Obesity is a chronic disease and should not be treated as an aesthetic issue, said Prof. Michał Holecki, who heads the Department and Clinic of Internal Medicine, Autoimmune Diseases and Diabetology at the Medical University of Silesia in Katowice, southern Poland.
“Excess weight and obesity affect around 60 percent of society in Poland, and if we talk about obesity alone, we are talking about around 9 million Poles,” Holecki told Polish state news agency PAP.
He cited data suggesting that one in five children in Poland has obesity, and that a five-year-old today faces a 60 percent risk of living with obesity by age 40.
Globally, obesity rates are expected to rise sharply by 2035, from 14 percent to 24 percent of the population, affecting nearly 2 billion adults, children, and adolescents, he added.
“This is an epidemic of the 21st century. The problem is growing, and the health consequences are very serious,” Holecki said.
While genetics and endocrine disorders can increase susceptibility, he said they cannot explain the scale of the trend. Instead, he pointed to lifestyle factors, especially poor diet and low physical activity.
“We eat highly processed food, consume excess calories, and move less and less. Children have fewer physical activities and spend more time in front of screens. That affects their health in adulthood,” he said.
Holecki said obesity is linked to more than 200 medical conditions, most commonly type 2 diabetes, high blood pressure, coronary artery disease, stroke, osteoarthritis, and some cancers.
“If there were no obesity, we practically would not have a problem with type 2 diabetes,” he said, adding that weight loss and broader lifestyle changes can cut the risk of developing type 2 diabetes by as much as 80 percent.
He said obesity also affects mental health, with patients more likely to experience depression, low mood, and social exclusion, and to face stigma.
“In public space, what is promoted first of all is an attractive appearance, and less often health. People with obesity are sometimes seen through stereotypes, which worsens their social and professional functioning,” he said.
Doctors commonly use body mass index, or BMI, to identify obesity. BMI is a ratio of weight to height, and obesity is usually defined as a BMI above 30.
Holecki said physicians also measure waist circumference to detect visceral obesity, meaning fat around internal organs, which is particularly risky for metabolism. He explained that visceral fat releases pro-inflammatory signaling molecules that can disrupt metabolism and increase the risk of cardiovascular complications.
Holecki said obesity treatment should be comprehensive, combining lifestyle changes with dietary and psychological support, medication, and, in selected cases, bariatric surgery, which reduces food intake and absorption by changing the anatomy of the digestive system.
“Medicines are support, not a replacement for movement and proper nutrition,” he said.
Among newer options, he listed incretin-based medicines, including glucagon-like peptide-1, or GLP-1, receptor agonists and related drugs, such as liraglutide, semaglutide, and tirzepatide.
He said these treatments can support weight loss and may reduce cardiovascular risk, while semaglutide may also slow the progression of chronic kidney disease.
“These are medicines with pleiotropic effects, meaning they influence many physiological processes,” he said. “They improve prognosis, extend life, and reduce the risk of complications in patients with type 2 diabetes and multiple conditions.”
He said bariatric surgery is reserved for a narrower group of patients, including those with a BMI of 35 or higher, and also some people with type 2 diabetes and a BMI of 30 or higher, depending on clinical factors.
“This is an effective method, but not every patient qualifies,” he said.
Holecki argued that prevention is especially important for children, noting that pediatricians monitor development using growth charts that compare weight and height with age norms.
He said childhood obesity is most often connected to family eating habits.
“Most often, a child’s obesity is linked to the eating habits of the whole family. It is rare for slim parents to have a child with obesity,” he said.
Habits formed in childhood are hard to change later, he added, arguing that prevention efforts should involve whole families and focus on lasting lifestyle change.
“What a child absorbs in youth affects their health in the future,” Holecki said.
(rt/gs)
Source: PAP