What are the primary causes of obesity. How can diet and exercise help in weight management. What role does healthcare play in obesity treatment. How to maintain a healthy lifestyle for long-term weight control. What are the risks associated with extreme weight loss methods. How can support systems aid in weight loss journeys. What technological advancements are shaping obesity treatments.

Understanding Obesity: Causes and Health Implications

Obesity is a complex health condition that affects millions of people worldwide. It’s characterized by an excess accumulation of body fat, often resulting from a combination of genetic, environmental, and lifestyle factors. But what exactly causes obesity, and why is it such a pressing health concern?

The primary cause of obesity is an imbalance between calorie intake and expenditure. When we consume more calories than our bodies burn, the excess is stored as fat. Over time, this can lead to significant weight gain. However, the reasons behind this imbalance are multifaceted and can include:

• Genetic predisposition
• Sedentary lifestyle
• Poor dietary habits
• Hormonal imbalances
• Certain medications
• Psychological factors like stress and depression

The health implications of obesity are far-reaching. Individuals with obesity are at increased risk for various chronic conditions, including:

• Type 2 diabetes
• Cardiovascular diseases
• Certain types of cancer
• Osteoarthritis
• Sleep apnea
• Mental health disorders

Understanding these causes and risks is crucial for developing effective prevention and treatment strategies. It’s important to recognize that obesity is not simply a matter of willpower, but a complex interplay of various factors that require a comprehensive approach to address.

The Role of Healthcare Professionals in Obesity Management

When it comes to managing obesity, healthcare professionals play a pivotal role. They provide expert guidance, conduct necessary tests, and develop personalized treatment plans. But how exactly can your GP help you in your weight loss journey?

Your general practitioner (GP) is often the first point of contact in addressing obesity. They can:

• Assess your current health status and BMI
• Provide advice on safe and effective weight loss methods
• Recommend appropriate dietary changes
• Suggest suitable physical activities
• Screen for obesity-related health conditions
• Refer you to specialists if necessary

In some cases, your GP might recommend further tests or treatments, especially if you have underlying conditions associated with obesity. These might include:

• Polycystic ovary syndrome (PCOS)
• High blood pressure
• Diabetes
• Obstructive sleep apnea

Your GP can also connect you with valuable resources such as local weight loss groups, which may be provided by your local authority, the NHS, or commercial services. These groups can offer support, motivation, and practical advice for your weight loss journey.

Another useful service your GP might suggest is “exercise on prescription.” This involves a referral to a local active health team, where you’ll receive a number of sessions under the supervision of a qualified trainer. This can be particularly beneficial if you’re new to exercise or have health conditions that require careful monitoring during physical activity.

Crafting a Balanced Diet for Effective Weight Loss

Diet plays a crucial role in weight management. But what constitutes a healthy, balanced diet for weight loss? And how can you ensure you’re getting the right nutrients while reducing calorie intake?

The key to successful weight loss is creating a calorie deficit. This means consuming fewer calories than your body burns. For most people, a safe and sustainable rate of weight loss is 0.5 to 1kg (1lb to 2lbs) per week. To achieve this, it’s generally recommended to reduce daily energy intake by about 600 calories.

For most men, this translates to consuming no more than 1,900 calories a day, while for most women, the limit is around 1,400 calories a day. However, it’s important to note that these are general guidelines, and individual needs may vary based on factors like age, height, current weight, and activity level.

A healthy, balanced diet for weight loss should include:

• Plenty of fruits and vegetables
• Whole grains (bread, rice, pasta, and other starchy foods)
• Some milk and dairy foods
• Lean protein sources (meat, fish, eggs, beans, and other non-dairy proteins)
• Small amounts of foods and drinks high in fat and sugar

It’s crucial to limit foods high in salt, as they can raise blood pressure, which can be particularly dangerous for people who are already obese. Additionally, be mindful of portion sizes and keep track of calorie information for the foods and drinks you consume.

When eating out, be cautious of high-calorie options like burgers, fried chicken, and some curries or Chinese dishes. Many restaurants now provide calorie information, which can help you make informed choices.

The Truth About Fad Diets and Commercial Weight Loss Programs

While quick-fix solutions might seem tempting, it’s important to approach weight loss sensibly. Fad diets that recommend unsafe practices like extreme fasting or cutting out entire food groups should be avoided. These diets are often unsustainable and can be harmful to your health.

However, not all commercial diet programmes are unsafe. Many are based on sound medical and scientific principles and can work well for some people. A responsible diet programme should:

• Educate you about portion sizes, behavioral changes, and healthy eating
• Not be overly restrictive in terms of food choices
• Focus on gradual, sustainable weight loss rather than rapid, short-term results

Very low calorie diets (VLCDs), where you consume less than 800 calories a day, can lead to rapid weight loss but are not suitable for everyone. They should only be followed under medical supervision and for short periods, typically no longer than 12 weeks.

The Power of Physical Activity in Weight Management

While diet is crucial for weight loss, physical activity is equally important for maintaining a healthy weight and overall well-being. But how much exercise do you need, and what types of activities are most effective?

The Chief Medical Officers recommend that adults should engage in at least 150 minutes (two-and-a-half hours) of moderate-intensity activity per week. This could be broken down into five 30-minute sessions, for example. Alternatively, you could opt for 75 minutes of vigorous-intensity activity or a combination of both.

Moderate-intensity activities increase your heart and breathing rate and include:

• Brisk walking
• Cycling
• Recreational swimming
• Dancing

Vigorous activities, on the other hand, make breathing very hard, cause your heart to beat rapidly, and may make it difficult to hold a conversation. These might include:

• Running
• High-intensity interval training (HIIT)
• Team sports like basketball or football

Remember, any amount of physical activity is better than none. Even 10-minute bouts of exercise can be beneficial. The key is to find activities you enjoy and can incorporate into your daily routine.

Regular physical activity not only aids in weight management but also offers numerous other health benefits. It can help prevent and manage over 20 conditions, including reducing the risk of type 2 diabetes by 40%. Exercise also improves cardiovascular health, strengthens bones and muscles, enhances mental health, and boosts overall energy levels.

Psychological Aspects of Weight Loss and Obesity Management

The journey to weight loss and maintaining a healthy lifestyle isn’t just about physical changes; it also involves significant psychological factors. How does our mental state affect our weight, and how can we cultivate a positive mindset for successful weight management?

Obesity and mental health are often interlinked. Conditions like depression, anxiety, and low self-esteem can contribute to weight gain, while obesity itself can lead to these psychological issues. This creates a cycle that can be challenging to break.

Here are some psychological strategies that can support your weight loss journey:

• Cognitive Behavioral Therapy (CBT): This can help identify and change negative thought patterns related to eating and body image.
• Mindfulness: Practicing mindful eating can help you become more aware of your eating habits and make conscious choices.
• Stress management: Techniques like meditation, yoga, or deep breathing exercises can help reduce stress-related eating.
• Goal setting: Setting realistic, achievable goals can provide motivation and a sense of accomplishment.
• Support groups: Sharing experiences with others facing similar challenges can provide emotional support and practical tips.

It’s important to remember that weight loss is a journey, not a destination. Celebrate small victories along the way and be kind to yourself if you experience setbacks. A positive, resilient mindset can make a significant difference in achieving and maintaining a healthy weight.

Technological Advancements in Obesity Treatment

As technology continues to evolve, new tools and methods for managing obesity are emerging. But what are these innovations, and how are they changing the landscape of obesity treatment?

Several technological advancements are making waves in obesity management:

• Wearable devices: Fitness trackers and smartwatches can monitor physical activity, heart rate, and even sleep patterns, providing valuable data for weight management.
• Mobile apps: Numerous apps are available for tracking food intake, planning meals, and providing motivational support.
• Telemedicine: Virtual consultations with healthcare providers make it easier for individuals to receive ongoing support and guidance.
• Bariatric surgery innovations: Less invasive surgical techniques are being developed, making weight loss surgery safer and more accessible.
• Personalized nutrition: Genetic testing and microbiome analysis are paving the way for highly individualized dietary recommendations.

These technologies are not only making weight management more accessible but also more personalized. By leveraging data and AI, these tools can provide tailored recommendations and interventions, potentially improving the effectiveness of obesity treatments.

However, it’s important to note that while technology can be a valuable aid, it should be used in conjunction with, not as a replacement for, professional medical advice and traditional lifestyle modifications.

Long-term Strategies for Weight Maintenance

Losing weight is one challenge, but maintaining that weight loss over time is often even more difficult. What strategies can help ensure long-term success in weight management?

Successful long-term weight maintenance typically involves:

• Consistent monitoring: Regularly tracking your weight, food intake, and physical activity can help you stay on course.
• Sustainable habits: Focus on lifestyle changes you can maintain indefinitely, rather than short-term “diets”.
• Regular physical activity: Aim for at least 150 minutes of moderate-intensity exercise per week.
• Balanced nutrition: Continue to focus on a diet rich in fruits, vegetables, whole grains, and lean proteins.
• Stress management: Develop healthy coping mechanisms for stress that don’t involve food.
• Sleep hygiene: Ensure you’re getting adequate, quality sleep, as poor sleep can affect weight regulation.
• Social support: Surround yourself with supportive friends and family, or join support groups.

It’s also crucial to have realistic expectations. Your weight may fluctuate, and that’s normal. The goal is to maintain an overall healthy weight range rather than fixating on a specific number.

Remember, weight maintenance is a lifelong journey. It requires ongoing effort and commitment, but the health benefits are well worth it. By implementing these strategies and staying consistent, you can successfully manage your weight in the long term and enjoy improved overall health and well-being.

Obesity causes & treatments – Illnesses & conditions

If you’re obese, speak to your GP for advice about losing weight safely.

Your GP can advise you about losing weight safely by eating a healthy, balanced diet and regular physical activity.

They can also let you know about other useful services, such as:

• local weight loss groups – these could be provided by your local authority, the NHS, or commercial services you may have to pay for
• exercise on prescription – where you’re referred to a local active health team for a number of sessions under the supervision of a qualified trainer

If you have underlying problems associated with obesity, such as polycystic ovary syndrome (PCOS), high blood pressure, diabetes or obstructive sleep apnoea, your GP may recommend further tests or specific treatment. In some cases, they may refer you to a specialist.

Read more about how your GP can help you lose weight

Diet

There’s no single rule that applies to everyone, but to lose weight at a safe and sustainable rate of 0. 5 to 1kg (1lb to 2lbs) a week, most people are advised to reduce their energy intake by 600 calories a day.

For most men, this will mean consuming no more than 1,900 calories a day, and for most women, no more than 1,400 calories a day.

The best way to achieve this is to swap unhealthy and high-energy food choices – such as fast food, processed food and sugary drinks (including alcohol) – for healthier choices.

A healthy diet should consist of:

• plenty of fruit and vegetables
• plenty of potatoes, bread, rice, pasta and other starchy foods (ideally you should choose wholegrain varieties)
• some milk and dairy foods
• some meat, fish, aggs, beans and other non-dairy sources of protein
• just small amounts of food and drinks that are high in fat and suagr

Try to avoid foods containing high levels of salt because they can raise your blood pressure, which can be dangerous for people who are already obese.

You’ll also need to check calorie information for each type of food and drink you consume to make sure you don’t go over your daily limit.

Some restaurants, cafés and fast food outlets provide calorie information per portion, although providing this information isn’t compulsory. Be careful when eating out because some foods can quickly take you over the limit, such as burgers, fried chicken, and some curries or Chinese dishes.

Diet programmes and fad diets

Avoid fad diets that recommend unsafe practices, such as fasting (going without food for long periods of time) or cutting out entire food groups. These types of diets don’t work, can make you feel ill, and aren’t sustainable because they don’t teach you long-term healthy eating habits.

This isn’t to say that all commercial diet programmes are unsafe. Many are based on sound medical and scientific principles and can work well for some people.

A responsible diet programme should:

• educate you about issues such as portion size, making behavioural changes and healthy eating 
• not be overly restrictive in terms of the type of foods you can eat 
• be based on achieving gradual, sustainable weight loss rather than short-term rapid weight loss, which is unlikely to last

Very low calorie diets

A very low calorie diet (VLCD) is where you consume less than 800 calories a day.

These diets can lead to rapid weight loss, but they aren’t a suitable or safe method for everyone, and they aren’t routinely recommended for managing obesity.

VLCDs are usually only recommended if you have an obesity-related complication that would benefit from rapid weight loss.

VLCDs shouldn’t usually be followed for longer than 12 weeks at a time, and they should only be used under the supervision of a suitably qualified healthcare professional.

Speak to your GP first if you’re considering this type of diet.

Exercise

Reducing the amount of calories in your diet will help you lose weight, but maintaining a healthy weight requires physical activity to burn energy.

As well as helping you maintain a healthy weight, physical activity also has wider health benefits. For example, it can help prevent and manage more than 20 conditions, such as reducing the risk of type 2 diabetes by 40%.

The Chief Medical Officers recommend that adults should do at least 150 minutes (two-and-a-half hours) of at least moderate-intensity activity a week – for example, five 30-minute bouts a week. Something is better than nothing, and doing just 10 minutes of exercise at a time is beneficial.

Moderate-intensity activity is any activity that increases your heart and breathing rate, such as:

• brisk walking
• cycling
• recreational swimming
• dancing

Alternatively, you could do 75 minutes (one hour, fifteen minutes) of vigorous-intensity activity a week, or a combination of moderate and vigorous activity.

During vigorous activity, breathing is very hard, your heart beats rapidly and you may be unable to hold a conversation. Examples include:

• running
• most competitive sports
• circuit training

You should also do strength and balance training two days a week. This could be in the form of a gym workout, carrying shopping bags, or doing an activity such as tai chi. It’s also critical that you break up sitting (sedentary) time by getting up and moving around.

Read more about strength and balance exercises.

Your GP, weight loss adviser or staff at your local sports centre can help you create a plan suited to your own personal needs and circumstances, with achievable and motivating goals. Start small and build up gradually.

It’s also important to find activities you enjoy and want to keep doing. Activities with a social element or exercising with friends or family can help keep you motivated. Make a start today – it’s never too late.

Read more about the physical activity guidelines for adults and the physical activity guidelines for older adults.

Other useful strategies

Evidence has shown that weight loss can be more successful if it involves other strategies, alongside diet and lifestyle changes. This could include things like:

• setting realistic weight loss goals – if you’re obese, losing just 3% of your original body weight can significantly reduce your risk of developing obesity-related complications
• eating more slowly and being mindful of what and when you’re eating – for example, not being distracted by watching TV
• avoiding situations where you know you may be tempted to overeat
• involving your family and friends with your weight loss efforts –they can help to motivate you
• monitoring your progress – for example, weigh yourself regularly and make a note of your weight in a diary

Getting psychological support from a trained healthcare professional may also help you change the way you think about food and eating. Techniques such as cognitive behavioural therapy (CBT) can be useful.

Avoiding weight regain

It’s important to remember that as you lose weight your body needs less food (calories), so after a few months, weight loss slows and levels off, even if you continue to follow a diet.

If you go back to your previous calorie intake once you’ve lost weight, it’s very likely you’ll put the weight back on. Increasing physical activity to up to 60 minutes a day and continuing to watch what you eat may help you keep the weight off.

Medication

Many different types of anti-obesity medicines have been tested in clinical trials, but only one has proved to be safe and effective: orlistat.

You can only use orlistat if a doctor or pharmacist thinks it’s the right medicine for you. In most cases, orlistat is only available on prescription. Only one product (Alli) is available over the counter directly from pharmacies, under the supervision of a pharmacist.

Orlistat works by preventing around a third of the fat from the food you eat being absorbed. The undigested fat isn’t absorbed into your body and is passed out with your faeces (stools). This will help you avoid gaining weight, but won’t necessarily cause you to lose weight.

A balanced diet and exercise programme should be started before beginning treatment with orlistat, and you should continue this programme during treatment and after you stop taking orlistat.

When orlistat should be used

Orlistat will usually only be recommended if you’ve made a significant effort to lose weight through diet, exercise or changing your lifestyle.

Even then, orlistat is only prescribed if you have a:

• body mass index (BMI) of 28 or more, and other weight-related conditions, such as high blood pressure or type 2 diabetes
• BMI of 30 or more

Before prescribing orlistat, your doctor will discuss the benefits and potential limitations with you, including any potential side effects (see below). 

Treatment with orlistat must be combined with a balanced low-fat diet and other weight loss strategies, such as doing more exercise.  It’s important that the diet is nutritionally balanced over three main meals.

If you’re prescribed orlistat, you’ll also be offered advice and support about diet, exercise and making lifestyle changes.

Orlistat isn’t usually recommended for pregnant or breastfeeding women.

Dosage and duration of treatment

One orlistat capsule is taken with water immediately before, during or up to one hour after, each main meal (up to a maximum of three capsules a day).

If you miss a meal, or the meal doesn’t contain any fat, you shouldn’t need to take the orlistat capsule. Your doctor should explain this to you, or you can check the patient information leaflet that comes with your medicine.

Treatment with orlistat should only continue beyond three months if you’ve lost 5% of your body weight. It usually starts to affect how you digest fat within one to two days.

If you haven’t lost weight after taking orlistat for three months, it’s unlikely to be an effective treatment for you. Consult your doctor or pharmacist, as it may be necessary to stop your treatment.

Taking orlistat with other health conditions

See your GP before starting treatment with orlistat if you have another serious health condition, such as type 2 diabetes, high blood pressure, or kidney disease, which you’re taking medication for. It may be necessary to change the dose of your medicine.

If you have type 2 diabetes, it may take you longer to lose weight using orlistat, so your target weight loss after three months may therefore be slightly lower.

If orlistat has helped you lose weight after three months, your prescription may be continued for up to a year. After that, your GP will carry out a review and decide whether you should continue taking it.

Side effects

Common side effects of orlistat include:

• fatty or oily stools
• needing the toilet urgently
• passing stools more frequently
• an oily discharge from your rectum (you may have oily spots on your underwear)
• flatulence (wind)
• stomach pain
• headaches
• upper respiratory tract infections, such as a cold

These side effects are much less likely to occur if you stick to a low-fat diet.

Women taking the oral contraceptive pill should use an additional method of contraception, such as a condom, if they experience severe diarrhoea while taking orlistat. This is because the contraceptive pill may not be absorbed by your body if you have diarrhoea, so it may not be effective.

Surgery

Weight loss surgery, also called bariatric surgery, is sometimes used to treat people who are severely obese.

Bariatric surgery is usually only available on the NHS to treat people with severe obesity who fulfil all of the following criteria:

• they have a BMI of 40 or more, or between 35 and 40 and another serious health condition that could be improved with weight loss, such as type 2 diabetes or high blood pressure
• all appropriate non-surgical measures have been tried, but the person hasn’t achieved or maintained adequate, clinically beneficial weight loss
• the person is fit enough to have anaesthesia and surgery
• the person has been receiving, or will receive, intensive management as part of their treatment
• the person commits to the need for long-term follow-up

Bariatric surgery may also be considered as a possible treatment option for people with a BMI of 30 to 35 who have recently (in the last 10 years) been diagnosed with type 2 diabetes.

In rare cases, surgery may be recommended as the first treatment (instead of lifestyle treatments and medication) if a person’s BMI is 50 or above.

Treating obesity in children

Treating obesity in children usually involves improvements to diet and increasing physical activity using behaviour change strategies.

The amount of calories your child should eat each day will depend on their age and height. Your GP should be able to advise you about a recommended daily limit, and they may also be able to refer you to your local family healthy lifestyle programme.

Children over the age of five should ideally get at least one hour (60 minutes) of vigorous-intensity exercise a day, such as running or playing football or netball. Sedentary activities, such as watching television and playing computer games, should be restricted.

Read more about the physical activity guidelines for children and young people

Referral to a specialist in treating childhood obesity may be recommended if your child develops an obesity-related complication, or there’s thought to be an underlying medical condition causing obesity.

The use of orlistat in children is only recommended in exceptional circumstances, such as if a child is severely obese and has an obesity-related complication.

Bariatric surgery isn’t generally recommended for children, but may be considered for young people in exceptional circumstances, and if they’ve achieved, or nearly achieved, physiological maturity.

Prevention Strategies & Guidelines | Overweight & Obesity

• Nutrition, Physical Activity, and Obesity Prevention Strategies
• Early Care and Education Strategies
• School Health Guidelines
• Community Guide
• Clinical Guidelines

To reverse the obesity epidemic, places and practices need to support healthy eating and active living in many settings. Below are recommended strategies to prevent obesity.

Nutrition, Physical Activity, and Obesity Prevention Strategies

The CDC Guide to Strategies to Increase Physical Activity in the Community [PDF-1.2MB] provides guidance for program managers, policy makers, and others on how to select strategies to increase physical activity.

Physical Activity: Built Environment Approaches Combining Transportation System Interventions with Land Use and Environmental Design
The Community Preventive Services Task Force recommends built environment strategies that combine one or more interventions to improve pedestrian or bicycle transportation systems with one or more land use and environmental design interventions to increase physical activity.

The CDC Guide to Strategies to Increase the Consumption of Fruits and Vegetables [PDF-2.1MB] provides guidance for program managers, policy makers, and others on how to select strategies to increase the consumption of fruits and vegetables.

The CDC Guide to Breastfeeding Interventions provides state and local community members information to choose the breastfeeding intervention strategy that best meets their needs.

Recommended Community Strategies and Measurements to Prevent Obesity in the United States [PDF-376KB] contains 24 recommended obesity prevention strategies focusing on environmental and policy level change initiatives that can be implemented by local governments and school districts to promote healthy eating and active living.

• Implementation and Measurement Guide [PDF-2.6MB] can help communities implement the recommended obesity prevention strategies and report on the associated measurements.
• Healthy Communities: What Local Governments Can Do to Reduce and Prevent Obesity [PPT-8.5MB] is a presentation developed for use by local government staff that makes the case for investing in CDC’s Recommended Community Strategies and Measurements to Prevent Obesity in the United States [PDF – 375KB] . Also available in a PDF version [PDF-3.8MB].

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Early Care and Education Strategies

CDC’s framework for obesity prevention, in the ECE setting is known as the Spectrum of Opportunities [PDF-666KB]. The Spectrum identifies ways that states, and to some extent communities, can support child care and early education facilities to achieve recommended standards and best practices for obesity prevention. The Spectrum aligns with comprehensive national ECE standards for obesity prevention address nutrition, infant feeding, physical activity and screen time, Caring for Our Children: National Health and Safety Performance Standards (CFOC), 3rd ed.

School Health Guidelines

School Health Guidelines to Promote Healthy Eating and Physical Activity provides nine guidelines that serve as the foundation for developing, implementing, and evaluating school-based healthy eating and physical activity policies and practices for students in grades K-12.

The following resources are designed to assist schools and program coordinators to inform stakeholders and school health services staff on obesity facts, engaging students and managing chronic health conditions.

Community Guide

The Community Guide – Obesity Prevention and Control is a free resource to help you choose programs and policies to prevent and control obesity in your community.

Clinical Guidelines

Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents [PDF-3.26MB] This resource summarizes the integrated guidelines develop by the Federal Government to address cardiovascular disease in children and adolescents.

Screening for Obesity in Pediatric Primary Care: Recommendations from the U.S. Preventive Services Task Force Guidance for primary care providers in screening for obesity and offering or referring to comprehensive, intensive behavioral weight management interventions.

Expert Committee Recommendations The American Academy of Pediatrics released the Expert Committee Recommendations that suggest screening all children for obesity (>=2 years) and providing tiers of care regarding the treatment and prevention of obesity.

2013 Guideline on the Assessment of Cardiovascular RiskThis is a Report of the American College of Cardiology and the American Heart Association Task Force on Practice Guidelines for reducing the risk of cardiovascular disease.

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A new obesity paradigm: causes and solutions

Contents

• 1 A new obesity paradigm
  • 1.1 A new obesity paradigm
  • 1.2 Obesity: causes and consequences
  • 1.3 Influence of modern lifestyle
  • 1. 4 Genetic factors and obesity
  • 1.5 Metabolic disorders and obesity
  • 1.6 The role of dietary supplements and carbohydrates
  • 1.7 Obesity as a social problem
  • 1.8 The link between stress and obesity
  • 1.9 Childhood obesity and its prevention
  • 1.10 Sports and physical activity as a means of combating obesity
  • 1.11 Innovative treatments for obesity
  • 1.12 Related videos:
  • 1.13 Q&A:
    • • 1.13.0.1 Why has obesity become such a common problem in today’s society?
      • 1.13.0.2 What role do hormones play in obesity?
      • 1.13.0.3 Is there a genetic predisposition to obesity?
      • 1.13.0.4 How can I change my lifestyle to avoid obesity?

The New Obesity Paradigm: Current research shows that obesity is a more complex condition, driven not only by overnutrition and physical inactivity, but also by genetic, epigenetic, and environmental factors. Learn about new methods for diagnosing, treating and preventing obesity in this article.

The problem of obesity is becoming more and more urgent in modern society. Every year the number of overweight people is growing, which creates serious problems for both individuals and society as a whole. Obesity not only causes physical and psychological problems, but is also a risk factor for the development of serious diseases, including cardiovascular disease, diabetes, and even cancer.

Traditionally, the approach to combat obesity has been to control caloric intake and increase physical activity. However, modern research shows that the causes of obesity are much more complex, and traditional methods of malnutrition and lack of movement do not solve the problem in the bud. Moreover, such approaches often lead to weight loss, which is temporary and leads to the yo-yo effect.

A new paradigm in the problem of obesity considers not only physical aspects, but also psychological and social factors. Deviating from standard methods and finding new ways to tackle the problem of obesity are important steps in the fight against this epidemic. Research shows that emotional state, stress and depression are directly linked to food intake and obesity. In addition, social environment, genetic and biochemical factors also play a role in the development of obesity.

A new paradigm in the problem of obesity

Obesity has become one of the most urgent problems of modern society, and its prevalence continues to grow every year. However, recent research allows us to consider this problem from a new point of view, opening up a new paradigm in understanding the causes and solutions of obesity.

Another important component of the new paradigm is the awareness of the role of psychological factors in the development and maintenance of obesity. It turns out that emotional state, stress, depression and low self-esteem can be associated with improper eating behavior and reduced physical activity, which is one of the causes of weight gain.

Given the new paradigm, the approach to combating obesity should be comprehensive and include various aspects: nutritional intervention, stimulation of physical activity, treatment of metabolic disorders, as well as psychological support. Such an integrated approach will make it possible to more effectively combat obesity and prevent its occurrence in the future.

Obesity: causes and consequences

Obesity is one of the most urgent problems of modern society. With progress and improvement in living conditions, more and more people are overweight. The problem of obesity not only negatively affects the appearance of a person, but also leads to serious consequences for health.

The causes of obesity are manifold and often explained by a complex interaction of various factors. One of the main factors influencing the development of obesity is malnutrition. Overeating, excessive consumption of fatty, high-calorie and processed foods, as well as lack of physical activity lead to the accumulation of excess fat in the body.

Obesity can have serious health consequences. Excess body fat increases the risk of developing cardiovascular disease, diabetes, high blood pressure, musculoskeletal disorders, and certain types of cancer. In addition, obesity affects a person’s psychological and social well-being, increasing the risk of depression, low self-esteem, and social isolation.

Addressing the problem of obesity requires a complex intervention that includes changing dietary habits, increasing physical activity, treating comorbidities, and psychological support. However, the main factor in successfully overcoming obesity is the awareness of one’s own responsibility for one’s health and the desire for a healthy lifestyle.

The impact of modern lifestyle

Modern lifestyle has a significant impact on the problem of obesity. One of the reasons for this phenomenon is a sedentary lifestyle associated with the use of computers and gadgets. People spend more and more time indoors, in front of screens, without getting the necessary physical activity.

In addition, the influence of the modern way of life is manifested in nutrition. Fast food rich in fat and sugar has become the norm for many people. Regular consumption of such products, combined with a lack of physical activity, leads to weight gain and obesity.

The influence of modern lifestyle on the problem of obesity requires serious attention and action to change lifestyle. Physical activity, regular exercise and a healthier diet should be encouraged. It is also important to take time to rest and manage stress without the use of food. Only by changing the modern way of life, it is possible to solve the problem of obesity and improve the general health of the population.

Genetic factors and obesity

Genetic factors are one of the key causes of obesity. Studying the heredity of obesity allows us to understand why some people are more prone to gaining excess weight, even with the right lifestyle.

Obesity may be associated with the presence of certain genetic mutations. For example, in some people, there is a change in the gene responsible for satiety, which leads to the fact that a person needs more food to feel full. Studies also show that a genetic factor can influence the metabolic rate and the tendency to accumulate fat.

However, it is worth noting that genetic factors are not the only cause of obesity. Living conditions, nutrition, physical activity and other external factors also have an impact on the development of obesity.

In general, genetic factors play a significant role in the problem of obesity, and their inclusion in the diagnosis and treatment of this disease allows us to better understand the mechanisms of its development and determine the most effective strategies to combat it.

Metabolic disorders and obesity

Metabolic disorders are one of the main causes of obesity. Metabolism is the process of metabolism in the body, which includes the synthesis of substances, their destruction and absorption. With metabolic disorders, improper metabolism occurs, which can lead to the accumulation of excess weight.

One of the most common metabolic disorders associated with obesity is insulin resistance . Insulin is a hormone that plays an important role in regulating blood sugar levels. The nature of insulin resistance lies in the fact that tissue cells become less sensitive to the action of insulin, which leads to an increase in blood sugar levels and the accumulation of fat in the body.

In addition to insulin resistance, another disorder often associated with obesity is an imbalance in hunger and satiety hormones . There are various hormones in the body that are responsible for feelings of hunger and satiety. When these hormones are out of balance, appetite is not properly regulated, which can lead to overeating and weight gain.

Metabolic disorders and obesity are closely linked. Incorrect metabolism and imbalance of hormones play an important role in the appearance and development of obesity. Therefore, to combat obesity, it is necessary not only to control nutrition and engage in physical activity, but also pay attention to the state of your metabolism and hormonal balance.

The role of dietary supplements and carbohydrates

Dietary supplements and carbohydrates play an important role in the problem of obesity. Food additives are substances added to food to improve its taste, aroma, color or texture. They can be both natural and artificial origin. For example, flavor enhancers, sweeteners, preservatives, and stabilizers are all food additives that can act on taste buds and stimulate appetite.

A study article in the United Arab Emirates showed that dietary supplements and carbohydrates can affect body weight and lead to obesity. To prevent this, you need to maintain a balance in the diet and choose foods that contain healthy carbohydrates and supplements, as well as limit the intake of fast carbohydrates and food additives, especially those that can negatively affect the body.

Obesity as a social problem

Obesity is one of the most acute and widespread problems of modern society. This illness is caused not only by individual factors, but also by widespread social tendencies.

The first cause of obesity associated with social factors is the increasing consumption of high-calorie foods. Ready-made foods, fast food and sweets are immensely popular in modern society, and even those social strata that previously could not afford such products have access to them.

The second reason has to do with lifestyle changes. Growing technology and automation of human activities lead to physical inactivity. A person spends more and more time in front of gadget screens or in offices, not getting enough physical activity.

In addition, obesity is also associated with social pressure on appearance. The ideals of beauty promoted by the media, modeling agencies and social networks can create a lack of self-esteem and lead to weight gain due to the development of complexes and depression.

So, obesity is not a problem generated only by a person, but also by the prevailing social situation. To solve it, it is necessary to actively interact with various spheres of society, from the educational system to medical institutions.

Relationship between stress and obesity

Stress and obesity are significant problems in today’s society. Although the two phenomena may seem unrelated at first glance, multiple studies show a strong link between them.

Stress is the body’s response to physical and emotional stress. It can be caused by various factors such as work, family problems, financial difficulties, and others. Often people seek to cope with stress through food, eating very high-calorie foods rich in sugar and fat, which can lead to weight gain.

Stress also affects the hormonal balance in the body. During periods of stress, more of the hormone cortisol is produced, which stimulates appetite and promotes the accumulation of fat in the body. In addition, stress can cause changes in metabolism, leading to a slower metabolism and an increased tendency to become obese.

There is also a psychological link between stress and obesity. People suffering from frequent stress may experience emotional instability and low mood, which can lead to eating more food, especially high-calorie and unhealthy foods.

To address the link between stress and obesity, it is necessary not only to lead a healthy lifestyle, including regular exercise and proper nutrition, but also to pay attention to psychological well-being. Adequately managing stress, finding ways to relax and maintaining emotional balance will help reduce the risk of obesity and lead to overall improved health.

Childhood obesity and its prevention

Childhood obesity is a serious problem of modern society, which has negative consequences for the health and quality of life of children. Obesity in children occurs due to an unbalanced diet and lack of physical activity. It can cause diseases such as diabetes, cardiovascular disease, hypertension, and others.

The main causes of childhood obesity are malnutrition and a sedentary lifestyle. Children consume too many high-calorie foods rich in fats and sugar, and not enough fruits, vegetables and grains. In addition, many children spend most of the day in front of the TV or computer without getting enough physical activity.

Prevention of childhood obesity is an important task for parents, schools and the state. One of the main methods of preventing obesity is proper nutrition. Children need to learn to eat a varied and balanced diet, eating less fat and sugar and more fruits, vegetables and grains. In addition, it is important to limit the time children spend in front of screens and encourage them to play sports and play outdoors.

Successful prevention of childhood obesity also requires cooperation between family, school and health care providers. Parents should be informed about proper nutrition and physical activity for their children, schools should offer healthy meals and organize sports activities, and doctors should monitor children’s height and weight and provide recommendations for dietary and lifestyle changes.

Sport and physical activity in the fight against obesity

One of the key factors in the fight against obesity is regular physical activity. Sport helps not only burn excess calories, but also improves overall physical fitness, strengthens muscles and bones.

To achieve the maximum effect in the fight against obesity, it is necessary to choose the right physical activity. For example, cardio workouts such as running, walking, swimming, or cycling can boost your body’s energy production and speed up your metabolism.

However, cardio should not be limited. Strength training is an important part of an obesity plan as it helps increase muscle mass. Along with this, strength training increases your basal metabolic rate, which leads to increased calorie burning even at rest.

In order to include physical activity as a means of combating obesity in your life, you need to create a varied and interesting training program. It is recommended to combine cardio and strength training, as well as add various types of activity, such as yoga, Pilates or dancing.

It is important to remember that sport and physical activity should become an integral part of the lifestyle and not a temporary measure. Regular exercise will help not only reduce weight, but also improve health, improve mood and increase self-esteem.

Innovative treatments for obesity

Tackling obesity often requires a holistic approach that includes not only dietary changes and increased physical activity, but also innovative treatments. One such method is a surgical procedure called bariatric surgery.

Bariatric surgery offers long-term results and sustainable weight loss. There are several methods of this operation: gastrobypass, ruanimplantation, application of the sleeve of the stomach and others. Each of these methods has its own characteristics and allows you to achieve different degrees of weight loss.

However, surgery is a last resort and is recommended when conservative treatments for obesity fail. Before deciding on the operation, it is necessary to consult a doctor and study in detail all the possible consequences and risks.

Another innovative treatment for obesity is the use of drugs to reduce appetite and increase satiety. These drugs are usually used in complex therapy and help control food intake and speed up the metabolic process in the body.

Some of the newer treatments for obesity include the use of modern technologies such as electrical muscle stimulation devices or wearable devices that track calories burned and physical activity levels. Various applications for smartphones and gadgets are also being developed to help control nutrition and exercise.

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Q&A:

Why has obesity become such a common problem in today’s society?

Answer: Obesity has become a common problem in today’s society due to a combination of several factors. One of the main factors is the modern lifestyle, characterized by low physical activity and high consumption of high-calorie foods. Also, genetic predispositions and epigenetic changes associated with the environment have a significant impact on the development of obesity.

What role do hormones play in obesity?

Answer: Hormones play an important role in the problem of obesity. For example, the hormone leptin, which is produced by fat cells, regulates appetite and metabolism. Obese people usually have low levels of leptin, which can lead to uncontrollable appetite and misregulation of energy balance. Knowledge of these hormones and their interactions opens up new avenues for developing treatments and prevention of obesity.

Is there a genetic predisposition to obesity?

Answer: Yes, genetic predisposition plays an important role in the development of obesity. Some genes may influence metabolic processes, appetite regulation, and the tendency to accumulate fat. However, genetic predisposition is not the only cause of obesity. To develop obesity, the presence of adverse environmental factors, such as unhealthy diet and low physical activity, is also necessary.

How can I change my lifestyle to avoid obesity?

Answer: To avoid obesity, you need to make changes in your lifestyle. It is important to increase physical activity and exercise regularly. It is also necessary to monitor your diet, eat healthier and more balanced food, limit the intake of high-calorie and highly processed foods. Getting support from loved ones or using the services of a specialist, such as a dietitian or trainer, is helpful for successful lifestyle changes.

Prevention of obesity in children and adolescents

Obesity is currently responsible for up to 5% of all deaths worldwide. If the current trend continues, by 2030 almost half of the adult population of the Earth will be overweight or obese [1]. Obesity, along with smoking and armed violence, is one of the three most serious social problems created by man [2]. This is associated with huge personal, social and economic costs for both society and the healthcare system [3, 4].

Recently, there has been a sharp increase in the prevalence of childhood obesity and overweight worldwide. Some low- and middle-income per capita countries are experiencing a similar or even faster increase in childhood obesity than high-income countries, despite the continued high prevalence of malnutrition [5]. The global age-standardized prevalence of obesity increased from 0.7% in 1975 to 5.6% in 2016 in girls and from 0.9% in 1975 to 7.8% in 2016 in boys [6]. The growth of childhood obesity is accompanied by an increase in risk factors for cardiovascular and various diseases associated with obesity [7]. In addition, numerous studies have found that overweight/obesity, which formed in childhood, persists into adulthood in 75% of individuals [8, 9]. These data demonstrate the urgent need to identify effective preventive and therapeutic measures that act at the level of children and their families, contributing to the prevention of obesity not only in risk groups, but also in the entire population [10, 11].

Epidemiology of childhood and adolescent obesity

Since the 1980s, the number of obese children has doubled in over 70 countries around the world, and has tripled in some developing countries [12, 13]. The increase in the prevalence of obesity in children is faster than in adults and does not depend on socio-demographic affiliation [12]. In developed countries, there has been a significant increase in the incidence of overweight and obesity in children and adolescents. In 2013, this figure reached 23.8% for boys and 22.6% for girls, compared to 16.9and 16.2% in 1980, respectively [14]. In developing countries, the prevalence of obesity and overweight also increased from 8.1% in 1980 to 12.9% in 2013 in boys and from 8.4% in 1980 to 13.4% in 2013 .—in girls [14]. In 2015, obesity was detected in 107.7 million children worldwide in 195 countries (5%) [12]. In China, the number of overweight and obese children aged 7 to 18 increased 28-fold between 1985 and 2000 [15]. In some Asian countries, such as Vietnam and Bangladesh, there is a relatively low incidence of childhood obesity (1.6 and 1.2%, respectively) [12]. Moreover, in absolute terms, India and China lead in terms of the number of obese children [12].

According to a multicenter study, the prevalence of obesity in children in the Russian Federation aged 5 to 15 years (Astrakhan, Yekaterinburg, Krasnoyarsk, St. Petersburg, Samara) averaged 5.6%, no differences were found between regions [16].

Socio-economic and cultural-environmental factors have a greater influence on the development of childhood and adolescent obesity than genetic predisposition.

Etiology of childhood obesity

According to the etiology, childhood obesity is divided into two broad groups – endogenous and exogenous obesity. Exogenous obesity is formed as a result of a chronic imbalance between the intake of energy in the body and its consumption, while endogenous obesity is caused by various genetic, endocrine and syndromic causes. Metabolic programming, observed in children born large or small for gestational age, and from mothers with diabetes mellitus, in the first years of life complicates the problem of obesity resulting from lifestyle and dietary factors [17].

Exogenous obesity

Risk factors for obesity in the first year of life. The most significant risk factors for obesity in children at an early age include high birth weight (more than 4 kg), artificial feeding, rapid growth in the first months of life, and low levels of physical activity [18].

Maternal factors also have a significant effect on birth weight: both a high body mass index (BMI) before pregnancy and excessive body weight gain during pregnancy are independently associated with higher birth weight of the child [19, 20]. These data suggest that pregnancy with a normal BMI and avoidance of excess body weight gain during pregnancy may reduce the risk of obesity in children [20]. Lifestyle interventions (exercise and diet) are one approach to reduce weight gain during pregnancy [21]. In addition, promotion of breastfeeding is one of the most effective public health interventions to curb the rise in obesity.

When breastfeeding is not possible, choosing the right formula to feed your baby is important. Thus, in the period of long-term follow-up at the age of 6 years, there was a more than twofold increase in the risk of obesity in children who received a formula with a high protein content, compared with children who received a standard formula (for differences in BMI, 95% CI 1.12-5, 27; p = 0.024) [22]. These data suggest that lowering the protein content of formula-fed formula reduces the risk of developing obesity later in life in formula-fed infants.

The complementary feeding period (from the age of 6 months), when children transition from full breastfeeding to a more varied diet, is another critical period during which feeding behavior is formed [23]. This period is important for health in both the short and long term. Not surprisingly, eating large amounts of high-calorie foods as part of complementary foods is associated with rapid weight gain and an increased risk of obesity [24]. In particular, a high protein content in the diet is associated with the risk of obesity [25].

Risk factors for obesity in children older than 1 year. Children of the current generation live in an increasingly obese environment, where it is easy to gain excess body weight, and maintaining shape requires conscious and constant effort [26]. Unhealthy or obese behavior patterns are closely related to the microenvironment, including family, school, and society [27]. At the same time, macrosystems, such as the food industry and government, have their impact on the microenvironment [28].

Influence of behavior:

– abnormal eating habits. Eating high-calorie, refined foods, sugar-sweetened beverages, snack abuse, frequent skipping meals, large portions, and insufficient fruit and vegetable consumption are associated with the development of obesity [29];

– insufficient physical activity;

– Increase TV time for d nya. TV viewing is not only a sedentary lifestyle option, but also leads to overweight as a result of unconscious snacking, as well as through the impact of advertising on children’s food preferences; in addition, prolonged exposure to a computer/TV screen is often combined with shortened sleep [30, 31].

Microenvironment impact:

– family – parenting practices and behavior patterns, combined with lifestyle habits, have a powerful effect on a child’s level of physical activity and diet; there is an increased risk of childhood obesity in diabetes mellitus, obesity and smoking and in the mother; the type of nutrition of the newborn, the duration of sleep, the rate of increase in body weight in the postnatal period are also associated with obesity at a later age; in addition, the prevalence of obesity also increased if the child was raised not by parents, but by grandparents or nannies [32, 33];

– school – can contribute to the formation of obesity in the absence of training in proper nutrition and physical education; lack of playgrounds and sports equipment, potential unhealthy food in school lunches, and the availability of unhealthy snacks and drinks in or around school increase the risk of obesity in children [34];

– society – factors such as the lack of financial opportunities to buy healthy food and healthy food stores, park spaces can determine the formation of behavior leading to obesity [33].

Macro-environment impact:

– food industry – production of foods containing high amounts of fat, sugar and/or salt, use of various marketing and advertising practices, aggressive sales policies and misleading product labeling limit the ability of consumers to make rational and healthy choices;

– Government – Responsible for creating safe environments for physical activity, including playgrounds, stadiums, cycle- and pedestrian-friendly roads; strict nutritional policies are also needed to limit the availability of unhealthy snacks, taxation, visual product labeling, and price controls for fruit and vegetables, according to a systematic review, availability of sugar-sweetened beverages, serving size, and food industry marketing have the biggest impact on childhood obesity [28, 35].

Endogenous obesity

Endocrinopathy, monogenic syndromes and other genetic syndromes account for a small proportion of cases of childhood obesity.

Children with identified endocrinopathies (hypothyroidism, growth hormone deficiency, hypothalamic obesity, Itsenko-Cushing’s syndrome, Albright’s hereditary osteodystrophy, persistent hyperinsulinemia, etc.) constitute a minority (about 2-3%) among those referred for examination due to overweight children [36]. However, it is important that physicians be able to suspect and diagnose such conditions for specific treatment. An important symptom that makes it possible to suspect endocrine pathology is a slowdown or cessation of linear growth, when the child’s height is significantly less than the potential one based on the existing genetic predisposition [37].

Prevention and treatment

The key aspect of obesity control and prevention is not treatment, but prevention [38]. It is difficult to treat obesity after its onset, and in many cases therapy is unsuccessful [39]. In most countries, overweight in children is more common than obesity [14]. Thus, the target population for the prevention of obesity should be children with overweight and the risk of developing obesity. A study of overweight children at the age of 5 years found a 4-fold increase in the risk of obesity at the age of 5 to 14 years [40]. In overweight children, there is a high probability of a change in the BMI category, while in children with initially normal body weight or obesity, the same BMI category was noted after a year of observation [41]. These data indicate that targeting a population of overweight children may be more effective in preventing obesity than treating children who are already obese. Thus, an effective strategy for the prevention of childhood obesity is the identification of risk factors and active intervention in the population of children with overweight and a high risk of developing obesity. Finally, weight control strategies for children should be started as early as possible (at an earlier age) [42].

Understanding the nature of childhood and adolescent obesity should include behavioral aspects such as food intake and physical activity, psychological and environmental factors [43]. In childhood, under the influence of various factors, the formation of eating behavior and the level of physical activity occurs [44]. Numerous recommendations and literature reviews suggest the use of multidisciplinary strategies, including the modification of environmental risk factors [45-47]. Research findings suggest that a multicomponent approach covering antenatal life, infancy, school life, family and cultural backgrounds, combined with support from parents and teachers, is a promising strategy for the prevention and treatment of obesity. At the same time, the authors of the Cochrane Review indicate that current strategies for correcting childhood obesity are ineffective or ineffective [48, 49]. The US Disease Prevention Task Force reported that effective interventions must be multifaceted and include information about nutrition, physical activity, stimulus control, goal setting, and problem-solving skills; include classes aimed at working with both the parent and the child, as well as provide the opportunity for physical activity [46].

The goal of preventing and treating obesity is to create a negative energy balance by reducing food intake and increasing physical activity. Despite the apparent simplicity of this strategy, long-term maintenance of the achieved weight loss is difficult. And since there is a relative intellectual and psychological immaturity of children and adolescents, the treatment of obesity in this group is even more difficult.

Children are more exposed to environmental factors such as advertising. Approaches to the treatment of obesity in childhood should be intensive and long-term. A report from the US Disease Prevention Task Force emphasizes that intensive behavioral interventions are effective in programs lasting more than 26 hours of interaction; shorter programs did not demonstrate sufficient efficacy in the study [46]. An earlier study demonstrated that an intensive, comprehensive, long-term school program reduced BMI in children and adolescents aged 9up to 14 years [50]. National policies are also an important environmental factor in the prevention of obesity. In order to reduce the consumption of unhealthy foods, some parts of the US and Canada introduced additional small taxation of such products [51]. In Australia and New Zealand, the National Heart Foundation has introduced a special symbol that is placed on the packaging of products that meet certain nutritional standards [52]. This program helps you easily identify “healthy” foods. Some European countries, including Sweden, Norway, Denmark and Austria, have introduced restrictions on television advertising for young children [53].

Because risk factors for childhood obesity emerge early in development, prevention strategies should target infants, toddlers and preschool children.

Preventive measures for children under 1 year of age. Prevention measures aimed at reducing the risk of obesity in the first 2 years of life are predominantly behavioral and are aimed at developing flexible parenting and feeding strategies, as well as a family lifestyle [54]. A flexible feeding strategy, in which the mother adequately responds to the signs of hunger and satiety of the child, is currently recognized as the most powerful factor influencing the risk of obesity [54]. Interventions aimed at developing this strategy have an impact on the risk of obesity in the short term. For example, the “healthy start” methodology for developing a flexible parenting strategy, conducted in Australia in mother-child pairs, led to a lower BMI at age 2 years (the average difference in BMI level between the intervention group and the control group was 0.29, 95% CI 0.55–0.02; p = 0.04) [55].

A large number of studies in children are aimed at evaluating non-behavioral interventions, such as examining the effect of dietary composition at an early age on the risk of obesity later in life. A large randomized controlled trial found a higher BMI at 1 year of age in infants fed high protein formula compared to infants fed conventional formula [56].

Preventive measures for children of preschool and school age. Prevention measures for preschool and school-age children should include nutrition education, physical activity promotion, and behavior change strategies.

A systematic review by J. Ling et al analyzed 26 randomized interventions to prevent obesity in preschool children (2–5 years) [57]. The combined effect immediately after the intervention provided a reduction in BMI by 0.19units (95% CI -0.28 to -0.09; p <0.001). It is important to note that the lasting effect for up to 12 months was more pronounced and amounted to -0.21 units (95% CI -0.35 to -0.08; p = 0.002), which suggests a persistent lasting effect of ongoing interventions, likely associated with behavioral changes that have a delayed effect.

The MEND 2-4 program includes changes to several components such as nutrition, physical activity levels and behavior. The program includes 10 weekly sessions with preschool children and their parents. At 6 and 12 months after the completion of the educational program, no effect on BMI was found [58]. There was a positive effect on vegetable intake, snacking, and satiety sensitivity immediately after the intervention, but the effect was not sustained in the long-term follow-up [58].

The TrimTots 24-week multicomponent obesity prevention program in preschool children focuses on family involvement and learning through play and art therapy. TrimTots was evaluated in two small randomized controlled trials. The first study included children at high risk with a BMI above the 90th centile. At the end of the program, the BMI was significantly lower in the active intervention group compared to the children on the waiting list (difference in BMI z-score means: -0.9; 95% CI -1.4 to -0.4; p = 0.001). This effect was maintained in 39 children during 2 years of follow-up after completion of the intervention. BMI was lower after program participation compared to baseline (BMI z-score mean difference: –0.3, 95% CI –0.6 to –0.1; p = 0.007). In the second clinical study, children were recruited regardless of body weight and height at an early age. BMI was lower in the intervention group compared to the control group immediately after the end of the active phase of the study (BMI z-score mean difference -0.3; 95% CI -0.8 to 0.3; p =0.3) [59].

In the Russian Federation, in accordance with the recommendations of the Russian Association of Endocrinologists, the Russian Society for the Prevention of Noncommunicable Diseases, the Association of Pediatric Cardiologists of Russia, the main methods of prevention are the rationalization of the nutrition of children and adolescents and the optimization of physical activity. The main approaches to primary prevention of the disease include prevention in the family, at the school level and in primary health care. Schools of proper nutrition, where children and their parents are trained, are also a very effective method [60].

It is important to remember that the formation of childhood obesity is influenced by a large number of factors, including psychological ones. In the prevention of this disease, the main role is played by parents, whose main task is to support the child, a joint way to solve the problem and build a plan of action. If it is impossible to cope with the problem on their own, parents should seek psychological help. The basic rules of psychological support are that parents need to establish and observe a diet, not force the child to eat by force, form the habit of healthy food, go in for sports to set an example for the child, overcome their own complexes (getting rid of anxiety when the child refuses to eat and fear that he is hungry), do not focus on the appearance of the child in conversations (especially in adolescence), and also do not use food for educational purposes and as a way to control emotions [60].

Most childhood and adolescent obesity prevention and treatment programs are based on intervention at the family or school level. However, none of the interventions currently in use alone can stop the obesity epidemic.