage degeneration (osteoarthritis).
• Cancer: Obesity is linked to increased risk of multiple cancers including liver, breast, colon, pancreatic, and kidney cancer.
• Sleep disorders and respiratory problems: Obesity causes obstructive sleep apnea and snoring, reducing oxygen levels and increasing stroke risk.
• Fatty liver disease (NAFLD): Fat accumulation in the liver causes inflammation and potential cirrhosis and liver failure.
• Infertility and pregnancy complications: Obesity affects fertility in men and women and increases pregnancy and delivery complications.

• Maintain healthy weight from childhood: Establishing healthy eating habits and physical activity early prevents obesity in adulthood.
• Follow a balanced diet: Eat vegetables, fruits, whole grains, and lean proteins while avoiding processed foods and added sugars.
• Drink plenty of water: Consuming 6-8 glasses of water daily promotes fullness and reduces eating urges.
• Exercise regularly: At least 30 minutes of daily physical activity such as brisk walking provides effective prevention.
• Get adequate sleep: 7-9 hours of sleep daily regulates hormones affecting weight and hunger.
• Manage psychological stress: Practice relaxation and meditation while avoiding emotional eating reduces stress-related obesity.
• Avoid sugary beverages: Eliminating sodas and sweetened juices significantly reduces calorie intake.
• Reduce portion sizes: Eating smaller, frequent meals instead of large meals helps control weight.
• Monitor weight regularly: Checking weight weekly or monthly allows early detection of gains and prompt action.
• Health education: Understanding the importance of nutrition increases motivation for healthy habits.