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The Whole World is Getting More Obese

<ѻý class="mpt-content-deck">— Rates doubled in many countries since 1980 and rose in most others
MedpageToday

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Obesity isn't just a first-world problem -- it's a global epidemic, researchers reported from an analysis of 68.5 million people in 195 countries for the Global Burden of Disease study.

"Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries," Christopher Murray, MD, DPhil, of the University of Washington in Seattle, and colleague in conjunction with presentation at the EAT Stockholm Food Forum.

Global prevalence is now 12% in adults and 5% in children, but with a faster rate of increase in children in many countries. Notably, the U.S. had the highest level of age-standardized childhood obesity among the 20 most populous countries, at 12.7%, and tied with China for the largest number of obese adults in 2015.

In 2015, high BMI was estimated to account for 4 million deaths globally (7.1% of those from any cause), nearly 40% of which were among overweight individuals and 41% of which were due to cardiovascular disease.

An accompanying editorial called the findings discouraging but did find a silver-lining in that the population-level age-adjusted rates of high BMI-related death and disability have not grown as much as might be predicted, "which suggests that obese persons are healthier and live longer now than in previous decades because of better care and risk-factor management."

"Unfortunately, even this success brings a new burden, since the mix of increased prevalence and decreased mortality leads to more years spent with obesity and more time for the damaging coexisting illnesses, such as type 2 diabetes and chronic kidney disease, to develop," the editorialists noted.

The researchers called for "continued focus on surveillance of BMI and identification, implementation, and evaluation of evidence-based interventions to address this problem."

The editorialists agreed, noting the "shared global burden" of obesity and diabetes that demands a strong response from governments.

The study used a literature search and Global Health Data Exchange to turn up national or regional BMI data or the height and weight data from which to calculate it. In a few cases, time-lagged energy intake was used with some other covariates to impute prevalence.

Disclosures

The study was funded by the Bill and Melinda Gates Foundation.

Murray disclosed no relevant relationships with industry.

One of the editorialists disclosed a relationship with Novo Nordisk.

Primary Source

New England Journal of Medicine

GBD 2015 Obesity Collaborators "Health Effects of Overweight and Obesity in 195 Countries over 25 Years" N Engl J Med 2017; DOI: 10.1056/NEJMoa1614362

Secondary Source

New England Journal of Medicine

Gregg EW, Shaw JE "Global Health Effects of Overweight and Obesity" N Engl J Med 2017; DOI: 10.1056/NEJMel706095