Dr Georgia Rigas

General Practitioner and Bariatric Physician

Obesity is a medical condition, affecting millions of people across the world. It is defined by the World Health Organization (WHO) as having a body mass index (BMI) of 30 or higher.1 To shed light on this complex condition we spoke with General Practitioner and obesity expert Dr Georgia Rigas .

Obesity is defined as not a singular state but rather, “part of a continuum/spectrum”, similar to pre-diabetes progressing to diabetes or pre-cancer evolving into cancer. “Many people with pre-obesity will over time develop obesity and the associated health complications linked to this condition,” explains Dr Rigas.

How is obesity diagnosed?

People with a Body Mass Index (BMI) of between 27 and 30 (classified as overweight/pre-obesity), are at an increased risk of developing obesity and its associated complications. But BMI does have it’s limitations. “BMI doesn’t take into account difference between subcutaneous fat – under the skin which is NOT harmful to health – vs visceral fat around the internal organs which is harmful to one’s health,” explains Dr Rigas.”Visceral fat is harmful to a person’s health, increasing the risk of developing Type 2 diabetes, ischaemic heart disease, fatty liver, PCOS (polycystic ovarian syndrome) and associated infertility, as well as numerous cancers.” Another shortcoming is that the BMI doesn’t take into account if a person is pregnant, or does significant exercise and so is muscular amongst many other limitations.

Body composition analysis, especially the visceral fat score, are an alternative way to assess someone’s risk of obesity. “Body composition can be measured by bioimpedance analysis (BIA) or DEXA scan (however both of these cost money and are not reimbursed by Medicare which is in contrast with BMI which is easily calculated by any healthcare professional and costs nothing,” explains Dr Rigas.

Misconceptions of obesity

Obesity is a complex condition, now considered one of the most significant public health issues facing the global population.3 As individuals move along the continuum towards obesity, the risk of developing severe metabolic, mechanical, and mental health complications increases. It is essential to address obesity as a multifactorial issue, considering the interplay of genetic, environmental, and lifestyle factors.

By adopting a holistic approach that encompasses dietary modifications, increased physical activity, stress reduction, and adequate sleep, you can take proactive steps to manage and prevent obesity with professional guidance. Talking to your GP is the first step to getting help if you’re worried about living with obesity.

REFERENCES

1. World Health Organization. Obesity [Internet]. 2023. [cited 2023 June 27]. Available from https://www.who.int/health-topics/obesity#tab=tab_1

2. Stunkard AJ, Sørensen TI, Hanis C, Teasdale TW, Chakraborty R, Schull WJ, Schulsinger F. An adoption study of human obesity. N Engl J Med. 1986 Jan 23;314(4):193-8. 2023 [cited June 27]. Available from https://pubmed.ncbi.nlm.nih.gov/3941707/

3. World Obesity. About obesity [Internet]. 2023 [cited June 27]. Available from https://www.worldobesity.org/about/about-obesity