An overweight man is sitting on a stone wall by a river, eating a sandwich.
Dossier: Healthy eating

How to beat and treat obesity

Around one in eight adults in Switzerland are living with obesity, a modern lifestyle disease that has high health risks. But there are numerous ways to tackle obesity head on.

Text: Nicole Krättli; photo: iStock

Around one million people in Switzerland have to face the reality of knee pain, shortness of breath after climbing a few steps, and the feeling that their own body is a burden. Obesity is more than just a number on the scales – it affects nearly every aspect of life. But there are many options available today for anyone who wants to lose weight and live more healthily.

What is obesity?

Obesity is a serious chronic illness that can have long-term consequences for health and well-being. Excessive fatty tissue not only makes the body heavier, but also makes it more susceptible to a range of health risks. According to the World Health Organisation (WHO), a body mass index of 30 and above is considered obese. The BMI measures the ratio of your height to your weight to estimate the amount of body fat you have.

What’s the difference between being overweight and being obese?

While being overweight starts at a BMI of 25 and above and can often be reduced by changing diet and getting more exercise, obesity is a more serious form that those affected are usually unable to fight without medical support. A BMI of over 30 involves a massively higher risk of secondary diseases such as diabetes or high blood pressure, which the WHO describes as a “serious global health challenge”.

The BMI is categorised as follows:

  • Underweight: BMI under 18.5
  • Normal (healthy) weight: BMI between 18.5 and 24.9
  • Overweight: BMI above 25
  • Pre-obese: BMI between 25 and 29.9
  • Obese class I: BMI between 30 and 34.9
  • Obese class II: BMI between 35 and 39.9
  • Obese class III: BMI over 40

BMI: calculating when you’re overweight

The body mass index is calculated by dividing a person’s weight in kilograms by the square of their height in metres (m²). A BMI over 25 is considered overweight, and over 30 is obese. A BMI calculator from Zurich University Hospital can help you calculate your BMI.

However, BMI alone is not a sufficient indicator, because visceral fatty tissue that collects around the inner organs increases the risk of cardiovascular disease. A larger waist circumference of 88 cm for women and 102 cm for men is also considered a critical value. The distribution of body fat can also point to health risks:

  • Android (apple) shape: Most of the fat collects around the stomach and mid-section and increases the risk of cardiovascular disease and diabetes.
  • Gynoid (pear) shape: Most of the fat is stored about the hips and thighs, which is considered less dangerous, but can still be harmful to health.

Causes and risk factors

Obesity is promoted by a complex interplay of several factors that goes far beyond the simple equation of too much food and too little exercise. Genetic predisposition, psychological and social influences and the cultural environment play a central role. According to the Swiss Obesity Alliance, a high-calorie diet coupled with a lack of exercise is a major risk factor, but emotions such as stress, frustration and loneliness can also promote unhealthy eating habits and contribute to weight gain.

Genetic factors influence the basal metabolic rate, i.e. the amount of calories the body consumes at rest. People with a low basal metabolic rate tend to gain more weight, even if they don’t eat more than lean people. Hormonal disorders such as an underactive thyroid or Cushing’s syndrome, which leads to an overproduction of cortisol, can also affect the metabolism and increase the risk of obesity.

Symptoms and consequences of obesity

People with obesity often suffer from a variety of physical symptoms that make daily life more difficult. They are subject to physical limitations, and even simple activities such as climbing stairs or bending down lead to shortness of breath and rapid fatigue. They frequently sweat profusely, even with minimal exertion and at lower temperatures.

Painful joints

The extra weight puts a strain on the joints, particularly in the lower back, hips, knees and ankles. Furthermore, the joints are subject to faster wear and tear, which causes severe pain and, in the long term, osteoarthritis.

Poor sleep and sleep apnoea

In addition, the higher body weight results in a greater need for oxygen. But many obese people suffer increasingly from sleep apnoea at night, which further restricts the oxygen supply and leads to exhaustion and daytime sleepiness in those affected.

Diabetes and cardiovascular diseases

Visceral fatty tissue in the abdomen in particular, known as abdominal fat, also significantly increases the risk of type 2 diabetes and cardiovascular disease.

According to the World Health Organisation, obesity is responsible for at least 200,000 new cases of cancer every year in Europe alone and is one of the main causes of high blood pressure and atherosclerosis, which increase the risk of heart attacks and strokes.

Obesity as a taboo topic: psychological and social consequences

Psychological symptoms are also common in people with obesity. Many struggle with social exclusion, bullying and low self-esteem.

The Swiss Society for the Study of Morbid Obesity and Metabolic Disorders warns of a vicious circle: The limitations caused by obesity often exacerbate the problem, because those affected move less, which leads to more weight gain.

Diagnosis and treatment

Obesity is diagnosed by measuring the BMI and waist circumference. A blood test is also often taken to determine risks such as high blood sugar and cholesterol levels. A thorough diagnosis helps find the right treatment from a range of options taking in everything from exercise therapy to surgery.

Conservative treatment

Methods of conservative treatment include nutritional advice, movement and behavioural therapy:

  • Nutrition advice: An individual analysis of eating habits and a customised diet plan help to reduce weight sustainably.
  • Movement therapy: Regular exercise adjusted to the person’s fitness level increases calorie consumption and improves general resilience. Walking, light strength training or swimming are ideal.
  • Behavioural therapy: To achieve success in the long term, it is important to change bad habits. Psychological support can help identify unhealthy eating patterns and change them step by step.

Drug therapy

Drug treatments can be used as a supplement for some patients. Medication can help to reduce the feeling of hunger or inhibit fat absorption. Be sure to ask your doctor for advice. Drug treatments should only be carried out under strict medical supervision, as side effects are not uncommon.

Surgery

Surgery may be worthwhile under certain circumstances for people with severe obesity (BMI over 35) if conservative treatments have proven unsuccessful. The most common procedures include:

 

  • Roux-en-Y gastric bypass: Reducing the size of the stomach and shortening the small intestine helps patients feel fuller faster. And the digestive system doesn’t absorb all the nutrients (or calories) from the food.
  • Gastric sleeve: With this procedure, about 80% of the stomach is removed, leaving a small tube-shaped stomach about the size and shape of a banana.
  • Mini-gastric bypass: This procedure makes the stomach much smaller and reroutes the small intestine, which restricts the amount of food that can be consumed and reduces the absorption of calories and nutrients.

The choice of procedure is made on a case-by-case basis and depends on pre-existing conditions, the BMI and the patient’s personal goals. Close medical care is essential in the long term, because the patient has to change their diet and nutritional deficiencies may occur.

Preventing obesity

To prevent obesity, you have to eat healthily and get regular exercise. In its dietary recommendations, which were revised in 2024, the Federal Food Safety and Veterinary Office (BLV) recommends a diet based predominantly on plant-based protein, wholegrain products and seasonal fruit and vegetables.

A diet rich in dietary fibre with little sugar and few processed foods helps you feel fuller for longer and reduces the risk of gaining too much weight. It is also important to get more exercise in your daily routine. Being active for just 30 minutes a day is proven to reduce the risk of becoming obese.

Childhood obesity

Figures published by the WHO show that around one in three children in Europe are struggling with obesity – an alarming trend. According to the Swiss Obesity Alliance, around 15% of children and young people in Switzerland are overweight or obese. Programmes such as “Fourchette verte”, which promote healthy eating habits in schools, show that education and early support can have a lasting effect.

Gesundheitsförderung Schweiz, a foundation that supports programs in kindergartens and schools, recommends that parents pay attention to healthy eating and exercise from an early age in order to promote a healthy weight in the long term. The foundation encourages exercise and healthy eating to be taught in a playful and everyday way. Especially after the pandemic, the exercise habits of many children have changed for the worse – a trend that, according to the WHO, must be counteracted in order to prevent long-term health problems.

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