Obesity

Obesity is a chronic condition involving excess body fat that increases the risk of numerous health problems, including type 2 diabetes, hypertension, and heart disease. Rates are rising in Tanzania alongside urbanisation and changing lifestyles.

• Body mass index (BMI) of 30 or above (or elevated waist circumference), used as a practical screening measure alongside overall clinical assessment
• Reduced exercise tolerance and breathlessness with exertion
• Joint pain, particularly affecting weight-bearing joints such as the knees
• Often no symptoms directly from excess weight itself in earlier stages, though associated conditions such as diabetes or hypertension may develop over time

• Results from a sustained imbalance between calories consumed and calories used by the body, though the underlying contributors are complex.
• Risk is increased by a diet high in energy-dense processed foods, physical inactivity, certain medicines, genetic predisposition, and, less commonly, underlying hormonal conditions.
• Social and environmental factors, such as food availability and the built environment, also strongly influence risk at a population level.

• Assessed using body mass index (weight in kilograms divided by height in metres squared) together with waist circumference, which gives additional information about health risk.
• Screening for associated conditions — such as diabetes, hypertension, and abnormal blood lipids — is an important part of assessment.
• A detailed history of diet, activity level, and any contributing medicines or medical conditions supports a tailored management plan.

A structured approach combining dietary changes, increased physical activity, and behavioural support is the foundation of management, focusing on gradual, sustainable change rather than rapid weight loss.

Working with a health worker to set realistic, individualised goals improves the likelihood of sustained success.

Managing associated conditions, such as diabetes, hypertension, or abnormal cholesterol, is an important parallel focus, as these significantly affect long-term health.

For some adults with significant obesity and associated health conditions who have not achieved adequate results with lifestyle measures alone, additional medical or surgical options may be considered under specialist guidance where available.

Ongoing follow-up and support help maintain progress and address setbacks, since sustainable change typically takes time.

• Aim for a balanced diet emphasising whole foods, vegetables, and appropriate portion sizes, while limiting energy-dense processed foods and sugary drinks.
• Engage in regular physical activity, building up gradually if starting from a low baseline.
• Seek support from a health worker for a structured, individualised weight management plan rather than pursuing rapid, unsustainable approaches.
• Address underlying contributors, such as poor sleep or high stress, which can affect eating patterns and weight over time.
• Focus on overall health improvements rather than weight alone, as improvements in activity and diet benefit health even before significant weight change occurs.