Blog: From Losing the Battle to Winning the War Against Obesity
Obesity is a major public health challenge, but we can win this battle. By uniting families, healthcare professionals, educators, policymakers and communities, we can develop sustainable strategies for healthy living.
One day, as my father and I were driving, he looked at the people around us and remarked, "You are not doing your job well." As a nutrition researcher, these words struck a chord with me. Recently during the protocol concept presentations of our postgraduate nutrition students, I again experienced a profound sense of defeat. The focus on the prevalence of overweight and obesity revealed disheartening statistics. Alarmingly, infants are now being born overweight or obese, which often sets the stage for a lifelong struggle with weight—a struggle that could potentially be avoided. Are we truly losing this battle?
Adding to my frustration, we advised students to avoid using the term "normal" body mass index (BMI), as what was considered normal several decades ago is now referred to as a "healthy" BMI. A colleague introduced the body roundness index (BRI), proposed in 2013, as a more accurate measure than BMI for describing overweight and obesity and BRI has been called the new BMI. Describing the human body as "round" feels more fitting for an inanimate object than for a person.
BMI, BRI and waist circumference (WC) with their respective cut-off values for different categories:
|
Category |
BMI (kg/m²) |
BRI |
WC |
|
Underweight |
< 18.5 |
N/A |
N/A |
|
Normal Weight |
18.5 - 24.9 |
BRI < 4.5 |
Men: < 94 cm (37 in) |
|
Women: < 80 cm (31.5 in) |
|||
|
Overweight |
25 - 29.9 |
BRI 4.5 - 6 |
Men: 94 - 102 cm (37 - 40 in) |
|
Women: 80 - 88 cm (31.5 - 34.5 in) |
|||
|
Obesity Class I |
30 - 34.9 |
BRI 6 - 8 |
Men: > 102 cm (40 in) |
|
Women: > 88 cm (34.5 in) |
|||
|
Obesity Class II |
35 - 39.9 |
BRI 8 - 10 |
Men: > 102 cm (40 in) |
|
Women: > 88 cm (34.5 in) |
|||
|
Obesity Class III |
≥ 40 |
BRI > 10 |
Men: > 102 cm (40 in) |
|
Women: > 88 cm (34.5 in) |
Notes:
- BMI: Calculated as weight (kg) / height (m²).
- Waist circumference (WC): A measurement of abdominal fat. The risk of non-communicable diseases increases with waist measurements greater than 94 cm for men and 80 cm for women, with substantially increased risk above 102 cm and 88 cm, respectively.
- BRI: A BRI calculator can be found on the website https://webfce.com/bri-calculator/. Higher values indicate greater roundness and potentially higher levels of body fat.
We have also advised students to use more sensitive language, referring to individuals as people living with obesity. However, this terminology seems to admit defeat, suggesting that obesity cannot be overcome. This realisation underscores the shifting landscape of our understanding: maintaining a healthy BMI is increasingly rare.
As someone who trains dietitians and conducts research in nutrition, I am left to ponder: is there hope? Who should fight this battle? What can we do to prevail? In the table below I outline what I believe we could do to get the upper hand in this battle.
Key role-players and suggested strategies to combat obesity
|
Strategy |
Details |
|
Parents
and Families |
As
the first line of defence, parents should make healthy choices at home, set a
positive example, involve children in cooking, and engage in family physical
activities. |
|
Individuals |
Take
charge of your health through education about nutrition and physical
activity. Small, consistent lifestyle changes can lead to significant
improvements. Support and motivate each other, sharing tips and successes. |
|
Healthcare
Professionals |
Provide
personalised advice and support, advocate for preventive measures, and
educate about the risks of obesity. Your expertise is invaluable in this
collective effort. |
|
Educators
and Schools |
Promote
healthy eating in cafeterias, incorporate nutrition education into curricula,
and encourage physical activity through sports and active play. Schools play
a pivotal role in shaping lifelong habits. |
|
Food
Industry |
Influence
consumer choices by developing and marketing healthier products. Be
transparent with labelling and responsible with advertising, particularly to
children. |
|
Government
and Policymakers |
Implement
supportive public health policies. Subsidise healthy foods, introduce sugar
tax, regulate harmful ingredients, and fund public health campaigns to create
an environment that promotes healthy living. |
|
Communities
and Organisations |
Create
supportive environments through community fitness programs, health workshops,
and community gardens. Social support is crucial for sustaining healthy behaviours. |
|
Media
and Influencers |
Advocate
for healthy living through accurate information about nutrition and exercise.
Highlight success stories and inspire others to take action. |
|
Nutrition
Researchers |
Conduct
and disseminate research on obesity causes and interventions, inform policy
and practice and develop evidence-based strategies to support weight
management and healthy lifestyles. |
The fight against obesity is a complex and multifaceted challenge, but it is not insurmountable if we approach it with determination and collective action. By uniting our efforts across various sectors—families, individuals, healthcare professionals, educators, the food industry, policymakers, communities, and media—we can create a healthier, happier future for everyone. Every small step counts, and together, we can make a monumental difference. Let us refuse to accept defeat. Let us fight together and individually be the change we want to see in the world, starting today.
In the process of creating this work, the author employed ChatGPT 4 to streamline the text and to perform language editing.
