Details of Global Obesity Including Social
& Financial Costs
Obesity Levels Worldwide
Obesity - Epidemic Proportions
The prevalence of obesity is rising to
epidemic proportions at an alarming rate in both developed “Westernised”
and less developed countries around the world .
For example, the prevalence of obesity
has increased by about 10-50% in the majority of European countries in
the last 10 years and currently affects 77% of males living in urban areas
of Western Samoa in the Pacific.
Obesity - Health Consequences
The health consequences of obesity range
from a number of non-fatal complaints that impact on the quality of life
such as respiratory difficulties, musculo-skeletal problems, skin problems
and infertility; to complaints that lead to an increased risk of premature
death including non-insulin dependant diabetes, gallbladder disease, cardiovascular
problems (hypertension, stroke and CHD) and cancers which are hormone
related and associated with the large bowel. Hypertension, diabetes and
raised serum cholesterol are between two and six times more prevalent
among heavier women. Severe obesity is associated with a 12 fold increase
in mortality in 25-35 year olds when compared to lean individuals. Negative
attitudes towards the obese can lead to discrimination in many areas of
their life including health care and employment.
Obesity - Costs
The direct cost of diagnosis, treatment
and management of obesity within national health systems has only been
assessed in a few countries to date. Although the methodology varied considerably
between studies, making it difficult to compare costs across countries
and to extrapolate the results from one country to another, these estimates
suggest that between 2-8% of the total sick care costs in Western countries
are attributable to obesity. This represents a major fraction of national
health care budgets comparable with for example, the total cost of cancer
therapy. The potential impact on health care resources in the less developed
health care systems of developing countries is likely to be even more
severe .
Obesity & Weight Loss
Weight loss in overweight and obese individuals
improves physical, metabolic, and endocrinological complications, often
dramatically. Weight loss in obese persons can also improve depression,
anxiety, psycho-social functioning, mood and quality of life.
Intentional weight loss of 0.5-9.0 kg in
overweight women with existing obesity related disease led in a 12 year
study in the US, to a 20% fall in total mortality, a 40-50% reduction
in mortality from obesity related cancers, and a 30-40% reduction in diabetes
related deaths.
Obesity
Levels Rising in Developed & Under-Developed Countries
The prevalence of obesity is rising to
epidemic proportions around the world at an alarming rate. The rise in
obesity is not restricted to more developed countries. With increasing
Westernisation, the prevalence of overweight and obesity appears to be
rising amongst more affluent populations of Less Developed Countries,
even in those countries with current food security problems and significant
rates of under-nutrition. Ghana for example, has only slightly more underweight
(BMI<18.4), than overweight (BMI>25) people. This situation has
been exacerbated due to the image of prosperity and success associated
with weight gain in many of these societies. It will be interesting to
see whether these cultural attitudes to obesity alter with increasing
Westernisation.
Obesity Rates in Europe
Obesity is relatively common in Europe,
especially among women and in Southern and Eastern European countries.
Current prevalence data from individual
national studies suggests that the range of obesity prevalence in European
countries is from 10 to 20% for men, and 10 to 25% for women.
Prevalence of obesity has increased by about 10-40% in the majority of
European countries in the past 10 years1. The most dramatic increase has
been in the UK where it has more than doubled since 1980. There is some
evidence however, that this increasing trend is levelling off among women,
at least in some Scandinavian countries.
Obesity Levels in Africa
In contrast to most Western countries,
the emphasis in Africa has been on under-nutrition and food security rather
than overweight and obesity, and so there is little data on current prevalence.
Regional studies however, do indicate a
growing prevalence of overweight and obesity in certain socio-economic
groups. This can be illustrated by the high prevalence of obesity (44%)
found in black women in the Cape Peninsular of the Republic of South Africa.
Obesity Rates in Middle East
The limited data available indicates that
the prevalence of obesity in Middle Eastern countries is high, particularly
in women who appear in general to have a higher prevalence of obesity
than women in most Western countries.
Obesity Levels in America & Caribbean
Prevalence of obesity in US increased dramatically
in the 1980s, especially among black women for whom 49% were identified
as being overweight with a BMI > 27.3 in 1991.
Obesity is a significant problem in the
Caribbean, particularly in those countries with a higher per capita GNP,
and affects women more than men.
Brazil is the only Latin American country
to have a nationally representative survey conducted in the last 10 years.
The PNSN survey indicated that obesity is prevalent in Brazil and is rising,
especially among lower income groups. The problem of dietary deficit appears
to be rapidly shifting to one of dietary excess.
Obesity Rates in Western Pacific, Japan
& China
In Japan, obesity in men has doubled since
1982, whereas its rise in women has been restricted to the younger age
group (20-29 years) for which is has increased 1.8 times since 1976.
Obesity is increasing in China and is
more common in urban areas and among women.
Obesity is not new to the Pacific and has
long been regarded by Polynesian and Micronesian societies of this region
as a symbol of high social status and prosperity. Prevalence has risen
dramatically however, in the last 20 years. In 1991 for example, over
75% of urban males in Western Samoa were classified as obese. Childhood
obesity appears to be no longer restricted to the West as illustrated
by Tonga where 23% of school children were considered obese in 1986.
Obesity Management Systems
Despite the high prevalence of obesity
and improvements to our understanding of how the disease develops, there
are limited effective obesity management systems in place in national
health care services around the world. There is a wide variation in obesity
care services between countries, with very few having a coherent and comprehensive
range of services capable of providing the level of care required to effectively
manage obese patients. This is in contrast to other chronic diseases such
as diabetes and coronary heart disease where integrated care is frequently
provided.
It is clear therefore that the rational
development of co-ordinated health care services for the management of
overweight and obese patients is needed in most countries. Primary health
care services should play the dominant role, although hospital and specialist
services are also required for dealing with more severe cases and the
associated major life threatening complications. Clear communication between
the different type of health care service is also essential. At present,
family doctors and other primary care health professionals appear to have
incomplete, confused and occasional incorrect knowledge of obesity and
nutritional issues.
Obesity Not Viewed As Serious Medical
Condition
Obesity is generally not viewed as a serious
medical condition by doctors, and so many fail to advise and treat the
majority of their obese patients. Obesity tends to be treated only when
a co-morbidity is present, rather than before the co-morbidity develops
or is exacerbated by the obese state.
There is an urgent need for improved training
of all health care workers, not only to improve levels of knowledge and
skills in obesity management strategies but also to help overcome the
negative attitudes that many health professionals currently exhibit towards
obesity management and the obese.
Source: International Obesity Task Force
(IOTF) |
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