Ricardo Cohen, MD, PhD, is the president of the International Federation for the Surgery of Obesity and the director of the obesity and diabetes center at the Hospital Alemão Oswaldo Cruz.

Ricardo Cohen, MD, PhD

Obesity as a Disease: Reanalyzing and Reformatting How Excess Adiposity is Addressed In and Out of Clinics

 is among the most devastating chronic diseases in the world, with 1.6 million premature deaths from 

 connected back to excess adiposity every year. Current prediction models expect more than 2.9 billion adults worldwide to be living with a high body mass index (BMI) by 2030. What’s more, recent analyses have shown that 2/3 of all countries have ≤1 policy in place to address the epidemic.

Despite widespread awareness of both the condition and its potential comorbidities, combating obesity has thus far been an uphill battle. Its prevalence, combined with the immense social stigma surrounding the disease, has put patients in the unfortunate position of having to fight not only obesity itself, but also the assumptions and beliefs surrounding it. The American Diabetes Association (ADA) has released guidelines on addressing the bias and stigma around obesity and weight, suggesting that clinicians receive training on these biases to improve care for patients. This training emphasizes privacy and sensitivity during anthropometric measurements and asking permission before discussing weight and obesity with patients.

However, for every roadblock in the path to wellness, great strides have been made in obesity care over the last few years. From the advent of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) like semaglutide and tirzepatide to the broad adoption of the view of obesity as a multi-disciplinary condition, clinicians have begun to turn the tide against the disease. Prescription medications and the advancement of bariatric surgery have bolstered the effectiveness of major lifestyle interventions in managing excess adiposity. And the shifting perception of obesity as a chronic disease rather than a sign of weakness or laziness has only just begun to overhaul the way the condition is addressed.

Today, obesity is largely approached not as a risk factor but as a separate disease influencing all parts of the body. The recently proposed cardio-kidney-metabolic framework spotlights the interconnection between cardiovascular, renal, and metabolic diseases, among which obesity plays a substantial role. Clinicians have begun collaborating more often and more significantly in addressing these comorbidities, heading obesity off at each pass.

 editorial team spoke with 3 major voices in the world of obesity care, catching up with recent advancements, addressing ongoing challenges, and providing expert insights and advice.

Editor’s Note: Garvey reports disclosures with Boehringer-Ingelheim, Novo Nordisk, Eli Lilly, Merck, Neurovalens, Fractyl Health, and others. Cohen and Vedala report no relevant disclosures.

Lobstein T, Powis J, Thompson R, Jackson-Leach R. World Obesity Atlas 2025. 

https://www.worldobesity.org/resources/resource-library/world-obesity-atlas-2025

Bannuru RR; Professional Practice Committee. Weight stigma and bias: standards of care in overweight and obesity-2025. 

. 2025;13(Suppl 1):e004962. Published 2025 May 16. 

Moura AF, Pecoits-Filho R. Cardio-kidney-metabolic (CKM) framework: A nephrologist's perspective. 

. 2025;70(special 1):e250405. Published 2025 Nov 28. 

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This World Obesity Day, catch up on major paradigm shifts in the diagnosis, discussion, and treatment of obesity, one of the world’s most devastating chronic diseases.

Ricardo Cohen, MD, PhD

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