Epidemiology of Obesity

Abstract

Obesity, although recognised millennia ago as an unusual feature and a societal handicap, only since the 1980s has it become a major clinical and public health problem. Originally a disease of affluence it became evident in poorer countries in the 1990s with children then showing increasing evidence of their excess weight gain with all its propensities to premature disease and death. Obesity rates are rising rapidly in poor countries with clear evidence that many societies are more prone to obesity’s amplification of diabetes and hypertension rates than in Western Europe and North American. These differences probably relate to the impact of poor fetal and early nutrition as well as infections on development and the epigenetic control of metabolism. The epidemic was precipitated by dramatic rises in the mechanisation and computerisation of labour, household work and home entertainment combined with a huge drive to market readily prepared high energy dense fatty, sugary and salty foods and drinks. Now dietary factors dominate global health burdens and obesity overwhelms health services with the global societal cost estimated as $2trillion a year, approximately the same as the cost of all warfare and conflicts. Only coherent government initiatives can reverse these burdens with little evidence so far of any appropriate national or international response.