20^th Global Obesity Meeting August 24-25, 2018 Singapore

The balance between calorie intake and energy expenditure determines a person's weight. A lack of energy balance most often causes overweight and obesity. Energy balance means that energy IN should be equal to energy OUT. Some hormone problems may cause obesity and overweight, such as hypothyroidism, Cushing's syndrome, and polycystic ovarian syndrome (PCOS). Other causes include Lack of exercise, age, health conditions and emotional factors.

Among adults under the age of 70, obesity is second in the number of deaths it causes each year. As obesity rates continue to rise, the number of deaths due to this may soon exceed that of tobacco. Obesity causes  is closely linked with a huge number of health conditions, including heart disease, stroke, diabetes, high blood pressure, unhealthy cholesterol, asthma, sleep apnea, gallstones, kidney stones, infertility, and as many as 11 types of cancers, including leukemia, breast, and colon cancer. 

Childhood obesity is a condition where excess body fat has negative affects a child's health. Childhood obesity is troubling because the extra pounds often cause problems that were considered as adult problems — diabetes, high blood pressure and high cholesterol.Many obese children become obese adults, especially if their parents are obese. Childhood obesity can also lead to low self-esteem and depression. 

The causes behind the rising levels of childhood obesity are a shift in diet towards increased intake of energy-dense foods that are high in fat and sugars but low in vitamins, proteins, minerals and other healthy micronutrients, and a trend towards decreased levels of physical activity.

Obesity is associated with many endocrine abnormalities which are associated with hormonal imbalance and resistance. Some of these abnormalities are considered as factors to cause for the development of obesity, whereas others are considered to be secondary effects of obesity and usually are restored after weight loss. Hormones play an important role in appetite, metabolism, body fat distribution and storage of excess energy in food as fats. 

Weight reduction generally normalizes these endocrine alterations, implicating obesity as a direct cause. Hormones are chemical messengers that regulate processes in our body. They are one of the factors causing obesity. When an individual's hormones are out of balance, it may be impossible to achieve sustained weight management. People with obesity have levels of hormones that can increase accumulation of body fat by altering the metabolism of the fats.

Extra fat in the body may have harmful effects, like producing hormones and growth factors that affect the way our cells work. Fat cells can also attract immune cells to body tissues which release chemicals that cause long-lasting inflammation. This can raise the risk of several diseases including cancer. People with obesity have chronic low-level or subacute unresolved inflammation, which is associated with increased cancer risk.

One of the strongest links between obesity and cancer is an increased risk of breast and womb cancers in women who are obese after the menopause, and this relates to higher estrogen levels. Overweight people often have increased levels of insulin and insulin-like growth factor-1 which may lead to the development of certain tumors.

Obesity increases the chances of developing the common type of diabetes, type 2 diabetes. In type 2 diabetes, body makes enough insulin but the cells in the body have become resistant to the salutary action of insulin. Therefore the blood sugar levels are high as the muscle cells become resistant to glucose. Hence, the glucose from blood cannot enter in the cells where it is used for energy.  Fat in the abdomen can also cause insulin insensitivity. An overweight body with a BMI more than 30 is one of the risk factor for Insulin resistance.

The exact causes of diabetes are still not fully understood, it is known that factors up the risk of developing different types of diabetes Mellitus. For type 2 diabetes, this includes being obese (having a body mass index - BMI - of 30 or greater). In fact, obesity is believed to account for 80-85% of the risk of developing type 2 diabetes, while recent research suggests obese people develop type 2 diabetes 80 times more than those with a BMI of less than 22.

Genetics plays an important role in obesity. In disorders such as Bardet-Biedl syndrome and Prader- willi syndrome, genes can directly cause obesity. The percentage of obesity that can be attributed to genetics varies widely, depending on the population examined, from 6% to 85%.At the risk of oversimplification, it seems that from a genetic standpoint, human obesity appears less a metabolic than a neurobehavioural disease.

Genes do not always predict future health but genes and behavior may both be needed for a person to be overweight. In few cases multiple genes and other factors; such as abundant food supply or little physical activity increases susceptibility for obesity. Population-based association and linkage studies have highlighted a number of loci at which genetic variation is associated with obesity. 

Obesity in pregnancy can affect health later in life for both mother and child. Maternal obesity can cause negative outcomes for both women and fetuses and it also increases the risk of a number of pregnancy complications. Women who are overweight or obese are less likely to have a live birth following in vitro fertilization (IVF).

For women, the risks include heart disease and hypertension. Children have a risk of future obesity and heart disease. Both women and their offspring are at increased risk for diabetes.

Obesity in animals occurs when the weight of animal body is 20% greater than its optimal body weight. It is associated with metabolic and hormonal changes in the animal body. Approximately one in three veterinary patients is considered overweight and obese. Compared to non-obese animals, obese animals have a higher chance of osteoarthritis and diabetes mellitus, which also occur earlier in the life of the animal. 

Obesity is alarming because both conditions increase the risk for a number of health problems, including chronic diseases, which can lead to reduced quality of life, premature death, and substantial medical care - and productivity-related costs. To prevent obesity and maintain a healthy body weight, eat a well-balanced diet and exercise regularly. 

Once fat cells are formed, they remain in your body forever. Although you can reduce the size of fat cells, you cannot get rid of them. The use of a systematic legal framework, the use of legislation, regulation, and the policy to address the multiple factors that contribute to obesogenic environments can assist in the development, execution, and estimation of a variety of legal approaches for obesity prevention and control.

Managing obesity includes lifestyle changes, medications, or surgery and the main treatment for obesity consists of dieting and physical exercise. Diet programs may produce weight loss over the short term period, but maintaining this weight loss is frequently difficult and often requires making exercise and a lower calorie diet a permanent part of an individual's lifestyle. 

Numerous business health improvement plans and self-improvement groups are accessible. The quality and adequacy of projects shift generally, from trustworthy heftiness facilities connected with doctor's facilities to brisk weight reduction plots that may mischief your wellbeing with untested "supernatural occurrence" items. 

A characteristic strategy and a new clarification for obesity is required which must be applicable, adds value to the health-promoting effects of weight loss and medically-meaningful.  A conscious target is to begin dynamic lifestyle changes by creating physical activity and eating sound sustenance.

Weight Loss can be caused by surgical procedures by restricting the amount food the stomach can hold. This causes abnormal absorption of nutrients by the digestive tract. Most weight loss surgeries today are performed using minimally invasive techniques

Obesity counselling is proven to be beneficial for those who are overweight. It provides support, guidance and encouragement to the individuals for overcoming the problem and improving their quality of life. Management of an obese patient includes lifestyle changes of increasing physical activity and reducing calorie intake. Counselling also provides emotional strengthening to manage feelings like stress, and unhappiness without turning to food.

Proper counselling helps obese people realize that weight loss is a slow process that requires hard work and commitment. So, one has to be strong and patient to follow the right weight loss plan. It also highlights the importance of healthy eating and physical activity for weight loss and maintenance, apart from identifying other factors like genetic and environment that are becoming an obstacle. Behaviourial scientists have suggested a framework for behavioural counselling known as the 5 A’s (ask advise, assess, assist, and arrange) which has been used to improve patient outcomes.

In addition to health impacts, obesity leads to many problems including depression and mental health. Depression can both cause stress, which, in turn, may cause you to change your eating and activity habits. Real life stories demonstrate all these experience of an obese person. It is also the impact a health care provider can have on achieving successful weight-loss.