The obesity epidemic

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Related tags: Body mass index, Obesity

As western nations draw up strategies to combat the growing number
of starving people in the developing world - currently standing at
a staggering 800 million and growing - a British based group warns
this week that, at the other end of the spectrum, up to 1.7 billion
people worldwide could be overweight or obese. But, this is not
just a problem for developed countries - obesity is hitting the
developing world.

As western nations draw up strategies to combat the growing number of starving people in the developing world- currently standing at a staggering 800 million and growing - a British based group warns this week that, at the other end of the spectrum, up to 1.7 billion people worldwide could be overweight or obese. But, this is not just a problem for developed countries - obesity is hitting the developing world.

Professor Philip James, chairman of the International Obesity TaskForce​ , said the revised figure - 50 per cent higher than earlier estimates - meant that most governments were simply ignoring one of the biggest risks to health affecting the world's population.

The updated estimate takes into account a new recommendation from a WHO expert group, which concluded that obesity-related health risks increase among Asians from a lower body mass index threshold because of their special vulnerability to weight-related disorders.(Lancet, Vol 360 July 20 2002​) If the proposal were adopted as a new benchmark, it could add another half billion to current estimates of the world's overweight population.

Speaking at a Roche-sponsored meeting of obesity specialists in Monte Carlo, Prof James said that appropriate medical treatment was rarely provided to manage obesity, yet it was clearly established that even a modest weight reduction and improved weight control could bring benefits both in improved health of the individual and long term cost savings if the prevalence of serious co-morbidities such as type 2 diabetes, heart disease, and some forms of cancer were reduced or prevented. (Obesity: Preventing and Managing the Global Epidemic. WHO Technical Report Series 894 - 2000​).

Part of the International Association for the Study of Obesity, the IOTF is conducting long term research on obesity and the global burden of disease as part of a WHO programme. Existing estimates suggest more than 1.1 billion people already fall into the pre-obese or obese categories using WHO classic definitions based on a body mass index (BMI) of 25 and above for overweight and BMI 30 and above for obesity.

The proposal from the WHO expert group, of which Prof James was a member, is based on evidence that the risk of obesity-related diseases among Asians rises from a BMI of 23.3 If this were adopted as a new benchmark for overweight in Asians, it would require a major revision of approaches in the Asian sub-regions, where IOTF estimates that a significant proportion of the 3.6 billion population already has a mean body mass index of 23. 4.

Prof James, who previously chaired the United Nations Commission on the Nutrition Challenges of the 21st Century, said there was growing evidence that the impact on health of the escalating obesity epidemic could overtake that of tobacco.

"There is a wide spectrum of risk factors related to obesity, which when viewed as a whole, have a tremendous impact on health. By tackling overweight through improvements in diet, activity levels and treatment, we can have a far reaching effect on what is already a huge health burden from cardiovascular diseases and type 2 diabetes."

"It is clear that extreme forms of obesity are rising even faster than the overall epidemic and we are witnessing a real health tragedy unfolding. In the USA the percentage of black women with morbid obesity - a BMI of 40 or more - has doubled in less than a decade to a rather disturbing 15 per cent. Overall 6.3 per cent of US women - that is one in 16 - are morbidly obese.

"We are seeing a rapid increase in morbid obesity in Europe too, although with smaller percentages. The data for England show that morbid obesity in women increased 180 per cent while rising three fold among men in less than a decade! One in 40 women in England now has a body mass index so great they are unquestionably in need of immediate treatment for their obesity, but how many are being helped?"​ Prof James asked.

Prof Arne Astrup, president-elect of IASO, said: "There is a global obesity epidemic which underpins the increasing levels of non-communicable diseases which are forecast to explode in the next 20 years. It is vital that we take a more serious approach to the treatment of the huge numbers who are obese, as well as introducing effective measures to prevent the problem getting worse."

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