The Obesity Working Group of the Spanish Society of Endocrinology and Nutrition (GOSEEN) is actively promoting awareness campaigns to address the rising incidence of obesity at both national and global levels.
Dr. Irene Breton, President of GOSEEN, stresses the need to recognize obesity as a chronic disease, stating, “Only by recognizing obesity as a chronic disease will more action be taken to combat it.” Despite being widely attributed to lifestyle choices, genetic factors contribute 40% to 70% of an individual’s risk of developing obesity. This predisposition is linked to multiple genes involved in body weight regulation, making obesity a complex metabolic disorder rather than a simple consequence of overeating.
Obesity is associated with over 200 diseases that significantly impair patients’ quality of life, including joint pain, mobility issues, chronic fatigue, and sleep disturbances. It is also a significant risk factor for cardiovascular disease and certain cancers. Breton explains that obesity results from dysregulation in energy metabolism, leading to excessive fat accumulation and chronic inflammation: “Obesity is not just about weight. The body controls adipose tissue, and when this mechanism fails, excess fat causes an inflammatory reaction.” This metabolic dysfunction makes sustained weight loss through willpower alone highly challenging.
Recent guidelines from The Lancet Diabetes & Endocrinology suggest redefining obesity beyond body mass index (BMI), proposing a diagnosis based on excess adipose tissue that negatively impacts physiological functions. The European Association for the Study of Obesity, in Nature Medicine, advocates for body composition analysis and the waist-to-height ratio as better indicators of cardiovascular risk. The location of fat deposits—whether in the liver, abdomen, or intestines—should also be considered in clinical evaluations.
Advancements in pharmacological treatments have transformed obesity management, with new drugs demonstrating high efficacy in reducing weight and improving obesity-related conditions. “These drugs are highly effective and contribute to weight loss, but also improve the course of comorbidities,” says Breton. Bariatric surgery remains a crucial option for severe obesity cases, particularly when medical therapy fails. However, disparities in access persist due to long waiting lists and inadequate funding. Breton underscores the importance of a collaborative approach: “Obesity is a shared responsibility involving families, the educational system and medical professionals.” Effective treatment requires a multidisciplinary team of cardiologists, endocrinologists, gastroenterologists, nutritionists, psychologists, and bariatric surgeons.
