Obesity as a Disease
Obesity is recognised as a chronic, complex disease characterised by excessive accumulation of body fat that impairs health.
The prevalence of obesity has risen dramatically over recent decades, contributing substantially to the burden of other non-communicable diseases, including cardiometabolic disease, musculoskeletal disorders, and increased risk of certain cancers. Rather than resulting from a single cause, obesity arises from a complex interaction of genetic, biological, behavioural, environmental, and social determinants, reflecting broader changes in food systems, physical activity patterns, and societal structures. There has been a paradigm shift in understanding that obesity is not the result of individual lifestyle choices or lack
of willpower, to recognising it as a chronic, complex, relapsing disease influenced by genetic, biological, environmental and social factors.
Historically, obesity was framed as a simple imbalance between calorie intake and expenditure, placing responsibility largely on individual behaviour such as overeating or physical inactivity. This perspective often led to stigma and an overemphasis on short-term lifestyle advice as the main treatment strategy. Modern research has demonstrated that obesity involves complex physiological mechanisms, including genetic predisposition, neuroendocrine regulation of appetite and metabolism, hormonal signalling
and changes in energy homeostasis. In addition, environmental and social determinants, such as food environments, socioeconomic status, urban design, and marketing of foods play a significant role
in shaping risk.
As a result, obesity is now widely recognised by organisations such as the World Health Organisation
and the European Association for the Study of Obesity as a chronic disease that requires long-term, interdisciplinary management, rather than short-term weight loss efforts alone. This shift has important implications for healthcare systems, emphasising structured care pathways, medical and/or surgical treatments and interprofessional approaches, while also helping to reduce stigma and improving access
to to personalised care.
This first section of the PROMINENCE Open Education Resource (OER) will give an overview of the epidemiology, determinants, pathophysiology, and complications of obesity, before outlining the clinical care pathway and the role of interprofessional models of care in its management. It will also provide
an overview of evidence-based approaches to obesity management in adults, including lifestyle, medical,
and surgical interventions, emphasising the need for coordinated, long-term strategies to effectively prevent and treat this complex disease.
