Obesity is more than a number on the scale. For many people, it quietly drives a range of serious health problems across the body — from the heart and kidneys to the liver, joints and breathing during sleep.¹ Understanding these hidden risks can help you spot warning signs early and get the right care to reduce harm.

How excess weight harms your body

Fat tissue is not inert. It acts like an endocrine organ, releasing hormones and inflammatory substances that interfere with how the body uses insulin and controls blood sugar.² Over time, this can lead to insulin resistance and type 2 diabetes, even if blood sugar looks only mildly raised at first.^2,3 Diabetes increases the risk of heart disease, stroke and kidney damage if left untreated.⁴ The same metabolic changes promote non-alcoholic fatty liver disease (NAFLD), which can progress to liver inflammation and scarring if not addressed.⁵

Breathing and sleep risks

People with obesity are more likely to develop sleep-disordered breathing, including obstructive sleep apnoea. Poor sleep and intermittent oxygen drops worsen blood pressure, blood sugar control and daytime fatigue, creating a harmful cycle that further undermines health and quality of life.⁶

Musculoskeletal and mobility impacts

Extra weight increases stress on joints, accelerating osteoarthritis, especially in weight-bearing joints like knees and hips. This causes pain, reduced mobility and lower activity levels — which in turn make weight management harder.⁷

Heart and kidney effects

Obesity often coexists with high blood pressure, raised cholesterol and inflammation — all contributors to heart disease. It also raises the risk of reduced kidney function through prolonged high blood pressure and diabetes-related damage.^8,9

When should you seek medical help?

Be alert to warning signs such as breathlessness at rest or on minimal exertion, chest pain, swelling in the legs, very high blood sugar readings, difficulty sleeping with loud snoring or choking awakenings, or sudden deterioration of mobility and pain.^10,11,12,13 These warrant prompt medical assessment, not delayed reassurance. What can be done — small changes, big impact.

Even modest weight loss can improve blood pressure, glucose control, sleep apnoea and liver enzymes.¹⁴ A specialist approach that combines lifestyle support, guideline-directed medication and, when appropriate, bariatric surgery, offers the best chance to prevent or reverse complications over time.¹⁵ The new South African Obesity Guidelines (2025) emphasise obesity as achronic, treatable disease that benefits from early, coordinated care.¹⁶

Where to find reliable support and treatment

If you are considering anti-obesity medication, get these through credible, regulated channels: your GP, an endocrinologist or a multidisciplinary obesity clinic. These clinicians can assess your overall health, choose appropriate, scheduled medications when indicated, and provide necessary monitoring. Beware of unregulated online sellers and products that are not prescribed and monitored — these can be unsafe.

For trusted information and resources, visit www.novonordiskcare.co.za for downloadable checklists and links to local services. If you’re in doubt, start by asking your GP for obesity screening and, if needed, a referral to specialist obesity care.

Final word

Obesity is a complex, chronic health condition that increases the risk of many serious, sometimes silent problems.^1,15 Early recognition and guideline-based care can prevent complications and improve health and well-being.¹⁶ If you’re worried about your weight or related symptoms, don’t wait — seek medical advice and ask for help tailored to your needs.