Beyond the scale: Experts explain why obesity is more about the brain, emotions, and genetics than just weight

Obesity is often reduced to a number on the weighing scale or a Body Mass Index (BMI) chart. But in reality, it goes far beyond numbers. It is not just about how much a person weighs it is about how they feel, how their body functions, and how deeply it affects their mental and emotional well-being. Recent discussions by health experts highlight that obesity is a complex, chronic condition influenced by genetics, lifestyle, environment, and even psychological factors.

Obesity and depression are closely linked, creating a cycle that can be difficult to break. People living with obesity often have a higher risk of developing depression, while those dealing with depression may also be more prone to gaining weight.

Dr Jasjeet S Wasir, Bariatric & Metabolic Physician Director, Medanta, explained, “Obesity is not just about physical health. It is also about the emotional and mental state of a person. The feeling inside matters as much as the number on the scale.”

Dr Wasir suggest that individuals with obesity are more likely to experience low self-esteem, anxiety, and social stigma. At the same time, emotional eating, stress, and hormonal imbalances can contribute to weight gain.

For years, BMI has been used as a primary indicator of obesity. However, experts now believe that this approach is too simplistic.

“The physical form of obesity talks about numbers, but the real impact lies beyond those figures,” says Dr Wasir.

In countries like India, many individuals may appear lean but still have high body fat especially around the abdomen. This condition, often referred to as “lean obesity,” increases the risk of diabetes, heart disease, and fatty liver. Waist circumference and body fat distribution are now considered more accurate indicators of health risks than BMI alone.

“Obesity is not solely a result of lifestyle choices. Genetics plays a significant role, accounting for nearly 60–80% of the risk in some individuals,” says Dr Wasir.

But beyond genetics, there is another crucial factor: epigenetics.

Dr Wasir explains, “Epigenetics is the interaction between your environment and your genes. It can influence how diseases like obesity develop, even if you are doing everything right.”

Factors such as stress, poor sleep, unhealthy eating habits, and lack of physical activity can trigger genetic tendencies, leading to weight gain and related diseases at a younger age.

Many people assume that weight loss is just about “eating less and moving more.” However, the reality is far more complex.

“Even when someone is working out regularly, eating healthy, and maintaining a calorie deficit, weight loss may not happen easily. It requires multiple strategies working together,” Dr Wasir said.

Additionally, the body adapts over time. When a person loses weight, their metabolic rate may slow down, making it harder to maintain that weight loss. This is why many people regain weight even after strict dieting or intense exercise routines.

Research shows that maintaining weight loss is often more challenging than losing weight.

According to Dr Wasir, “Diet and exercise are essential for health, but when used only for weight loss, they may not always work long-term. Instead, focus on nutrition and fitness rather than just the number on the scale.”

The body’s natural tendency to return to its previous weight, combined with metabolic changes, makes long-term weight management a continuous process rather than a one-time effort.

A growing concern, especially among Indians, is the concept of being “thin outside, fat inside.”

“You don’t need to weigh 100 kg to have obesity. Even people with normal weight can have high visceral fat, which is more dangerous,” Dr Wasir highlighted.

This hidden fat, particularly around the abdomen, increases the risk of serious conditions such as diabetes, heart disease, and liver disorders—even in individuals who appear healthy.

Obesity also affects how individuals perceive themselves and interact with society. Many people struggle with low confidence, social judgment, and internal guilt.

Statements like “it’s your fault” or “just eat less” oversimplify the issue and contribute to stigma.

Dr Wasir further added, “Obesity is not just a personal failure. It is influenced by hormones, metabolism, appetite, and neurochemistry.”

Factors like hunger signals, emotional triggers, stress responses, and brain chemistry all play a role in how and why people eat.

Interestingly, obesity is not just about fat; it is also about the brain.

Dr Wasir explained, “The real control centre of obesity lies in the brain, where hormones, appetite, metabolism, and emotions interact.”

This means that managing obesity requires addressing both physical and psychological aspects, rather than focusing solely on diet and exercise.

To effectively manage obesity, a multi-dimensional approach is essential. This includes:

Balanced nutrition instead of restrictive dieting

Regular physical activity for fitness, not just weight loss

Proper sleep and stress management

Emotional well-being and mental health support

Medical guidance when needed

“If you are eating right, exercising, sleeping well, and managing stress, keep doing it. These habits matter, regardless of immediate weight loss.”

Obesity is not just about numbers, appearance, or willpower; it is a complex condition shaped by biology, environment, and emotions. Understanding this can help reduce stigma and encourage more compassionate, effective approaches to health. Instead of chasing a number on the scale, the focus should shift to overall well-being because true health goes far beyond weight.

(This article is meant for informational purposes only and must not be considered a substitute for advice provided by qualified medical professionals. Always seek the advice of your doctor with any questions about a medical condition.)