Obesity: Pathophysiology, Management, and Public Health

Introduction

Obesity is a global epidemic affecting almost all population cohorts, with rates rising worldwide. According to the World Health Organization (WHO, 2013), the obesity epidemic "is not restricted to industrialized societies," with millions of obesity-related cases burgeoning in developing countries (p. 1). With billions of cases worldwide, obesity has been described as the "major health hazard of the 21st century" (Zhang, Liu, Yao, et al., 2014, p. 5153). Given the global nature of the disease, clinical guidelines have become increasingly standardized, but it remains necessary to tailor interventions to specific populations in order to create age-appropriate, culturally appropriate, and gender-appropriate treatment plans. After a brief discussion of obesity pathophysiology, this paper evaluates standard practices at local, state, national, and international levels. Because access to care and treatment options also determine disease outcomes, this paper additionally addresses the core factors involved in public health strategies and health policy.

Pathophysiology

Defined clinically as "an exaggeration of normal adiposity," obesity is the condition of being excessively overweight based on quantitative measures such as body mass index (BMI) (Redinger, 2007, p. 856). However, the pathophysiology of obesity is also linked to ancillary factors like metabolic and immune dysfunction. BMI alone is not a reliable assessment measure due to individual differences (Li & Cheung, 2009).

The most significant health-related problem with obesity is its comorbidity with a number of potentially fatal conditions, including diabetes, heart disease, and cancer (Zhang, Liu, Yao, et al., 2014). Obesity is a complex problem linked to many variables, but lifestyle is typically implicated, given that "overconsumption of calorie-dense foods" is a known culprit in disease etiology (Zhang, Liu, Yao, et al., 2014, p. 5153). The increased availability and low cost of calorie-dense foods has contributed to the proliferation of obesity; however, physiological and neurological factors also contribute to disease progression. Due to biological or genetic reasons, some individuals appear predisposed toward obesity based on neuroimaging evidence (Zhang, Liu, Yao, et al., 2014). Therefore, obesity is a result of both genetic and lifestyle factors, and a biopsychosocial approach to treatment interventions may be warranted in most cases.