The world is facing an obesity crisis. In February, research by Imperial College London’s School of Public Health revealed that the total number of children, adolescents and adults living with obesity worldwide has surpassed 1 billion. That’s one in eight people globally.
Researchers, who gathered data from more than 190 countries, estimated that among children and adolescents, the rate of obesity in 2022 was four times higher than in 1990. In adults, rates of obesity have more than doubled in women and nearly tripled in men.
Once considered a high-income-country problem, obesity is now on the rise across low- and middle-income countries too. In Africa, the number of overweight children under 5 years old has increased by nearly 23% since 2000. And, almost half of the children aged under 5 who were overweight or obese in 2022 lived in Asia.
These statistics are having a devastating financial impact on global healthcare systems too. At its current rate the cost of obesity is expected to reach $3tn (£2.3tn) per year by 2030 and more than $18tn (£13.7tn) by 2060.
But, more worryingly, the disease is also increasing the risk of millions of people developing a host of other serious health problems. These include heart disease, Type 2 diabetes, high cholesterol, high blood pressure and even some cancers, which could put the healthcare system under more strain.
The role of genetics
People suffering with obesity are often accused of simply eating too much and not exercising enough. But groundbreaking research by biotech firm Genomics LTD has revealed a critical underlying factor. At Bupa’s Healthcare Symposium: Unboxing Digital Health, Genomics’ LTD CEO, Sir Peter Donnelly, unveiled the results of a study that showed how a person’s genetic profile has a direct influence on their BMI and subsequent risk of developing obesity.
During his talk, a series of graphs illustrated how a child’s BMI is already associated with their genetics by their fourth birthday. As they grow into adults, this problem worsens. Adults in their 20s with a relatively high genetic-risk score for BMI will typically experience an increase in BMI that’s three times higher than those with low risk, over the next 20 years of their lives. People with a higher genetic-risk BMI and an unhealthy lifestyle will suffer an even greater increase. Donnelly says the research must spark a change in the conversations around obesity and underpin future treatments that target long-term lifestyle changes.
“We need to change the discourse around being overweight, from a culture of blame and guilt to focusing on how best to help people overcome these challenges,” said Donnelly. “We know our research, and others’, shows that a healthy lifestyle can prevent obesity and comorbidities even in individuals with a high genetic risk. However our research shows that those at high risk of obesity will need more support to help them stay at, or return to, a healthy weight. It also shows that the effort required for those with a high genetic risk is much greater.”
For example, a person with a polygenic-risk score (PRS) at the 95th percentile has to walk 10,000 steps a day more than someone at the 20th percentile to balance the impact of their PRS, notes Donnelly.
He added: “It’s clear that healthcare initiatives that take into account genetic profiles would be significantly more effective in helping people stay healthier for longer. This information means we have a golden opportunity to develop much more sophisticated, personalised and successful obesity-prevention programmes.”
Personalised treatments
The starting point for creating a personalised treatment programme is genetic testing. Bupa has become the first major private healthcare provider in the UK and Spain to offer its customers whole genomic sequencing under its two-year pilot programme, My Genomic Health.
The pilot will give more than 14,000 healthy customers the opportunity to undergo an analysis of over 300 genes and nine polygenic-risk scores to identify their risk of developing obesity and 36 potentially life-threatening health conditions that are often associated with the disease. These include heart disease, diabetes and 10 types of cancer.
Bupa’s chief medical officer, Anne Lepetit, says the pilot could have a transformative impact on the treatment of obesity. “Early detection enables us to deliver a risk-factor action plan,” she says.
“People can be really preventative in this area by understanding the lifestyle habits they need to maintain a healthy BMI. The tests will also give people insights into how their bodies are likely to respond to different types of medications if they’re already suffering with more serious health complications from obesity.”
Digital technology
In recent years, the potential of weight-loss wonder drugs such as semaglutide have generated headlines and optimism for those suffering with obesity. But pharmaceutical solutions are expensive and questionable if taken over the long term. For Bupa, personalised lifestyle-focused interventions delivered by digital technology are exciting.
For example, Bupa’s clinicians can use genetic testing to create personalised health and exercise programmes that will eventually be delivered through the company’s digital health solution, Blua. In Spain, an AI-powered physio function in Blua also enables users to use their smartphone camera to track physio sessions and provide real-time feedback on their efforts. Alerts can keep people on track by informing them about their daily step count or reminding them of upcoming sessions.
For patients suffering from complex complications from obesity, other digital services can aid their treatment. Virtual or in-person physio appointments can be booked via Blua to address musculoskeletal issues and mental health problems. “People with obesity are more likely to suffer from anxiety and depression,” says Lepetit. “We can use Blua to monitor their activity levels and their physical and mental health on an ongoing basis and recommend lifestyle interventions or a therapist before a serious problem occurs.”
Find out more about how Bupa’s Blua is transforming digital healthcare
