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Données épidémiologiques

Epidemiological data

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Obésité

Résumé

Dans les pays industrialisés, l’obésité (indice de masse corporelle [IMC] supérieur à 30 kg/m2) concerne aujourd’hui 1 adulte sur 10 à 1 adulte sur 3 (aux USA), selon l’âge. L’IMC moyen augmente dans la population adulte mais la distribution de l’IMC semble changer de forme au profit des valeurs élevées. Les enfants sont également concernés par cette progression: la fréquence de l’obésité infantile atteint 3–4 % en France et plus de 10 % aux États-Unis. L’augmentation de la prévalence dans ce pays a été particulièrement forte depuis le début des années 1980, alors qu’en Europe, et particulièrement en France, une telle évolution n’apparaît que dans les années 1990. L’élévation de l’IMC durant les années 1990 peut être observée dans toutes les tranches d’âge et dans les deux sexes. Les causes de l’évolution actuelle qui semble peu dépendre de la génération de naissance, sont donc probablement à rechercher dans les changements concernant les conditions et les habitudes de vie de la population dans la période ellemême.

Les complications en termes de santé pourraient être beaucoup plus fréquentes à l’avenir car elles augmentent selon l’importance de l’obésité et la distribution centrale du tissu adipeux, mais aussi avec sa plus grande ancienneté. Les complications métaboliques, cardiovasculaires et mécaniques sont relativement bien connues. Le lien avec la survenue d’autres pathologies chroniques de l’adulte et particulièrement de certaines formes de cancer est désormais reconnu. Les études récentes suggèrent que l’obésité et la maigreur (IMC < 18,5 kg/m2) chez l’adulte sont associées à un excès de mortalité mais pas le simple surpoids (IMC compris entre 25 et 30 kg/m2).

Abstract

Current data indicates that 10% to 33% (latter figure from the US) of adults in industrialised countries are obese (i.e. with a body mass index (BMI) above 30kg/m2), depending on the age bracket. While the average body mass index (BMI) is increasing in the adult population, its distribution appears to be changing in a way that favours higher values. Children are also affected by this upward trend: the rate of childhood obesity has reached 3% to 4% in France and over 10% in the US. The rise in prevalence in the US has been particularly steep since the beginning of the 1980s, whereas in Europe, and particularly in France, the change has only become apparent in the 1990s. The rise in BMI during the 1990s was observed in all age brackets and in both sexes. These changes, which appear unrelated to generation, are most likely explained by changing lifestyles and behaviour within populations during specific periods.

Health-related complications may be much more frequent in the future because they increase with the degree of obesity and body distribution of adipose tissue as well as the length of time the person has been obese. The metabolic, cardiovascular and mechanical complications are relatively well known and the links to other chronic conditions in adults, especially certain types of cancer, has also been recognized. Recent studies suggest that obesity and underweight (BMI < 18.5 kg/m2) in adults are associated with excess mortality, although that is not the case for overweight (BMI between 25 and 30 kg/m2).

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Groupe d’expertise collective de l’Inserm. Données épidémiologiques. Obes 2, 21–31 (2007). https://doi.org/10.1007/s11690-007-0028-x

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