Obesity and Disease: Global Facts and Costs

Chapter summary

People are fat and getting fatter. We now understand better why some people eat a lot and stay lean while others do not.
Childhood obesity is a rising tide.
Metabolic syndrome, the precursor to many diseases, has increased.
We know enough about obesity’s causes to say diet must change.

WHO: obesity doubled in every region between 1980 and 2008. Half a billion people (12% of the world) are obese.
Over 1.5 billion are overweight or obese. Older people (over 40) and males are more affected in this data.
In 65% of the world’s population, you are more likely to die from complications of obesity than from malnutrition.
US and Canada costs run about $300 billion. Obese people have about 25% higher health costs. Obesity takes 1 to 3% of health spending in most OECD countries and 5 to 10% in the US.
Obese people earn up to 18% less.
Obesity rates: Women rose from 7.9% in 1980 to 13.8% in 2008, and men from 4.8% to 9.8%.
Pacific Island nations hold eight of the top ten places for overweight citizens. Mexico was reported in 2013 as the fattest country at 32.8%.

14 million are overweight or obese, with over 5 million obese. A quarter of children are overweight or obese.
Obesity doubled in 20 years and has overtaken smoking as the leading cause of premature death and illness.
Indigenous Australians are 1.9 times as likely to be obese.
If trends continue, close to 80% of adults and a third of children will be overweight or obese by 2025. Health costs are $35 billion a year.

Metabolic syndrome: Driven by obesity, inactivity, genetics, race, ageing and other endocrine disorders.
Normal weight is not a safe harbour: St-Onge (2004) found over 20% of people in the normal BMI range had metabolic syndrome, so the normal BMI guidance may need revisiting.
Blood pressure: Cowley and colleagues at Monash showed obese people generally have raised blood pressure, and traced a leptin pathway to hypertension and fast heart rate.
Immune system: Obesity is also a key component of a range of autoimmune diseases (Kanneganti).
Children: Overweight children face orthopaedic problems, low self-image, depression and higher risk in adulthood. Australian data for two to three-year-olds suggest a slowing, while four to eight-year-olds are still increasing.

Weight as the cause: Most public health bodies treat excess weight as the main driver.
The author: Because normal-weight people also develop metabolic syndrome, diet quality (especially sugar) matters beyond weight.
Costs: Hospitals already face heavier equipment and more complex surgery.

OECD (2010) Obesity and the Economics of Prevention: Fit not Fat.
OECD (2012) Obesity Update. OECD (2014) Obesity Update.
OECD (2013) Health at a Glance 2013.
WHO (2012) World Health Statistics 2012.
St-Onge, M-P. et al. (2004) Prevalence of metabolic syndrome in normal-weight adults. Arch Intern Med.
Huffington Post (2013) Mexico overtakes United States as world’s fattest country.