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Obesity

Overview

Obesity is considered by many to be the major public health issue of our time. Obesity is the disease process of excess accumulation of body fat. It is defined for epidemiology purposes as a body mass index (BMI) greater than 30 kg/m2; this is the level at which the risk of developing many diseases increases. Waist circumference can also be used to categorise people as overweight or obese. This measurement correlates with total body fat and disease risk better than BMI, so waist circumference is a better guide when making clinical decisions.

About one quarter of all adults in the UK are obese, and this proportion increases with age. Projections suggest that by 2010 one third of adults in the UK will be obese. 1

The pathological consequences of obesity are widespread and affect all ages and nearly all organ systems. In addition to diabetes, heart disease, and hypertension the risk of developing various cancers, liver and lung diseases, sleep apnoea, osteoarthritis, most complications of pregnancy, and infertility in men and women are increased with obesity. Obesity also influences mental wellbeing in the short term (eg increased risk of depression and lower self esteem) and the longer term (eg increased risk of dementia). There is a stigma associated with being overweight or obese and obesity is associated with discrimination in the workplace.

The obesity problem may get much worse. It is overtaking smoking as the leading preventable cause of disease and premature death and it could lead to reductions in population life expectancy, reversing a 300–400 year trend towards increased life expectancy. 2 Obesity levels are rising year on year in children in the UK and elsewhere. By 2025, we will face an epidemic of diabetes and its complications because many young people are already obese. 2

The cost of obesity to the NHS is huge – possibly as much as all cancers combined – and increasing. Yet few measures are in place to provide specialist help or training and clinical services are patchy or non-existent.

Treating obesity must be prioritised alongside prevention. This will take unprecedented cooperation between government departments, schools, food manufacturers, retail and advertising industries, architects, town planners, and many other groups. Crosscutting funding and training in many professional sectors are also vital.

References

  1. Lean M, Gruer L, Alberti G, Sattar N. ABC of obesity. Obesity – can we turn the tide? BMJ 2006;333:1261-4. External Link
  2. Haslam D, Sattar N, Lean M. ABC of obesity. Obesity – time to wake up. BMJ 2006;333:640-2. External Link