The complex truth about obesity and its health implications

“EAT less and move more.”

- VUYILE MADWANTSI

We hear this often, as if obesity were that simple to solve. But science reveals otherwise. Obesity isn’t about willpower; it's a chronic disease recognised by the World Health Organization (WHO) and impacts far more than the number on the scale.

For women, the dangers of obesity go beyond appearance or stigma.

Excess abdominal weight is linked to hormonal imbalances, pregnancy complications and even changes to a baby’s DNA, called epigenetic programming.

Why does the WHO call obesity a chronic disease

The WHO now classifies obesity as a chronic disease because it is complex, long-term, and relapsing. It involves a mix of genetic, biological, psychological, social and environmental factors that go beyond personal choice.

Research published in The Lancet shows that 40-70% of obesity has a genetic basis meaning biology, not lack of effort, plays a big role.

At the South African launch of Wegovy, the first once-weekly GLP-1 therapy approved locally for obesity, Dr Kershlin Naidu, an endocrinologist at Netcare Waterfall City Hospital, explained it best: “Treating obesity isn’t about willpower. It’s about the science.

“Obesity is a journey, and the body often fights weight loss through mechanisms like metabolic adaptation, where the body slows metabolism and increases hunger hormones to push you back to your old weight.”

Naidu’s metaphor, “grab your metaphorical backpacks and let’s unpack this together,” invites us into the conversation, demystifying complexity with warmth.

He walks us through six intertwining causes of obesity:

@ Biological drivers (the brain’s three eating centres: hunger, choice, pleasure)