Breaking the Cycle:
New Frontiers in Fighting Obesity
Most of us have known someone who has struggled with being overweight or even obese. However, it is far less common to know someone who has successfully overcome this challenge. Obesity is notoriously difficult to reverse, and the reasons behind this will be extensively explored in this article, along with measures that can help prevent its resurgence in the future.
But why is it so important to combat obesity? As a society, we have long looked down on individuals with excess body weight, often resorting to cognitive biases that fuel hurtful and misguided comments such as, “Obese individuals lack the discipline to lose weight.” This oversimplification ignores the reality that obesity is a vicious cycle, one that perpetuates an overall unhealthy lifestyle through biological, psychological, and societal factors.
Obesity is defined as an excessive accumulation of body fat that poses significant health risks. According to the World Health Organization (WHO), the global prevalence of obesity has more than tripled since 1975. In the WHO European Region, nearly 60% of adults and one in three children are now affected by being overweight or obese.1 Within the European Union (EU), 50.6% of individualsaged 16 and over were classified as overweight in 2022, with national figures ranging from 41.3% in Italy to 62.0% in Malta.2 These numbers underscore the urgent need to address obesity, not just as an individual concern but as a major public health challenge.
Beyond its impact on individuals, obesity also poses significant challenges on a broader scale. It places a strain on economies, has deeply rooted biological mechanisms that make it difficult to combat, and requires innovative medical and policy-driven solutions to address effectively.
The Societal Challenges of Obesity
Obesity is not just a personal or medical issue, it carries profound societal consequences that impact economies, workplaces, and communities. As obesity rates continue to rise, so do the associated costs, both financial and social, creating a burden that extends far beyond the individual.
Healthcare Costs and Productivity Loss
The economic toll of obesity is immense, straining healthcare systems worldwide. Individuals with obesity are at a higher risk for chronic conditions such as diabetes, cardiovascular disease, and musculoskeletal disorders, leading to increased medical expenses, hospitalizations, and long-term treatments. The World Obesity Federation estimates that by 2035, the global economic impact of obesity will exceed $4 trillion annually, putting it on the same level as some of the most serious global issues.3
Beyond direct healthcare costs, obesity affects workplace productivity. Employees with obesity are more likely to experience absenteeism (missing work due to health issues) and presenteeism (reduced efficiency while at work).4 Studies suggest that obesity-related productivity losses cost economies billionsannually, further reinforcing the need for prevention and intervention strategies.5
In an article I wrote in 2022 on the Yaba drug epidemic in Bangladesh,6 I explored how widespread drug abuse led to similar societal issues, particularly in terms of workforce disruption. While obesity and drug addiction are vastly different, both create self-perpetuating cycles that impact individuals and economies in comparable ways. Highly processed, calorie-dense foods, much like addictive substances, stimulate the brain’s reward system, reinforcing behaviors that are difficult to control. Viewing obesity through this lens can help shift the conversation from personal blame to systemic solutions that address the root causes of this growing crisis.
Social Stigma, Mental Health, and Quality of Life
Despite its widespread prevalence, obesity remains highly stigmatized. Individuals with obesity often face discrimination in various settings, including employment, healthcare, and social interactions. Negative stereotypes -such as assumptions that people with obesity are lazy or lack self-control- can lead to exclusion, lower self-esteem, and psychological distress.
This stigma has tangible consequences for mental health. Studies indicate that weight-based discrimination is linked to higher rates of depression, anxiety, and eating disorders.7 Furthermore, individuals who experience weight stigma may avoid medical care for fear of judgment, leading to delayed diagnoses and poorer health outcomes.8 The psychological burden of obesity is just as significant as its physical impact, contributing to the aforementioned vicious cycle where stress and emotional distress lead to further weight gain.
Accessibility Issues: Food Deserts and the Cost of Healthy Eating
A significant but often overlooked challenge is the issue of food accessibility. In many regions, particularly in low-income urban and rural areas, individuals face limited access to fresh, nutritious foods -a phenomenon known as food deserts. These communities often have an overabundance of fast-food restaurants and convenience stores but lack supermarkets or grocery stores offering fresh produce.
Even when healthier options are available, they are often significantly more expensive than processed, high-calorie foods. Studies have shown that healthier diets cost approximately $1.50 more per day than less nutritious alternatives, a financial barrier for many households.9 The affordability gap reinforces unhealthy eating patterns, making obesity prevention inaccessible for lower-income populations and perpetuating health disparities.
The societal challenges of obesity highlight the external pressures that make weight management difficult: economic burdens, stigma, and accessibility issues all play a role in shaping lifestyle choices. However, obesity is not merely a result of behavior or environment; it is also deeply rooted in biological mechanisms.
Body weight is influenced by a complex interplay of genetics, metabolism, and hormonal regulation, all of which can make losing weight far more difficult than simply “eating less and moving more.” To fully understand obesity and develop effective solutions, it is essential to look beyond external factors and explore the biological forces that contribute to weight gain and retention.
The Science of Obesity
Genetics
Genetic predisposition significantly influences an individual's susceptibility to obesity. Variations in multiple genes can affect appetite regulation, energy expenditure, and fat storage. For instance, polymorphisms in the FTO gene are associated with increased BMI and a higher risk of obesity. Individuals carrying certain variants of this gene may experience heightened hunger and caloric intake, leading to weight gain.10
Metabolism
Metabolic rate -the speed at which the body converts food into energy- varies among individuals and plays a crucial role in weight management. A slower basal metabolic rate can result in fewer calories burned at rest, making weight gain more likely if caloric intake isn't adjusted accordingly. Factors influencing metabolic rate include age, muscle mass, and genetic makeup. Research indicates that individuals with obesity may have metabolic adaptations that favour energy storage, complicating weight loss efforts.11
Hormonal Factors
Hormones are pivotal in regulating hunger, satiety, and fat distribution. Leptin, produced by adipose tissue, signals the brain to reduce appetite; however, many individuals with obesity exhibit leptin resistance, where the brain doesn't respond adequately to leptin signals, leading to overeating. Conversely, ghrelin, known as the "hunger hormone," stimulates appetite. Elevated ghrelin levels can increase food intake and promote fat storage. Imbalances in these and other hormones can disrupt energy balance and contribute to weight gain.12
Environmental and Behavioral Contributors
The modern environment significantly influences obesity prevalence. Sedentary lifestyles, characterized by prolonged periods of inactivity, reduce total daily energy expenditure, facilitating weight gain. Concurrently, the pervasive marketing of energy-dense, nutrient-poor foods encourages overconsumption. Behavioural factors, such as irregular eating patterns and insufficient sleep, further exacerbate this risk. Addressing these contributors requires comprehensive public health strategies promoting physical activity and healthy eating habits.13
However, modern society is built around this sedentary lifestyle, making it difficult for individuals -especially students- to break free from it. University life is a prime example: as academic demands increase, time for physical activity and meal preparation decreases. Long hours spent in lectures, labs, practicals, libraries, and in front of screens lead to prolonged sitting, while the pressure to meet deadlines often results in quick, unhealthy food choices. The more rigorous the program, the harder it becomes to prioritize a balanced lifestyle, forcing many students to rely on energy drinks, fast food, and “freestyling” their sleep schedules just to keep up. This cycle, though often temporary, can establish long-term habits that persist into adulthood, contributing to weight gain and metabolic health issues. Recognizing this reality is the first step toward reshaping environments -both in universities and beyond- to promote healthier behaviours in a sustainable and accessible way.
Advances in Tackling Obesity
Emerging Pharmacological Solutions
Glucagon-like peptide-1 (aka GLP-1) receptor agonists, such as semaglutide, have emerged as effective treatments for obesity. Originally developed for type 2 diabetes management, these medications aid weight loss by enhancing insulin secretion, suppressing appetite, and slowing gastric emptying. Clinical trials have demonstrated that semaglutide can lead to significant weight reduction, with participants experiencing an average loss of approximately 15% of their body weight over 68 weeks.14
However, despite the high effectiveness of such drugs, there are some risks that make them a less-appealing choice for a lot of people. Apart from the common side-effects (such as nausea, dizziness, fatigue etc.) some people that have used such drugs have reported chronic health problems such as osteoporosis and osteopenia, voicing their negative experience in social media. However, we must keep in mind that these serious consequences are brought by not having a balanced diet. GLP-1, as mentioned above, suppresses one’s appetite, but it doesn’t make them eat “healthy”. Thus, some people lose a lot of weight very quickly by eating very few calories, and as a result of this malnutrition, they develop chronic problems. As expert -Johann Hari- mentioned in the podcast with Dr. Mayim Bialik (actress in TBBT)“Ozempic [a GLP-1 drug] is like a double-edged sword. It will save the lives of some individuals, but it will destroy the lives of others [in context, we see that he refers to individuals that show early symptoms of eating disorders caused]”.15 So, you can understand why it is strongly advised to consult with an experienced dietitian while taking a GLP-1 medication.
Preventative Measures
Preventing obesity requires a proactive approach, with education playing a key role in shaping healthier behaviours from an early age. Implementing nutrition and physical activity education programs in schools helps students develop a better understanding of how lifestyle choices affect their long-term health.16 Similarly, structured school programs that promote physical activity and balanced diets have been shown to effectively reduce obesity rates among children and adolescents. Beyond the school setting, public health campaigns play an essential role in spreading awareness and encouraging healthier habits on a larger scale. By fostering environments that support active living and nutritious eating, these initiatives aim to make obesity prevention more accessible and sustainable for communities.17
Technological Innovations
In addition to education-based efforts, technological innovations offer promising tools in the fight against obesity. Wearable devices, such as fitness trackers and smartwatches, help individuals monitor their physical activity and overall health, keeping them motivated to stay active.18 Meanwhile, mobile applications provide convenient ways to track food intake, exercise routines, and weight loss progress, often incorporating goal-setting features and social support for added accountability.19 The rise of AI-driven fitness programs further enhances these efforts by using personalized data to optimize nutrition and workout plans, improving long-term adherence.20 Using ChatGPT, one can very easily create a full meal plan that will help them lose weight. In this day and age, AI chat bots are able to undertake the role of -inexperienced and untrained- dietitians, providing a free alternative to individuals not being able to afford the help of an expert.
As technology continues to evolve, these innovations provide new, accessible ways to support individuals in achieving and maintaining a healthier lifestyle.
Examples of Successful Policies
Governments around the world have introduced various policies to tackle obesity by making healthier choices more accessible and encouraging active lifestyles. One effective measure is the sugar tax, which adds a small extra cost to drinks containing sugar, to discourage excessive consumption. Countries like the UK and Mexico have seen a drop in soda sales after introducing these taxes, showing that financial incentives can influence healthier habits.
Another important step is clear food labelling, which helps consumers make better dietary choices by providing straightforward nutritional information. Systems like the Nutri-Score here in Europe use color-coded labels to rank foods based on their health impact, making it easier to choose nutritious options. Beyond food policies, urban planning plays a big role in promoting active living. Cities that invest in walkable spaces, bike lanes, and public parks encourage physical activity as part of daily routines. These community-focused strategies show that when the environment supports healthier lifestyles, people are more likely to make positive choices.
Conclusion
Obesity is far more than an issue of personal responsibility -it is a complex, multifaceted challenge deeply rooted in biological, societal, and environmental factors. It is shaped by genetics, reinforced by modern lifestyles, and sustained by policies and industries that often prioritize profit over public health. Yet, as overwhelming as this crisis may seem, it is not insurmountable.
Scientific advancements, policy reforms, and technological innovations provide a path forward. Emerging medical treatments like GLP-1 agonists offer new hope for those struggling with weight loss, while preventative measures such as school education programs and public health campaigns continue to shape healthier habits from an early age. At the same time, technology is changing the way we approach health, offering accessible solutions through fitness wearables, AI-driven nutrition plans, and mobile applications designed to keep people engaged and accountable. Governments, too, have begun to recognize their role in this fight -sugar taxes, improved food labelling, and urban planning initiatives are already making an impact.
But the real change starts with us. We must challenge the stigma that surrounds obesity and recognize that for many, weight gain is not a failure of willpower but the result of a system that makes unhealthy choices easier and more affordable than healthy ones. We must shift the conversation from blame to solutions, from shame to empowerment. Whether through better education, stronger policies, or personal action, every effort to reshape our environment and improve access to healthier living contributes to breaking the cycle of obesity.
The fight against obesity is not just about numbers on a scale; it is about building a future where health is a right, not a privilege -a future where individuals are equipped, supported, and empowered to take control of their well-being.
The solutions exist.
The change is possible.
It’s time to act.
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