**1. Introduction**

Obesity has significantly increased over the last years. Obesity is defined as excessive fat accumulation that adversely affects health, caused by consuming excess energy in relation to energy expenditure. Its etiology is complex and includes genetic, physiologic, environmental, lifestyle, psychological, social, economic, and political factors that interact to cause obesity (**Table 1**) [1–7]. Obesity is diagnosed using body mass index (BMI, kg/m2 ), weight in kilogram divided by the height in meters squared. Obesity is defined as BMI ≥ 30 kg/m2 while having a BMI 25.0–29.9 kg/m<sup>2</sup> is considered as overweight.

Obesity increases the probability of many ailments, with increased morbidity/ mortality and decreased quality of life. It is implicated in many health problems and complications e.g., hypertension, type 2 diabetes (T2DM), hyperlipidemia, cardiovascular conditions, obstructive sleep apnea, metabolic syndrome, chronic kidney disease (CKD), nonalcoholic fatty liver disease (NAFLD), osteoarthritis, depression and some cancers [8]. These are mainly a consequence of the increased


### **Table 1.**

*Factors contributing to obesity.*

body fat, which result in endocrine and metabolic disturbances as well as increased mechanical pressure on various organs [9].

Obesity is a chronic disease given its multifaceted etiology and complex pathophysiologies. It has characteristic signs and symptoms consistent with anatomical changes across various organs (cardiovascular, endocrine, immunological functions) and results in complications. Hence, it needs treatment for life; and because it is a heterogeneous condition, individual assessment, risk stratification, and management are necessary [9].

At the societal level, existing weight loss (WL) therapies are not likely to reduce the obesity epidemic, however, at the individual level, they can be useful in reducing the morbidity and mortality associated with obesity [10]. Current treatment guidelines for overweight and obesity recommend diet, exercise, and behavior modification for individuals whose BMI is ≥30 and those with BMI > 27 in addition to two weight-related comorbidities [11].
