It has been proven that obesity markedly reduces life expectancy [ 13 ]. The severe consequences of obesity for physical health and emotional well-being already emerge in childhood [ 14 ], and it is well known that childhood obesity is the most serious public health problem, as children are more likely to become obese adults in their future life. Furthermore, it has been shown that overweight and obesity developed in childhood confers significant impact on both physical and psychological health in the future [ 1 , 14 , 15 ].
Overweight and obese children will also be exposed to higher risk of disability and premature death [ 16 ]. A vicious circle has been shown in children who are overfed, as they become overeating adults [ 15 ].
The childhood obesity has also been linked to cardiovascular disease risk during adulthood. This is compounded by the risk related to chronic hyperglycemia exposure in youth with type 2 diabetes mellitus [ 17 ]. The World Health Organization WHO reported that children in low- and middle-income countries are more vulnerable to inadequate prenatal, infant- and young-child nutritional states.
And, at the same time, these kids are exposed to high-fat, high-sugar, high-salt, energy-dense, micronutrient-poor foods, which tend to be lower in cost and also lower in nutrient quality [ 18 ]. These dietary patterns, in conjunction with lower levels of physical activity, result in a sharp increase in childhood obesity, while undernutrition issues remain unsolved [ 18 ]. The obesity and overweight conditions are also pervasive among elderly people.
It has been reported that obesity is also the problem of wealthy people. However, obesity now inversely affects the poor and uneducated people. It has been reported in several studies that obesity is higher in low social classes, amongst those on a low educational level, and within ethnic minority groups [ 7 , 18 ]. WHO reported that children in developing countries incur a risk of obesity and inadequate nutrition, simultaneously [ 18 ].
The obesity and overweight are also pervasive among elderly people. The prevalence of obesity is rising progressively among older age groups [ 19 ], and it is well known that main complications of obesity in elderly people is the metabolic syndrome with glucose intolerance, hypertension, and cardiovascular disease [ 20 , 21 ]. It is therefore not surprising that obesity increases the risk of heart failure in elderly. It has been proven that inactivity, mostly depending on obesity , aging, and comorbidity reduced quality of life are commonly leading to frailty and premature death in elderly people [ 3 , 24 ].
The other dark side of obesity is the economy. It is obvious that obesity leads to many health problems, which can cost millions to treat.
Obese individuals are likely to have more medical and health problems [ 1 ]. Moreover, these reduce personal economic productivity, due to impaired health. Obesity is considered a top public health concern, due to the high level of morbidity and mortality in the United States [ 26 ]. Recently, it was reported that direct medical cost of overweight and obesity combined is approximately 5.
The actual cost of obesity and related morbidity in developing countries have not been reported in any detail to date, but it is clear that prevalence of childhood and adulthood obesity is increasing in low-income countries, which lead to heavy treatment burden in their domestic budget.
Obesity threats public health more than communicable diseases in the present world. Overweight and obesity cause death in more people than those being underweight. The increased prevalence of obesity has occurred in the United States during the last 30 years [ 27 ], and according to WHO, the worldwide prevalence of obesity, more than doubled between and [ 18 ]. In , more than 1. Of these, over million were obese [ 28 ]. Historically, at the beginning of the era, obesity was only the problem of rich people and the affluent countries.
However, obesity is now dramatically increased in lower and middle-income countries. Rural-urban comparisons and migration studies provide evidence for an effect of modernization in increasing the prevalence of obesity [ 7 ]. Fifty percent of the adults are overweight and obese in many countries [ 15 ]. It was asserted, in a research report from China, that However, the Japanese population is exempted from these trends [ 28 ].
Overweight and obesity affect every age group around the world. A longitudinal study of girls aged 9—18 years documented the dramatic decline in physical activity during adolescence, particularly among Black girls A number of factors may result in limited physical activity at schools, such as budget constraints and pressure to meet academic performance targets.
Out of school, physical activity is also frequently limited. The Centers for Disease Control and Prevention reported a dramatic decline in the proportion of children who walk or bike to school, from close to 42 percent in to 16 percent in At home, the average US teenager spends over 30 hours per week watching television This activity is not only sedentary but also associated with reduced consumption of fresh fruits and vegetables 23 , possibly related to consumption of snack foods while watching television and to the influence of food commercials, most of which advertise low-nutrient-density foods The relative contribution of increased energy intake and decreased energy expenditure to the obesity epidemic is not easy to quantify.
In countries such as the United States, the data show a dramatically low level of physical activity, particularly among children and adolescents, so one would conclude that this is a major factor in causing a positive energy balance in the US population. In turn, energy balance at such a low level of energy output could be maintained only by major reductions in food intake, perhaps to the point of jeopardizing intake of essential nutrients. Conversely, even minor increases in energy intake will result in a positive balance and weight gain.
Both terms of the energy balance equation must change in order to put weight stability within the reach of most of the population. The epidemiologist David Barker 25 , 26 is credited with finding a link between early fetal growth patterns and risk of several chronic diseases in adulthood. In a retrospective review of medical records in Southampton, United Kingdom, Barker found that a high percentage of middle-age adults with cardiovascular disease were born at a low birth weight This finding was somewhat counterintuitive, because the population studied was predominantly of low socioeconomic level and cardiovascular disease was traditionally associated with the better-off segments of the population.
Still, Barker's findings were consistent with observations among survivors of the Dutch famine during World War II, where intrauterine growth retardation was found to be associated with a high incidence of cardiovascular disease and diabetes in adulthood 28 , Studies in animal models have shown that pups born undernourished exhibit hyperphagia, resulting in accelerated weight gain and increased body adiposity 31 , Pups gaining weight more gradually reach similar adult weight but have a normal body composition.
Low birth weight and excess weight gain in adulthood are additive risk factors for the comorbidities of obesity, particularly insulin resistance and type 2 diabetes This association of earlier undernutrition with adult obesity has critical implications for developing countries, where intrauterine growth retardation and stunting during early childhood are common As discussed below, the nutrition transition in developing countries results in increasing rates of adult obesity, leading to the emerging problem of chronic noncommunicable diseases in those countries Historically, human obesity was commonly associated with gluttony and lack of self-control at the table.
Thus, treatment and prevention approaches were largely focused on individual behavior. Over the past decades, however, as the obesity epidemic continued to advance in the United States, there has been increasing focus on the external determinants of energy balance. One dramatic example of how the built environment affects energy balance is mechanization and automation, which have sharply reduced the amount of energy we need to spend in basic survival activities and at work.
Until recently, the obesity field was largely unfamiliar with the quantification of environmental variables such as air pollution, traffic patterns, and urban density, which have been widely used in environmental and occupational health. There are now incipient efforts to identify major factors in the built environment associated with excess weight gain Until relatively recently, obesity was considered a condition associated with high socioeconomic status.
Indeed, early in the 20th century, most populations in which obesity became a public health problem were in the developed world, primarily the United States and Europe. In more recent decades, available data show that the most dramatic increases in obesity are in developing countries such as Mexico, China, and Thailand The global nature of the obesity epidemic was formally recognized by a World Health Organization consultation in Although few developing countries have nationally representative longitudinal data to assess trends, global estimates using both longitudinal and cross-sectional data indicate that obesity prevalence in countries in intermediate development has increased from 30 percent to percent over the past decade The emergence of obesity in developing countries initially affected primarily the higher socioeconomic strata of the population.
But more recent trends show a shift in prevalence from the higher to the lower socioeconomic level. For example, national surveys in Brazil found that while in obesity in adults was more prevalent in the higher socioeconomic status, 10 years later the higher prevalence was observed among the lower socioeconomic status Of the multiple causal factors associated with the rise in obesity in developing countries, perhaps the two most important are urbanization and globalization of food production and marketing.
Urban dwelling has a profound effect on energy balance, particularly on energy expenditure. On the energy output side, urban living is usually associated with lower energy demands compared with rural life.
The energy-intense manual labor typical of rural areas may be replaced by a sedentary desk or sidewalk job. Long walks to work or to procure wood or water are replaced by mechanized transportation and public utilities. The global nature of modern commerce, sustained by the technical advances in food production and transportation, has permitted the introduction of low-cost, energy-dense foods in the domestic food market of many developing countries.
According to the Centers for Disease Control and Prevention, obesity affects Obesity is closely related to several other chronic diseases, including heart disease, hypertension, type 2 diabetes, sleep apnea, certain cancers, joint diseases, and more. Obesity, with its overwhelming prevalence of 1 in 6 adults in the U. The Centers for Disease Control and Prevention CDC defines chronic disease as conditions that last one year or more and require ongoing medical attention or limit activities of daily living, or both.
Three leading chronic diseases are heart disease, cancer, type 2 diabetes. Obesity is associated with all three of these chronic diseases. CDC also acknowledges widespread consequences of obesity when compared to normal or healthy weight for many serious health conditions, including all causes of death, hypertension, diabetes mellitus, coronary heart disease, stroke and many cancers.
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Correspondence to W P T James. Reprints and Permissions. James, W. WHO recognition of the global obesity epidemic. Int J Obes 32, S—S Download citation. Published : 12 January Issue Date : December Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article.
Provided by the Springer Nature SharedIt content-sharing initiative. Medicine, Health Care and Philosophy Archives of Gynecology and Obstetrics Irish Journal of Medical Science - Lipids in Health and Disease Brain Structure and Function Advanced search. Skip to main content Thank you for visiting nature. Download PDF. Abstract The recognition of obesity as a disease was in theory established in by WHO's World Health Organization taking on the International Classification of Diseases but the early highlighting of the potential public health problem in the United States and the United Kingdom 35 years ago was considered irrelevant elsewhere.
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