Advertisement

The epidemiology of obesity

  • Yu Chung Chooi
    Affiliations
    Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore
    Search for articles by this author
  • Cherlyn Ding
    Affiliations
    Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore
    Search for articles by this author
  • Faidon Magkos
    Correspondence
    Corresponding author at: University of Copenhagen, Faculty of Science, Department of Nutrition, Exercise and Sports - Obesity Research, Rolighedsvej 26, 1958 Frederiksberg C, Building 2-85, Room H134, Denmark.
    Affiliations
    Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore

    Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore

    Department of Nutrition, Exercise and Sports - Obesity Research, University of Copenhagen, Denmark
    Search for articles by this author
Published:September 22, 2018DOI:https://doi.org/10.1016/j.metabol.2018.09.005

      Abstract

      Obesity is a complex multifactorial disease. The worldwide prevalence of overweight and obesity has doubled since 1980 to an extent that nearly a third of the world's population is now classified as overweight or obese. Obesity rates have increased in all ages and both sexes irrespective of geographical locality, ethnicity or socioeconomic status, although the prevalence of obesity is generally greater in older persons and women. This trend was similar across regions and countries, although absolute prevalence rates of overweight and obesity varied widely. For some developed countries, the prevalence rates of obesity seem to have levelled off during the past few years. Body mass index (BMI) is typically used to define overweight and obesity in epidemiological studies. However, BMI has low sensitivity and there is a large inter-individual variability in the percent body fat for any given BMI value, partly attributed to age, sex, and ethnicity. For instance, Asians have greater percent body fat than Caucasians for the same BMI. Greater cardiometabolic risk has also been associated with the localization of excess fat in the visceral adipose tissue and ectopic depots (such as muscle and liver), as well as in cases of increased fat to lean mass ratio (e.g. metabolically-obese normal-weight). These data suggest that obesity may be far more common and requires more urgent attention than what large epidemiological studies suggest. Simply relying on BMI to assess its prevalence could hinder future interventions aimed at obesity prevention and control.

      Abbreviations:

      BMI (body mass index), GBD (Global Burden of Disease), CDC (US Centers for Disease Control and Prevention), IDF (International Diabetes Federation), MHO (Metabolically Healthy Obesity), MONW (Metabolically Obese Normal Weight), NCD (non-communicable disease), WHO (World Health Organization)

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Metabolism - Clinical and Experimental
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Global Burden of Disease Study 2015
        Global burden of disease study 2015 (GBD 2015) obesity and overweight prevalence 1980–2015.
        Institute for Health Metrics and Evaluation (IHME), Seattle, United States2017
        • Singh G.M.
        • Danaei G.
        • Farzadfar F.
        • et al.
        The age-specific quantitative effects of metabolic risk factors on cardiovascular diseases and diabetes: a pooled analysis.
        PLoS One. 2013; 8e65174
        • Czernichow S.
        • Kengne A.P.
        • Stamatakis E.
        • et al.
        Body mass index, waist circumference and waist-hip ratio: which is the better discriminator of cardiovascular disease mortality risk?: evidence from an individual-participant meta-analysis of 82 864 participants from nine cohort studies.
        Obes Rev. 2011; 12: 680-687
        • Lauby-Secretan B.
        • Scoccianti C.
        • Loomis D.
        • et al.
        Body fatness and cancer–viewpoint of the IARC working group.
        N Engl J Med. 2016; 375: 794-798
        • Anandacoomarasamy A.
        • Caterson I.
        • Sambrook P.
        • et al.
        The impact of obesity on the musculoskeletal system.
        Int J Obes. 2008; 32: 211-222
        • Anstey K.J.
        • Cherbuin N.
        • Budge M.
        • et al.
        Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies.
        Obes Rev. 2011; 12: e426-e437
        • Kim D.D.
        • Basu A.
        Estimating the medical care costs of obesity in the United States: systematic review, meta-analysis, and empirical analysis.
        Value Health. 2016; 19: 602-613
        • von Lengerke T.
        • Krauth C.
        Economic costs of adult obesity: a review of recent European studies with a focus on subgroup-specific costs.
        Maturitas. 2011; 69: 220-229
        • World Health Organization
        Obesity and overweight. Fact sheet no 311 January 2015.
        ([cited 2016 20 April 2016; Available from])
        • Swinburn B.A.
        • Sacks G.
        • Hall K.D.
        • et al.
        The global obesity pandemic: shaped by global drivers and local environments.
        Lancet. 2011; 378: 804-814
        • Ng S.W.
        • Popkin B.M.
        Time use and physical activity: a shift away from movement across the globe.
        Obes Rev. 2012; 13: 659-680
        • Ladabaum U.
        • Mannalithara A.
        • Myer P.A.
        • et al.
        Obesity, abdominal obesity, physical activity, and caloric intake in US adults: 1988 to 2010.
        Am J Med. 2014; 127: 717-727.e712
        • Kelly T.
        • Yang W.
        • Chen C.S.
        • et al.
        Global burden of obesity in 2005 and projections to 2030.
        Int J Obes. 2008; 32: 1431-1437
        • NCD-RisC
        Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants.
        Lancet. 2016; 387: 1377-1396
        • Afshin A.
        • Forouzanfar M.H.
        • Reitsma M.B.
        • et al.
        Health effects of overweight and obesity in 195 countries over 25 years.
        N Engl J Med. 2017; 377: 13-27
        • Stevens G.A.
        • Singh G.M.
        • Lu Y.
        • et al.
        National, regional, and global trends in adult overweight and obesity prevalences.
        Popul Health Metrics. 2012; 10: 22
        • He Y.
        • Pan A.
        • Wang Y.
        • et al.
        Prevalence of overweight and obesity in 15.8 million men aged 15–49 years in rural China from 2010 to 2014.
        Sci Rep. 2017; 7: 5012
        • Ng M.
        • Fleming T.
        • Robinson M.
        • et al.
        Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013.
        Lancet. 2014; 384: 766-781
        • Mi Y.-J.
        • Zhang B.
        • Wang H.-J.
        • et al.
        Prevalence and secular trends in obesity among Chinese adults, 1991–2011.
        Am J Prev Med. 2015; 49: 661-669
        • Wang H.
        • Wang J.
        • Liu M.-M.
        • et al.
        Epidemiology of general obesity, abdominal obesity and related risk factors in urban adults from 33 communities of Northeast China: the CHPSNE study.
        BMC Public Health. 2012; 12967
        • Reynolds K.
        • Gu D.
        • Whelton P.K.
        • et al.
        Prevalence and risk factors of overweight and obesity in China.
        Obesity (Silver Spring). 2007; 15: 10-18
        • Gallagher D.
        • Heymsfield S.B.
        • Heo M.
        • et al.
        Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index.
        Am J Clin Nutr. 2000; 72: 694-701
        • Gallagher D.
        • Visser M.
        • Sepulveda D.
        • et al.
        How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups?.
        Am J Epidemiol. 1996; 143: 228-239
        • W. H. O. Expert Consultation
        Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies.
        Lancet. 2004; 363: 157-163
        • Zhou B.F.
        Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults–study on optimal cut-off points of body mass index and waist circumference in Chinese adults.
        Biomed Environ Sci. 2002; 15: 83-96
        • Deurenberg-Yap M.
        • Schmidt G.
        • van Staveren W.A.
        • et al.
        The paradox of low body mass index and high body fat percentage among Chinese, Malays and Indians in Singapore.
        Int J Obes Relat Metab Disord. 2000; 24: 1011-1017
        • Gujral U.P.
        • Vittinghoff E.
        • Mongraw-Chaffin M.
        • et al.
        Cardiometabolic abnormalities among normal-weight persons from five racial/ethnic groups in the United States: a cross-sectional analysis of two cohort studies.
        Ann Intern Med. 2017; 166: 628-636
        • Ding C.
        • Chan Z.
        • Magkos F.
        Lean, but not healthy: the ‘metabolically obese, normal-weight’ phenotype.
        Curr Opin Clin Nutr Metab Care. 2016; 19: 408-417