Determinants of obesity and prevention strategies: A narrative review

Abstract

Obesity has emerged as one of the most pressing public health challenges of the 21st century. According to the World Health Organization, the prevalence of obesity among adults increased from approximately 7% in 1990 to 16% in 2022, while obesity among children and adolescents aged 5–19 years increased from 2% to 8% during the same period. The continuous rise of overweight and obesity in both developed and developing countries contributes significantly to the growing burden of non-communicable diseases, driven primarily by changes in dietary habits, urbanization, and increasingly sedentary lifestyles. This narrative review aims to explore the main determinants of obesity and to examine current evidence on prevention strategies from a public health perspective. A narrative review of peer-reviewed literature published between 2018 and 2024 was conducted using PubMed, Scopus, and Google Scholar. Relevant international guidelines, policy reports, and epidemiological data were also included to provide a broader public health perspective. The reviewed evidence indicates that obesity results from a complex interaction of behavioral, environmental, and socioeconomic determinants. High intake of energy-dense and ultra-processed foods, reduced physical activity, and increased sedentary behavior were consistently identified as major contributing factors. Multicomponent interventions combining nutrition education with physical activity promotion generally demonstrated more favorable outcomes than single-component approaches. However, socioeconomic inequalities and limited access to healthy food environments remain significant barriers to intervention effectiveness. These findings underscore the need for comprehensive public health approaches that address both individual behaviors and broader environmental influences. Strengthening community-based programs, improving access to nutritious foods, and promoting active lifestyles are essential strategies for reducing the long-term health consequences of obesity at the population level.