The Big O: Why We Need to Talk About Obesity
Expert: Dr Andrew Viljoen, The Weight Loss Centre
Obesity is one of the most urgent health challenges of our time. However, conversations around it are often clouded by stigma, shame and an unhealthy obsession with appearance. The constant noise hides one important truth: obesity is a medical condition, not a cosmetic issue. Addressing it isn’t about fitting into a certain size; it’s about saving lives.
Globally, obesity rates have nearly tripled since 1975. In South Africa alone, more than 68% of women and 31% of men are either overweight or obese, according to the World Health Organization, and it’s increasing under the younger population. This isn’t just a statistic; it’s a warning. Obesity significantly increases the risk of a wide range of health conditions that impact every system in the body, even from a young age.
The Hidden Health Toll
Cardiovascular Disease
Obesity is a major risk factor for high blood pressure, high cholesterol and type 2 diabetes – all increasing the risk of heart attacks and strokes. Fat accumulation – especially around the abdomen – can cause insulin resistance and inflammation, leading to atherosclerosis (hardening of the arteries).
Cancer
According to the American Cancer Society, excess body fat is linked to at least 13 types of cancer, including breast (post-menopausal), colorectal, liver, kidney, pancreatic and endometrial cancer. Fat tissue produces hormones and inflammatory signals that can fuel the growth of cancer cells.
Fertility and Hormonal Health
Obesity can disrupt hormonal balance in women and men. For women, it increases the risk of polycystic ovary syndrome (PCOS), irregular menstrual cycles and difficulty falling pregnant. For men, obesity can reduce testosterone levels, affect sperm quality and decrease libido. It can also lead to pregnancy and childbirth complications.
Musculoskeletal Problems
Excess weight places enormous strain on joints, especially the knees, hips and lower back. This contributes to osteoarthritis, reduced mobility and chronic pain. Obesity is one of the leading causes of disability worldwide, because of physical limitations and the accompanying pain.
Pulmonary and Sleep Disorders
Excess weight makes it harder for the lungs to expand and function effectively. This can lead to asthma and obesity hypoventilation syndrome. Or, most commonly, obstructive sleep apnea – a condition that causes breathing to stop and start during sleep. It’s linked to daytime fatigue, increased risk of accidents and heart disease.
Mental Health
While the emotional toll of stigma is real, research also shows that obesity is linked to an increased risk of depression and anxiety. The biological effects of chronic inflammation, insulin resistance and hormonal changes can influence brain chemistry. Evidently, mental and physical health continuously affect one another.
Shifting the Conversation
We need to stop framing obesity as a personal failure or an aesthetic issue. It’s a chronic, complex medical condition influenced by genetics, environment, behavior and socioeconomic status and deserves the same compassionate and evidence-based approach as any other medical concern.
Weight is not the only measure of health. In fact, focusing solely on the scale can lead to frustration and disordered habits. Instead, we should emphasise improving nutrition, increasing physical activity, getting enough sleep, reducing stress and accessing proper medical care.
The Path Forward
Even modest weight loss – just 5% to 10% of body weight – can lead to significant improvements in health markers like blood pressure, blood sugar and cholesterol. The goal should always be better health, though. Not smaller jeans.
So, let’s keep talking about obesity – openly, honestly and without judgment. The conversation matters because health matters.
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