How common it is
In Kenya's national STEPS health survey, nearly half of adults had central (abdominal) obesity: about 58% of women and 36% of men. Weight around the middle matters most, because it is the fat most closely linked to diabetes, heart disease and fatty liver.
Measuring it
- Body mass index (BMI): weight in kg divided by height in metres squared. 25–29.9 is overweight and 30 or more is obesity.
- Waist circumference: often more telling than BMI. Risk rises above about 80 cm for women and 94 cm for men.
- Waist-to-height ratio: keep your waist below half your height.
Why it is a medical condition
Body weight is regulated by the brain through hormones from the gut, fat tissue and pancreas. Genetics, sleep, stress, some medicines (for example certain antidepressants, steroids and diabetes treatments), hormonal conditions such as PCOS and underactive thyroid, and the modern food environment all push that regulation upwards. When you diet, the body defends its weight by raising hunger and lowering energy use. That is why most diets eventually stall.
What it does to health
- Type 2 diabetes and prediabetes
- High blood pressure, heart attack and stroke
- Fatty liver disease
- Sleep apnoea, joint pain and osteoarthritis
- Fertility problems, PCOS and pregnancy complications
- Several cancers, including womb, breast (after menopause) and bowel
Losing just 5–10% of body weight measurably improves blood sugar, blood pressure and liver fat.
Treatment options
| Option | Typical result | Notes |
|---|---|---|
| Nutrition, activity, sleep | About 3–7% loss | The foundation of every plan; hard to sustain alone |
| Modern weight-loss medicines | About 15–20% average loss in trials | Prescription-only; need supervision and a long-term plan |
| Bariatric surgery | About 25–30% or more | For severe obesity; a major operation with lifelong follow-up |
The right option depends on your BMI, your health conditions and your goals. Most people do best with a combination, reviewed regularly by a doctor.
Talk it through with a doctor
Whether any of these medicines is right for you depends on your health, your history and your goals. The first phone consultation is free, and there is no obligation.
Book a free consultationSources
- Prevalence and determinants of central obesity among adults in Kenya (STEPS 2015 analysis). medRxiv 2024
- Wilding et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). N Engl J Med 2021
- Jastreboff et al. Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1). N Engl J Med 2022
- Lincoff et al. Semaglutide and cardiovascular outcomes in obesity without diabetes (SELECT). N Engl J Med 2023