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The global trend of overweight and obesity over three decades

Comment by Christine Graf, EACPR Prevention, Epidemiology and Population Science Section


Overweight and obesity are important clinical and health burdens worldwide because it is associated with an increase of cardiovascular risk, stroke, cancer, osteoarthritis, psychosocial disorders etc. To show the secular trend, Ng et al. (2014) estimated the overall prevalence of overweight and obesity in childhood and adulthood in 188 countries and 21 regions during 1980 and 2013. Therefore, the authors analysed 1769 studies including data for height and weight, self-reported and through physical measurements (n=19244), with a spatiotemporal Gaussian process regression model.

Worldwide the prevalence of overweight and obesity rose by 27.5% for adults and by 47.1% for children and adolescents during the past three decades. The number of overweight and obese individuals increased from 857 million in 1980, to 2.1 billion in 2013. This increase was found in both, developed and developing countries. Gender differences are found as follows: in developed countries the prevalence of overweight and obesity was higher in men, whereas in developing countries more women are concerned. Trends in prevalence of adult age-standardised obesity in developed and developing countries seemed to be gaining weight at all ages, including children and adolescents, with most rapid gains between the ages of 20 and 40 years. More than 50% of the 671 million obese individuals live in 10 countries: USA, China, India, Russia, Brazil, Mexico, Egypt, Germany, Pakistan, and Indonesia. The rate of increase was greatest between 1992 and 2002, but has slowed down in the past 10 years, especially in the developed countries, although no effective national counter measures are reported.

The authors reported a number of limitations, e.g. Body Mass Index (BMI) does not reflect body composition, representativeness was not given in all included studies, and selection bias could not be ruled out. In addition, they briefly discuss some aetiological aspects but one of the most important factors like the socioeconomic status was not touched. In the discussion about effective preventive measures, the association between education level, migration background, poverty and healthy lifestyle (e.g. diet, physical activity, reduction of sedentary behaviour, weight management) must necessarily be taken into account. International and national programs to prevent and treat overweight, obesity as well as related comorbidities and mortalities for every age group (and comparable measurement strategies) should be a public health priority.