Quick answer: Obesity is a medical condition, not a lack of willpower. For South Asians, a BMI of 25 or more counts as obese. A doctor can check for hormonal causes such as thyroid disease or PCOS and build a plan with nutrition, activity and, when suitable, medicines.
In this article
Obesity is not a lack of willpower. It is a long-term medical condition influenced by genes, hormones, sleep, stress, medicines, food environment and activity. It raises the risk of diabetes, high blood pressure, fatty liver, heart disease, joint problems and some cancers, which is why a medical approach can help where repeated crash diets have not.
How is obesity measured?
Body mass index (BMI) is calculated from height and weight. South Asians tend to develop health problems at a lower body weight than people of other backgrounds, so lower cut-offs are often used:
| Category | BMI (South Asian cut-offs) |
|---|---|
| Healthy weight | 18.5–22.9 |
| Overweight | 23–24.9 |
| Obese | 25 or higher |
Waist size matters too, because fat around the abdomen is linked to diabetes and heart disease. A waist above about 90 cm in men or 80 cm in women is generally considered high for South Asians.
Medical causes to rule out
Sometimes weight gain has an underlying cause that should be checked and treated:
- Underactive thyroid
- Polycystic ovary syndrome (PCOS)
- Insulin resistance or prediabetes
- Cushing's syndrome (excess cortisol), which is uncommon
- Certain medicines, such as some steroids, antidepressants and diabetes tablets
- Poor sleep or sleep apnoea
What a specialist weight plan includes
- Assessment: history, examination, BMI and waist, and blood tests such as sugar, thyroid, cholesterol and liver tests.
- Nutrition: a realistic plan based on foods you actually eat, with attention to portions, refined carbohydrates and sugary drinks.
- Activity: a gradual plan, starting with walking and building up.
- Sleep and stress: poor sleep and stress can drive appetite and weight gain.
- Medicines when appropriate: in some people, doctor-prescribed medicines can help alongside lifestyle changes.
- Surgery in selected cases: weight-loss surgery may be considered for people with severe obesity or serious weight-related illness.
- Follow-up: regular reviews keep progress on track and adjust the plan.
Losing even 5% to 10% of body weight can improve blood sugar, blood pressure and cholesterol. Slow, steady loss is more likely to last than rapid loss.
Be careful with
- Crash diets and "detox" products
- Injections or tablets bought without a prescription
- Herbal weight-loss products whose ingredients are unknown
When to see an endocrinologist
Consider seeing a specialist if you have tried to lose weight without success, you have diabetes, prediabetes, thyroid problems or PCOS, your weight rose quickly without a clear reason, or you want a medically supervised plan.
Frequently asked questions
What is a healthy BMI for Pakistanis?
For South Asians, a BMI of 18.5 to 22.9 is generally considered healthy, 23 to 24.9 is overweight, and 25 or above is obese.
Can thyroid cause weight gain?
An underactive thyroid can contribute to modest weight gain. A simple blood test (TSH) can check this.
How fast should I lose weight?
A steady loss of about 0.5 to 1 kg per week is a reasonable target for most people. Faster loss is harder to keep off and can cause problems.
Are weight-loss medicines safe?
Some prescription medicines are safe and useful when chosen and monitored by a doctor, but they are not right for everyone. Do not use them without medical advice.
Book a consultation with Dr. Junaid Iqbal
Evening clinic Monday to Saturday, 5:00–9:00 PM at City Clinic, Muzaffargarh.
WhatsApp Call +92 313 7667979This article is for general information only and is not a substitute for personal medical advice, diagnosis or treatment. Always speak to a qualified doctor about your own health.