Girish Mahajan

Epidemiology of obesity

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Epidemiology of obesity

Obesity has been observed throughout human history. Many early depictions of the human form in art and sculpture appear obese. However, it was not until the 20th century that obesity became common—so much so that in 1997 the World Health Organization (WHO) formally recognized obesity as a global epidemic. In June 2013 the American Medical Association classified obesity as a disease with much controversy.

Contents

In 2013, an estimated 2.1 billion adults were overweight as compared with 857 million in 1980. The rate of obesity also increases with age at least up to 50 or 60 years old.

Once considered a problem only of high-income countries, obesity rates are rising worldwide. These increases have been seen most in urban settings. The only remaining region of the world where obesity is not common is sub-Saharan Africa.

It should also be noted that statistics on the epidemiology of obesity vary between sources.

Globally

In its June 2014 report on the problems of obesity affecting people across the globe, the Organisation for Economic Co-operation and Development (OECD) has made the following key points:

  • A major part of the population in the OECD countries is obese, having one obese (or overweight) child out of five children in total. Its almost a tenfold variation as recorded against the OECD nations. But the latest data collected may not provide a complete picture of the extent of the epidemic.
  • Over the past five years, the epidemic has spread out further. However, the rate of this epidemic's growth has slowed as compared to previously recorded data. Presently, in the United Kingdom, Italy, Korea, and the United States both "obesity" and "overweight" are virtually stable, while in Australia, Canada, France, Mexico, Spain, and Switzerland these have increased.
  • Many countries have built multi-stakeholder network, and that involves both the civil as well as business society factors in order to devise appropriate public health policies. These initiatives are being evaluated now for their effectiveness in delivering the right output.
  • Africa

    Obesity rates in Western Africa are estimated to be 10%. Rates of obesity among women are three times those found in men. In urban West Africa rates of obesity have more than doubled in the last 15 years.

    Egypt

    Those in rural Egypt believe that fatness is proper as the "envelope for conception;" therefore, there is enough room to bear and give warmth to the child.

    China

    China is currently facing challenges of overnutrition. This is believed to be primarily due to the rapid declines in physical activity and changing dietary habits which have occurred between the 1980s and the 2000s. The decline in physical activity is attributed to increasing technology in the workplace and changing leisure activities.

    In 1989 65% of Chinese had jobs that required heavy labor. This decreased to 51% in the year 2000. Combined with this has been a change to a diet higher in meat and oil, and an increase in overall available calories. Available calories per person increased from 2,330 kilocalories (9,700 kJ) per day in 1980 to 2,940 kilocalories (12,300 kJ) per day in 2002. Rates of overweight and obese adults increased 12.9% in 1991 to 27.3% in 2004.

    Overall rates of obesity are below 5% in China as a whole but are greater than 20% in some cities.

    India

    Obesity has reached epidemic proportions in India in the 21st century, with morbid obesity affecting 5% of the country's population. Obesity is a major risk factor for cardiovascular disease and NGOs such as the Indian Heart Association have been raising awareness about this issue. Urbanization and modernization has been associated with obesity. In Northern India obesity was most prevalent in urban populations (male = 5.5%, female = 12.6%), followed by the urban slums (male = 1.9%, female = 7.2%). Obesity rates were the lowest in rural populations (male = 1.6%, female = 3.8%).

    Socioeconomic class also had an effect on the rate of obesity. Women of high socioeconomic class had rates of 10.4% as opposed to 0.9% in women of low socioeconomic class. With people moving into urban centers and wealth increasing, concerns about an obesity epidemic in India are growing.

    Iran

    In Iran the prevalence of obesity was 26.3% in 2008. Prevalence of obesity was more among women (39.5%) than men (14.5%).

    Japan

    Using the WHO criteria Japan has the lowest rate of obesity among the OECD member countries at 3.2%. However, as Asian populations are particularly susceptible to the health risks of excess adipose tissue the Japanese have redefined obesity as any BMI greater than 25. Using this cut off value the prevalence of obesity in Japan would be 20%, a threefold increase from 1962 to 2002. A 2008 report stated that 28.6% of men and 20.6% of women in Japan were considered to be obese.

    Pakistan

    Changing lifestyles, owing to urbanisation, as well as diet issues are the main reasons for obesity in Pakistan. According to a recent study, approximately one out of four Pakistani adults (or 22.2% of individuals) are classified as obese.

    Taiwan

    In 2002, 15% of children from 6 to 12 years of age were overweight; by gender, 15.5% of males and 14.4% of females were overweight. In the same age range, 12% of children were obese; by gender, 14.7% of males and 9.1% of females were categorized as obese. In 2005, 14.9% children from 6 to 12 years of age were overweight; by gender, 15.85% of males and 14.02% of females were overweight. 10.3% were categorized as obese; by gender, 10.92% of males and 9.73% of females were categorized as obese.

    Based on these numbers, the trends were inconclusive, although with more than 10% of the age group being obese, obesity does appear to be a problem.

    Europe

    Between the 1970s and the 2000s, rates of obesity in most European countries have increased. During the 1990s and 2000s, the 27 countries making up the EU reported rates of obesity from 10–27% in men and from 10–38% in women.

    The most recent combined Eurostat statistics, for 2009, show that, among the 19 EU Member States for which data are available, the proportion of obese people in the adult population varied in 2008/9 between 8.0% (Romania) and 23.9% (UK) for women and between 7.6% (Romania) and 24.7% (Malta) for men. Overall the UK had the highest proportions, and Romania the lowest. Men, the elderly and people with lower educations also have significantly higher obesity rates.

    United Kingdom

    In the UK the rate of obesity has increased about fourfold over the last 30 years, reaching levels of 22-24% in 2008/9. The United Kingdom now has the highest rate of obesity in Europe.

    Canada

    The number of Canadians who are obese has risen dramatically in recent years. In 2004, direct measurements of height and weight found 23.1% of Canadians older than 18 had a BMI greater than 30. When broken down into degrees of obesity, 15.2% were class I (BMI 30–34.9), 5.1% were class II (BMI 35–39.9), and 2.7%, class III (BMI > 40). This is in contrast to self-reported data the previous year of 15.2% and in 1978/1979 of 13.8%. The greatest increases occurred among the more severe degrees of obesity; class III obesity increased from 0.9% to 2.7% from 1978/1979 to 2004. Obesity in Canada varies by ethnicity; people of Aboriginal origin have a significantly higher rate of obesity (37.6%) than the national average.

    In children obesity has substantially increased between 1989 and 2004 with rates in boys increasing from 2% to 10% and rates among girls increasing from 2% to 9%.

    Mexico

    Mexico has the highest rate of obesity among OECD members. In Latino culture, fat babies are viewed by mothers as healthy. Overweight infants are more likely to have lifetime fight against obesity.

    United States

    The United States has the second highest obesity rates in the developed world. This is a long-standing phenomenon: By 1962, 45% of adult Americans were overweight, and 13% of adult Americans were obese; these numbers were already higher than obesity rates observed in most developed countries as late as 2001-02. From 1980 to 2002, obesity rates have doubled, reaching the current rate of 33% of the adult population.

    As of 2007, 33% of men and 36% of women are obese. Rates of obesity vary between social groups, with minorities and low-income individuals more likely to be overweight. The rates are as high as 50% among African American women.

    Geography is a major factor. The American South has been described alternatively as "Stroke belt", "Obesity belt", or "Diabetes belt", to reflect the fact that residents of the region have high incidences of these three conditions, compared to people of the same race/ethnicity elsewhere in the country.

    The lowest obesity rates of major racial/ethnic groups across 50 states are thought to be among non-Hispanic white residents of Colorado and Hawaii, at around 16%. However, these numbers are based on self-reported height and weight data and likely to be underestimated. (The bias is so large that, for example, estimates of obesity that rely on self-reported data arrive at the rate of 22% among non-Hispanic white females, whereas studies that involve direct measurement show that the rate is closer to 34%.)

    The prevalence of class III obesity (BMI ≥40) has increased the most dramatically, from 1.3% in the late 1970s, to 2.9% in 1988-94, to 4.7% in 2000, to 5.7% in 2008. Among African American women, its prevalence is estimated to be as high as 14%.

    The overall rate of obesity began to plateau in the 2000s, but severe obesity and obesity in children continued to rise. In January 2010, a study published in the Journal of the American Medical Association found that the obesity rate for American women has remained constant over the last decade, with only small rises amongst men and children.

    Obesity is one of the leading health issues in US society, resulting in about 300,000 excess deaths per year in the United States. About 65 percent of Americans are now considered either overweight or obese. However, using a different methodology and incorporating new data, researches at the Centers for Disease Control and Prevention reduced the estimate to 26,000 excess deaths per year. According to National Health and Nutrition Examination Study collected between the 1970s and 2004, overweight and obesity prevalence have increased steadily among all groups of Americans over the past three decades.

    It is estimated that in 2010, >6% of adult population in the United States may be classified as clinically severe or morbidly obese.

    Caribbean

    Trinidad and Tobago has the highest obesity in the Caribbean, with over 30% of its adult population overweight. It is ranked sixth in the world. Although not a geographical part of the Caribbean, the Bahamas have a major obesity epidemic. 48.6% of people between 15 and 64 years old are obese. A female adolescent from the Bahamas is more likely to be overweight than her male counterpart. In Jamaica, 7.2% of men over the age of 20 are obese, while 31.5 of women are obese. Surveys in different Caribbean countries found that 7-20% of males and 22-48% of females over the age of 15 are obese.

    Australia

    According to self-reported and measured results of the 2007-2008 National Health Survey, 61% of Australians were overweight (above a 25 BMI), with 24% falling into the "obese" category (above a 30 BMI). Men were more likely to be overweight (67.7%) and obese (25.5%) than women (30.9% and 23.4% respectively).

    New Zealand

    Obesity in New Zealand has become an important national health concern in recent years, with high numbers of people afflicted in every age and ethnic group. In 2011/12, 28.4% of New Zealand adults were obese, a number only surpassed in the English-speaking world by the United States.

    South Pacific

    Many of the island nations of the South Pacific have very high rates of obesity. Nauru has the highest rates of obesity in the world (94.5%) followed by Samoa, the Federated States of Micronesia, and the American Samoa. Being big has traditionally been associated with health, beauty, and status and many of these beliefs remain prevalent today.

    References

    Epidemiology of obesity Wikipedia


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