Overweight: Causes, Risks and Treatment

What Is Overweight?

Overweight is a condition in which a person carries more body weight than is considered healthy in relation to their height. The most commonly used measure is the Body Mass Index (BMI), calculated by dividing body weight in kilograms by the square of height in meters. According to the World Health Organization (WHO), a BMI between 25 and 29.9 kg/m² is classified as overweight, while a BMI of 30 kg/m² or above is classified as obesity. Overweight is one of the most widespread public health challenges globally, affecting people of all ages and backgrounds.

Causes

Overweight develops when the body consistently takes in more energy than it expends. The causes are diverse and often interconnected:

• Unhealthy diet: High consumption of calorie-dense, high-fat, and high-sugar foods, as well as sugar-sweetened beverages.
• Physical inactivity: Sedentary lifestyle with little movement during daily life or at work.
• Genetic predisposition: Hereditary factors can influence fat storage, metabolism, and appetite regulation.
• Hormonal conditions: Disorders such as hypothyroidism or Cushing syndrome can promote weight gain.
• Medications: Certain drugs including corticosteroids, antidepressants, and antipsychotics may contribute to weight gain as a side effect.
• Psychosocial factors: Chronic stress, sleep deprivation, emotional eating, and socioeconomic influences all play a role.

Symptoms and Associated Conditions

Overweight itself may not cause immediate symptoms, but over time it significantly increases the risk of developing serious health conditions:

• Type 2 diabetes: Insulin resistance and elevated blood sugar levels.
• Cardiovascular disease: High blood pressure, coronary artery disease, heart attack, and stroke.
• Dyslipidemia: Abnormal blood lipid levels, including elevated cholesterol and triglycerides.
• Musculoskeletal disorders: Osteoarthritis, back pain, and joint problems due to excess mechanical load.
• Sleep apnea: Interrupted breathing during sleep, particularly common in people with significant excess weight.
• Non-alcoholic fatty liver disease (NAFLD): Accumulation of fat in liver cells.
• Mental health conditions: Increased risk of depression, anxiety, and reduced self-esteem.
• Certain cancers: Elevated risk for colorectal, breast, and endometrial cancers.

Diagnosis

Overweight is primarily diagnosed using the Body Mass Index (BMI). Additional measurements help provide a more complete clinical picture:

• Waist circumference: A waist measurement above 88 cm in women and above 102 cm in men indicates increased cardiometabolic risk.
• Waist-to-hip ratio (WHR): Provides information about body fat distribution, particularly abdominal fat.
• Laboratory tests: Blood glucose, lipid profile, liver enzymes, and thyroid hormones to assess for related conditions.
• Body composition analysis: Measurement of body fat percentage using bioelectrical impedance analysis (BIA) or other methods.

Treatment

Treating overweight typically requires a combination of approaches tailored to the individual:

Dietary Changes

A balanced, calorie-controlled diet is the cornerstone of weight management. Emphasis should be placed on vegetables, fruits, whole grains, lean protein, and healthy fats. Highly processed foods, added sugars, and saturated fats should be reduced.

Physical Activity

Regular exercise is a key component of treatment. Health guidelines recommend at least 150 minutes of moderate-intensity physical activity per week, such as brisk walking, swimming, or cycling.

Behavioral Therapy

Psychological support and behavioral therapy help individuals identify and change unhealthy eating and activity patterns, and address emotional eating in a sustainable way.

Medical Treatment

In certain cases, weight-loss medications (e.g., GLP-1 receptor agonists such as semaglutide) may be prescribed under medical supervision when lifestyle changes alone are insufficient.

Bariatric Surgery

For severe obesity (BMI above 40 kg/m², or above 35 kg/m² with serious comorbidities), surgical options such as gastric bypass or sleeve gastrectomy may be considered.

Prevention

Overweight can be effectively prevented through a healthy lifestyle. Key measures include a balanced diet, regular physical activity, adequate sleep, and effective stress management. Early education and prevention programs -- especially during childhood and adolescence -- are essential for long-term impact.

References

1. World Health Organization (WHO): Obesity and overweight. Fact sheet. Geneva, 2024. Available at: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
2. Apovian CM et al.: Pharmacological Management of Obesity: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology and Metabolism, 2015; 100(2): 342-362.
3. Bray GA, Kim KK, Wilding JPH: Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obesity Reviews, 2017; 18(7): 715-723.