More Evidence That Obesity Is A Global Catastrophe In Slow Motion

Sometimes it is harder to see things that move in slow motion. Perhaps if the global obesity epidemic moved any faster, it would garner an emergency response similar to Ebola, Zika, and other infectious disease epidemics that have gripped the world in recent years. As two recent studies published in The Lancet and authored by the Non-Communicable Disease (NCD) Risk Factor Collaboration have re-emphasized, the sheer magnitude of the global obesity epidemic dwarfs those of most other epidemics. The impact may be much greater as well, accounting for many more deaths  (over 3.4 million a year) and more costs (over $2 trillion a year). My colleague Larry Cheskin, MD, Associate Director of our Global Obesity Prevention Center (GOPC) at Johns Hopkins University and Associate Professor at the Johns Hopkins Bloomberg School of Public Health, describes the global obesity epidemic as “a catastrophe happening in slow motion.” But has everyone around the world responded as if the obesity epidemic were indeed a catastrophe ?

One of the Lancet studies confirmed that obesity and overweight is a growing problem worldwide, even in countries that in the past have had problems with lack of food. The study analyzed the change in body mass index (BMI) from 1698 studies among 19.2 million adults in 200 countries from 1975 to 2014. The researchers found that during this time period the average BMI increased from 21·7 to 24·2 kg/m2 among men and from 22·1 to 24·4 kg/m2 among women. Average BMIs among men were lowest (21·4 kg/m2) in central Africa and south Asia and highest in 29·2 kg/m2 in Polynesia and Micronesia. Among women, average BMIs were lowest (21·8 kg/m2) in south Asia to and also highest (32·2 kg/m2) in Polynesia and Micronesia. During the same time period, obesity prevalence more than tripled from 3·2% to 10·8% among men and more than doubled (6·4% to 14·9%) among women. By comparison, the prevalence of people are underweight, presumably from lack of enough food, decreased from 13·8% to 8·8% among men and 14·6% to 9·7% among women.

The other Lancet study showed a substantial worldwide increase in diabetes since 1980 by analyzing 751 studies that included nearly 4·4 million people. As the study’s senior author Professor Majid Ezzati form Imperial College  explained,“obesity is the most important risk factor for type 2 diabetes and our attempts to control rising rates of obesity have so far not proved successful. Identifying people who are at high risk of diabetes should be a particular priority since the onset can be prevented or delayed through lifestyle changes, diet or medication.” The study found that between 1980 and 2014, diabetes prevalence more than doubled from 4·3% to 9·0% among men and climbed by over 50% from 5·0% to 7·9% among women. This corresponded to the number of adults with diabetes worldwide nearly quadrupling from 108 million to 422 million. In 2014, northwestern Europe has the lowest diabetes rates. Polynesia and Micronesia has the highest (affecting nearly a quarter of adults), followed by Melanesia and the Middle East and north Africa. While not all diabetes cases are related to obesity, obesity is a major risk factor for the more common type of diabetes, Type II or adult-onset diabetes. And diabetes can have devastating health consequences such as heart problems, kidney disease, and stroke. (Of course, obesity can result in many other health problems besides diabetes.)