Obesity isn’t a choice

There is widespread misconception that obesity is just a question of weight, caused by a lack of willpower or exercise. But the reality is much more complicated. It’s a serious and complex chronic disease where clear definitions and a shared understanding matter.

What is obesity?

Obesity is internationally recognized as a chronic disease that can pose

serious health risks and complications:


“Obesity is a chronic complex disease defined by excessive fat deposits that can impair health.1


Code 5B81: “Obesity is a chronic complex disease defined by excessive adiposity that can impair health.2


“Obesity is a chronic relapsing disease, which in turn acts as a gateway to a range of other non-communicable diseases, such as diabetes, cardiovascular diseases and cancer.3

The many paths to obesity

It’s often believed that obesity can be rectified by lifestyle changes like better diet

and more exercise. Yet the story isn’t this straightforward. The science continues to show

that obesity is a complex interplay of several factors:


It’s well documented how the brain controls eating behavior and appetite4


Around 40-70% of our weight is dependent on our genetic makeup5


Stress and psychological distress can significantly impact appetite6


Health, social and economic inequalities all contribute to obesity levels7


Several medications are known to promote long-term weight gain8


Unhealthy eating patterns and sedentary lifestyle are key environmental factors2

A gateway to
serious health risks

Obesity can start to develop at any age of stage of life and can lead to more than 230 complications. These include type 2 diabetes, cardiovascular diseases, dementia, and several types of cancer, such as colon, rectum, breast, endometrium, liver, and kidney.9


Obesity is associated with 230 complications but we can’t predict who will develop them – yet

Gradient rect

Beyond the limitations of BMI

Obesity is commonly diagnosed, quantified, and assessed using the anthropometric body mass index (BMI). BMI may be useful at the population level, but it isn’t sufficient to capture the metabolic health differences from person to person.10

To better understand the onset and progression of obesity and diagnose obesity earlier, we need a more holistic assessment process that also considers:

  • Body composition

  • Physical biomarkers

  • Physiological biomarkers

More comprehensive datasets will also provide meaningful insights for primary as well as secondary use of data for healthcare spending and policy formation worldwide.

It’s time to redefine obesity care

Despite our current level of knowledge and understanding of obesity and its many complications, there’s still a lot to learn.

That’s why SOPHIA is working towards a future where healthcare professionals can reliably predict the obesity risk and response to treatment – improving patient outcomes.


1. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight#:~:text=Obesity%20is%20a%20chronic%20complex,the%20risk%20of%20certain%20cancers

2. https://www.findacode.com/icd-11/code-149403041.html#:~:text=5B81%20Obesity%20%2D%20ICD%2D11%20MMS

3. https://knowledge4policy.ec.europa.eu/health-promotion-knowledge-gateway/obesity_en#:~:text=Obesity%20is%20a%20chronic%20relapsing,diabetes%2C%20cardiovascular%20diseases%20and%20cancer.

4. Hall KD, Farooqi IS, Friedman JM, Klein S, Loos RJF, Mangelsdorf DJ, et al. The energy balance model of obesity: beyond calories in, calories out. Am J Clin Nutr [Internet]. 2022 May 1 [cited 2023 Nov 24];115(5):1243–54. Available from: https://pubmed.ncbi.nlm.nih.gov/35134825/

5. Herrera BM, Lindgren CM. The Genetics of Obesity. Curr Diab Rep [Internet]. 2010 Dec [cited 2023 Nov 24];10(6):498. Available from: /pmc/articles/PMC2955913/

6. Sominsky L, Spencer SJ. Eating behavior and stress: a pathway to obesity. Front Psychol [Internet]. 2014 [cited 2023 Nov 24];5(MAY). Available from: https://pubmed.ncbi.nlm.nih.gov/24860541/

7. Robertson A;, Loring B. Obesity and inequities. Guidance for addressing inequities in overweight and obesity [Internet]. World Health Organization, Europe. World Health Organization; 2014 [cited 2023 Nov 24]. 1–6 p. Available from: https://www.ucviden.dk/en/publications/obesity-and-inequities-guidance-for-addressing-inequities-in-over-2<

8. Wharton S, Lau DCW, Vallis M, Sharma AM, Biertho L, Campbell-Scherer D, et al. Obesity in adults: A clinical practice guideline. CMAJ [Internet]. 2020 Aug 4 [cited 2023 Nov 24];192(31):E875–91. Available from: https://obesitycanada.ca/guidelines/epidemiology/

9. Czernichow S, Bain SC, Capehorn M, Bøgelund M, Madsen ME, Yssing C, et al. Costs of the COVID-19 pandemic associated with obesity in Europe: A health-care cost model. Clin Obes [Internet]. 2021 Apr 1 [cited 2023 Nov 24];11(2). Available from: https://pubmed.ncbi.nlm.nih.gov/33554456/

10. Watanabe K, Wilmanski T, Diener C, Earls JC, Zimmer A, Lincoln B, et al. Multiomic signatures of body mass index identify heterogeneous health phenotypes and responses to a lifestyle intervention. Nat Med. 2023 Apr 1;29(4):996–1008."