21^st Global Obesity Meeting June 21-22, 2019 Brisbane, Australia

Weight management is a process which involves adopting long-term lifestyle modifications to maintain a healthy body weight. Methods of weight management include eating a healthy diet and increasing physical activity levels.

Obesity management includes lifestyle changes, surgery or medications and the main treatment for obesity consists of dieting and physical exercise. Diet programs can produce weight loss over a short period of time, but maintaining this weight loss is difficult and often requires a permanent lifestyle change which includes exercise and a low calorie diet. Weight management involves many ways to track weight over time and set ideal body weights for different individuals depending on their age, sex and height.

Childhood obesity is a condition where excess body fat has negative affects a child's health. Childhood obesity is bothering as the extra weight often cause problems that were considered as adult problems —high blood pressure, high cholesterol, diabetes and depression. 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 increasing levels of childhood obesity are due to a shift in diet towards increased intake of energy-dense foods that are high in fats and sugars but low in vitamins, proteins, minerals and other healthy micronutrients, and a trend towards decreased levels of physical activity.

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.

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 actual 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 known to account for 80-85% of the risk of developing type 2 diabetes, while recent research shows obese people develop type 2 diabetes 80 times more than those with a BMI of less than 22.

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.

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 both mother and child. Maternal obesity can cause negative outcomes for both women and fetuses and it also increases the risk of pregnancy complications. Women who are 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 obesity in the future and heart disease. Both women and their offspring will have a  risk for diabetes.

Obesity is associated with many endocrine abnormalities which are related to 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.

Nutrition and Diet play an important role in the promotion of health and prevention of chronic diseases. A balanced diet gives a body the nutrients it needs to function properly. It is important because the organs and tissues of body need proper nutrition to work effectively. Without good nutrition, body is more prone to disease, fatigue, and poor performance.

The number of calories in food is a measurement of the amount of energy stored in that food. Body uses calories for day to day activities and other important functions. An average person needs to eat about 2,000 calories per day to maintain their weight. Daily calorie intake can vary depending on age, gender, physical activity level and BMI. Eating right types of food can reduce obesity.

Eating disorders is a mental disorder which is related to eating behaviors that negatively impact physical and mental health. Most eating disorders mostly involve focusing too much on weight, body shape and food, which leads to dangerous eating behaviors. These behaviors can significantly impact a body's ability to get right nutrition. Eating disorders can harm all the systems in body and can lead to other diseases.

Eating disorders often develop in the teens, they can also develop at other ages. Treatment can help to return to healthier eating habits and sometimes reverse serious complications caused by the eating disorder.

Obesity has increased in the last few decades, both in humans and in several animal populations. Obesity in animals starts when the weight of animal body becomes 20% greater than its optimal body weight. It is associated with hormonal and metabolic changes in the animal body. Approximately one in three veterinary patients is considered to be overweight and obese. When obese animals are compared to non-obese animals, they have a higher chance of osteoarthritis and diabetes mellitus, which also occur earlier in the life of the animal.

Obesity and overweight may increase the risk of many serious diseases health related problems, including diabetes, heart disease, and certain cancers. It also leads to short and long term health problems in pregnant women and their offsprings.

Obesity is not just a cosmetic problem; it is a chronic disease that can have a negative effect on many systems in your body. People who are 40% overweight are twice as likely to die prematurely as is an average-weight person.

Bariatric surgery is a weight loss surgery which includes a many procedures performed on obese people. The size of the stomach is reduced with a gastric band or a portion of the stomach is removed (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or by re-routing the small intestine to a small stomach pouch (gastric bypass surgery). Some of its benefits include reduced risk of cancer, longer life, and improvement in fertility and complications during pregnancy.

The objectives of obesity treatment include achieving and maintaining a healthy body. Obesity treatment, other than weight loss surgeries include dietary changes, physical activity, weight-loss medication, behaviour changes.

Obesity counselling is beneficial for those who are overweight. It provides and encouragement, guidance and support to the individuals to overcome the problem and improve their quality of life. Management of a patient with obesity includes lifestyle changes of increasing physical activity and reducing calorie intake. Counselling also provides emotional strength to manage feelings like stress, and unhappiness without turning to food. Proper counselling helps people with obesity to 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 the outcomes of a patient.