Obesity in the 21st Century: Where Do We Stand?

Obesity in the 21st century has become a global epidemic owing to its heterogeneous aetiology and clinical presentation, as well as the development of associated comorbidities such as cardiovascular disease, type2 diabetes, hypertension, dyslipidaemia, obstructive sleep apnoea, and obesity-related cancers. Notably, cardiovascular disease and diabetes are major contributors to obesity-associated morbidity and mortality. Current diagnostic approaches rely predominantly on anthropometric measurements, which have proven limited in their ability to provide accurate and clinically meaningful stratification of patients with obesity. Consequently, obesity treatments, including metabolic surgery and pharmacological therapies, remain insufficiently tailored to the wide variability in obesity-related genotypes, phenotypes, and endotypes. In this context, a personalised medical approach offers considerable promise. A clear overview of currently effective diagnostic tools and treatments, as well as future possibilities, is therefore needed. Recent developments in precision medicine, multi-omics, biomarkers, and advanced diagnostic technologies may facilitate improved patient stratification and support more individualized therapeutic strategies. Together, these approaches may contribute to a more comprehensive, evidence-based, and patient-centered framework for the prevention, diagnosis, and management of obesity and its complications.