# Obesity: Causes, Health Risks and Treatment

> Obesity is a chronic disease, not a matter of willpower. Learn how to tell if your weight affects your health, why obesity matters, how it is treated and which doctor to see in Georgia.

Obesity is a chronic disease in which the body stores so much fat that it starts to harm health. The World Health Organization (WHO) treats it as a disease, not a cosmetic issue: in 2024, about 1.1 billion people worldwide were living with obesity. It develops from a mix of many causes, so willpower alone is rarely enough to treat it. The good news is that obesity is treatable, and even a moderate amount of weight loss brings real health benefits.

## How to tell if your weight is affecting your health

For adults, the main yardstick is body mass index (BMI): your weight in kilograms divided by your height in meters squared. According to WHO:

- a BMI of 25 or higher means overweight;
- a BMI of 30 or higher means obesity.

For example, someone who is 1.70 m tall and weighs 90 kg has a BMI of about 31. But BMI cannot tell fat from muscle, and it does not show where fat is stored, so doctors also look at the waist. NICE, the UK health guidance body, suggests a simple rule: keep your waist measurement to less than half your height. A waist-to-height ratio of 0.5 to 0.59 means extra fat around the belly, and 0.6 or more signals a high health risk.

The European Association for the Study of Obesity (EASO) advises looking beyond the number on the scale to a person's overall health: blood pressure, blood sugar, joints, sleep and well-being. Children and teenagers are assessed differently, using age-based growth charts, and a pediatrician should evaluate a child's weight.

## What causes obesity

WHO describes obesity as the result of complex interactions between environment, lifestyle and biology. Most often, weight goes up when you take in more calories than you burn, but many different factors sit behind that:

- a diet high in sugar and fat, and sugary drinks;
- too little movement and desk-bound work;
- genetics;
- certain medicines, such as some steroids, antidepressants and beta blockers;
- an underactive thyroid, Cushing's syndrome or polycystic ovary syndrome;
- menopause and age: weight tends to come on more easily over the years.

That is why "just eat less" rarely works. A doctor first looks for what is keeping the extra weight on in your particular case.

## Why obesity is dangerous

Obesity raises the risk of many diseases. According to WHO and the UK's National Health Service (NHS), these include:

- [type 2 diabetes](https://bigmed.ge/en/diseases/type-2-diabetes);
- high blood pressure, heart disease and stroke;
- fatty liver disease;
- kidney disease;
- osteoarthritis and [knee pain](https://bigmed.ge/en/symptoms/knee-pain);
- some cancers, including breast, womb and bowel cancer.

It also causes everyday problems: getting out of breath with effort, snoring, [constant tiredness](https://bigmed.ge/en/symptoms/fatigue), [back pain](https://bigmed.ge/en/symptoms/back-pain), [joint pain](https://bigmed.ge/en/symptoms/joint-pain) and low mood. WHO estimates that in 2023 about 3.7 million deaths worldwide were linked to a higher-than-optimal BMI.

## How obesity is treated

The goal of treatment is not an "ideal" number on the scale but better health: lower blood pressure and blood sugar, easier breathing and movement. According to the NHS, losing even 5 to 10% of your body weight improves your health. Treatment is built up step by step.

### Diet, activity and sleep

These are the foundation of any treatment, including treatment with medicines. This does not mean crash diets, but a way of eating you can keep up for years. WHO recommends building meals around vegetables, fruit, pulses and whole grains while limiting sugar, saturated fat and salt. For adults, WHO recommends at least 150 minutes of moderate physical activity a week. Sleep and support matter too: weight management programs with a dietitian, a psychologist or a group help you change habits and keep the results.

### Medicines

If your BMI is 30 or higher, or 27 or higher with a weight-related condition, your doctor may suggest medication. In December 2025, WHO issued its first recommendation on GLP-1 medicines (semaglutide, tirzepatide and liraglutide) for the long-term treatment of obesity in adults, alongside changes to diet and activity. These are prescription drugs with contraindications, and weight often comes back after stopping them. We cover which drugs are approved, what results to expect and what is sold in pharmacies in Georgia in our article [Weight Loss Medications: What Really Works](https://bigmed.ge/en/blog/weight-loss-medications-georgia). Do not buy "weight loss shots" from online ads: fakes are in circulation, and there is no way to check what is inside at home.

### Surgery

Bariatric (metabolic) surgery is usually considered for people with a BMI of 40 or higher, or 35 or higher with a weight-related condition. The thresholds are lower for some ethnic groups. The decision is made after a full assessment. After surgery, your diet changes for good, and you need follow-up checks and blood tests for the rest of your life.

## Preventing obesity

According to WHO, overweight and obesity are largely preventable. What helps: a healthy diet, regular physical activity, enough sleep, not smoking and avoiding harmful drinking, and breastfeeding for babies. WHO also advises assessing weight early instead of waiting for complications: BMI and waist size can be checked at any routine visit.

## Which doctor to see

- [Endocrinologist](https://bigmed.ge/en/doctors/endocrinologist): the main specialist. They check hormones and blood sugar, look for complications and, if needed, choose a medication.
- [Dietitian](https://bigmed.ge/en/doctors/dietitian): helps you build an eating plan, with or without medication.
- [General practitioner](https://bigmed.ge/en/doctors/general-practitioner): a good start if you are not sure where to go. They check your blood pressure, order basic tests and refer you to the right specialist.
- [Gynecologist-endocrinologist](https://bigmed.ge/en/doctors/gynecologist-endocrinologist): for women whose extra weight comes with irregular periods or polycystic ovary syndrome.

Bring a list of the medicines you take and any recent test results to your first appointment, and note how your weight has changed over the past few years.

## When not to put off seeing a doctor

- your waist measures more than half your height;
- you have strong thirst, frequent urination, blurred vision or unexplained tiredness, which can be signs of high blood sugar;
- you started gaining weight after a new medicine: do not stop it on your own, talk to your doctor first;
- you snore loudly and feel tired all day.

Call 112 if you have tight or squeezing chest pain that may spread to your arm, neck or jaw, or if you suddenly find it very hard to breathe.

## Doctors

- Tamari Shatirishvili — Endocrinologist: https://bigmed.ge/en/doctors/tamari-shatirishvili (markdown: https://bigmed.ge/en/doctors/tamari-shatirishvili.md)
- Karina — Dietitian, Gastroenterologist: https://bigmed.ge/en/doctors/karina-1 (markdown: https://bigmed.ge/en/doctors/karina-1.md)

## Frequently asked questions

### Is obesity a disease or a lifestyle issue?

WHO classifies obesity as a chronic disease. It results from a mix of environment, lifestyle, genetics and biology, so it needs long-term treatment with a doctor, not willpower alone.

### What BMI counts as obesity?

In adults, a BMI of 30 or higher is obesity, and 25 to 29.9 is overweight. Your waist matters too: it should measure less than half your height. Children are assessed with age-based charts.

### How much weight do I need to lose to see a benefit?

According to the NHS, losing just 5 to 10% of your body weight improves your health. For someone who weighs 100 kg, that is 5 to 10 kg. Keeping the weight off matters as much as losing it.

### Can I lose weight with shots or pills without a doctor?

It is not a good idea. Semaglutide, tirzepatide and similar drugs are prescription medicines with contraindications and side effects. WHO warns that high demand has led to the spread of falsified and substandard products. A doctor should choose the medicine for you.

## Symptoms

- Weakness and fatigue: https://bigmed.ge/en/symptoms/fatigue
- Back pain: https://bigmed.ge/en/symptoms/back-pain
- Joint pain: https://bigmed.ge/en/symptoms/joint-pain
- Knee pain: https://bigmed.ge/en/symptoms/knee-pain

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Canonical: https://bigmed.ge/en/diseases/obesity
Country: Georgia (GE), the country in the South Caucasus
Updated: 2026-10-12T17:10:30+04:00