Beyond the Scale: A New Era in Managing Obesity - Not merely a lifestyle issue

Khaleej Times

27-05-2025

Groundbreaking treatments and rising awareness are reshaping how we tackle the world's most underdiagnosed disease
A recent global study published in The Lancet has raised alarm bells across the UAE's healthcare landscape. It forecasts that the prevalence of overweight and obesity among adults aged 25 and above in the UAE will skyrocket from 84% in 2021 to 94% by 2050 for males - the highest worldwide. For females, the figure is expected to reach 95%, ranking the UAE fourth globally. Even more concerning, obesity among UAE youth aged 15 to 24 is projected to surge from 62% in 2021 to 81% by 2050.
This health crisis is largely attributed to sedentary lifestyles, excessive consumption of processed and fast food, and insufficient physical activity. However, it is crucial to recognize that obesity is not merely a lifestyle issue - it is a chronic, complex, and relapsing disease that demands serious medical attention and long-term management. We must avoid the misconception that obesity can be addressed simply by achieving a certain number on the scale. Obesity is not merely excessive adiposity; it is a serious, chronic, and relapsing disease that requires urgent attention. Left unmanaged, it can lead to more than 200 associated health complications.
Fortunately, we are now in an era where highly effective treatments are available. As highlighted in last week's European Congress on Obesity, we now have medications like Semaglutide that not only support substantial weight loss but also deliver benefits across the cardio-kidney-metabolic spectrum. This is, in my view, the most significant takeaway from the Congress: for the first time, Semaglutide molecule is not only effective in weight reduction but also benefit other vital organs, such as the heart, kidneys, liver while reducing inflammation. These developments are supported by robust evidence from numerous large-scale, randomized clinical trials involving tens of thousands of patients globally.
This marks a bright chapter in medical history. These new therapies are transforming treatment approaches across multiple medical disciplines, reinforcing the urgent need for a multidisciplinary approach to obesity care.
At the same time, childhood and adolescent obesity is on the rise worldwide. It has become a major public health concern that calls for action through family counselling, proactive patient management, and early intervention. Statistics show that about 55% of children with obesity continue to be obese in adolescence. Around 80% of adolescents with obesity become obese adults, and nearly 70% remain so after the age of 30. Clearly, early action is crucial.
However, we must also consider the flip side: approximately 70% of adults with obesity were not obese during childhood or adolescence. Therefore, while targeting children with obesity is important, it alone will not substantially reduce the burden of adult obesity. A broader and more inclusive strategy is required.
In Europe, the prevalence of overweight individuals ranges from 20% to 30%, depending on the country. When combined with obesity, this figure rises to 50%–70% - a staggering statistic. It's a pandemic worse than COVID-19 in terms of its reach, affecting nearly three out of four people. Alarmingly, half of those living with obesity remain undiagnosed and untreated. In my home country of Italy, for example, the vast majority of patients with obesity are never formally diagnosed, and only a small fraction receive pharmacological treatment.
We need early and targeted action that goes beyond just weight loss. The focus should be on reducing obesity-related complications such as cardiovascular disease (CVD), chronic kidney disease (CKD), and liver dysfunction. At the Congress, we saw compelling evidence of treatment options that address these conditions effectively.
Managing obesity means more than just helping patients lose weight in the short term. It requires understanding each person's individual health profile, including genetics, environment, occupation, family background, risk factors, and coexisting health conditions. Early use of semaglutide, which has shown strong evidence of cardiovascular benefits in addition to weight loss, can help prevent further health deterioration and future complications. With such powerful treatments now available, we have an obligation as doctors to utilize them and improve the lives - and lifespans - of our patients.
However, this is easier said than done. There is often a disconnect between what patients want and what doctors aim to achieve. While many patients focus solely on weight reduction, doctors strive for improved quality of life, fewer complications, and greater longevity. This is the mission of every committed healthcare provider: to offer the most effective, evidence-based therapies and to guide patients toward long-term wellness. That means spending more time with patients, educating them, and involving their families in the journey toward better health.
The data presented at the Congress is practice-changing. It signals a shift from focusing only on statistics to achieving real-world health improvements. We are moving toward a patient-centered, holistic approach that recognises each individual's unique health journey. Just as diabetes care has evolved from a glucose-focused model to one that considers overall health, so too must our approach to obesity evolve.
This paradigm shift is not just important - it is essential. We are facing a global obesity crisis that affects billions. The evidence is clear. The tools are in our hands. Now is the time for decisive action, ensuring that every individual with obesity receives the comprehensive care they need. By doing so, we can help extend lives and significantly improve quality of life for millions.