Obesity

Obesity is a complex disease with multiple interacting and causal factors in which an imbalance between caloric intake and caloric requirement leads to excess body fat and adverse impacts on health. The condition leads to physical disability; cardiovascular disorders such as increased risk for coronary artery disease, high blood pressure, myocardial infarction, and stroke; and metabolic diseases such as type 2 diabetes. Even certain forms of cancer are associated with obesity. Depending on the severity of obesity, different bone and joint disorders, with mechanical-and inflammatory-based origin may manifest. Last but not least, multiple psychological consequences may result from obesity.

Obesity is a complex disease in which excess body fat has accumulated to the point where it may have adverse effects on health. The origin of such metabolic imbalance is mainly due to an increased consumption of energy-dense foods high in saturated fats and carbohydrates, along with reduced physical activity.

The origins of obesity are mainly attributed to increased consumption of energy-dense foods high in saturated fats and carbohydrates combined with reduced physical activity. From a public health perspective, origins of such a complex metabolic problem are also currently related to epidemiological transitions in many countries. Economic growth, modernization, urbanization, and globalization of food markets (even in the context of so-called Westernization) have had profound changes in society and in behavioral nutritional patterns of communities over recent decades. Although genetic predisposition is important, energy imbalance related to those societal changes and worldwide nutrition transition are of utmost relevance when evaluating the obesity epidemic.

In many countries, malnutrition problems represent a double burden of disease. Although in the past, nutritional deficits were the most important of them, today overweight and obesity have become highly relevant, not only in adults but also in children, and not just in developed countries but also in many developing countries, where, it has been stated, the increase is often faster than in the developed nations. This worldwide problem has increased in frequency, particularly in the last three decades. Globally, there are more than 1 billion overweight adults, with at least 300 million of them being obese. This complex condition implies serious social and psychological dimensions, affecting virtually all ages and socioeconomic groups. Recently, it has been considered that, given the current prevalence of overweight and obese children, in the future, the extent of such pandemic will be even higher than today.

Although often not calculated, the economical burden of obesity will impose large primary healthcare costs and investments derived from related morbidity medical care. Different studies have found that the increase in obesity prevalence has led to even a threefold rise in hospital costs. In 2001, Canada's economic burden in terms of overweight and obesity was estimated at $4.3 billion ($1.6 billion in direct costs and $2.7 billion in indirect costs). In the United States, medical expenses accounted for 9.1 percent of total U.S. medical expenditures in 1998 and may have reached as high as $92.6 billion.

In children, the prevalence of obesity has a relatively high variability around the world. This problem of overweight and obese childhood has been increasing during the last 40 years. As has been stated, such increasing prevalence of childhood obesity could be strongly related to adult obesity, which should be identified early and treated in order to reduce its related morbidity and mortality during childhood and adulthood. Particularly in people with certain risk factors, such as those with a family history of obesity, low birth weight, low physical activity, type 1 diabetes, and fetal macrosomy, excessive weight and obesity should be screened and followed up, including not just anthropometrical variables but also biochemical and hormonal variables. Disease prevalence in children has doubled or more than doubled in many countries, including in North America in Canada and the United States; in South America in Brazil and Chile; in the western Pacific region in Australia and Japan; and in Europe in the United Kingdom, Finland, Germany, Greece, and Spain. It is estimated that in the decade 2010–2020, around 45 percent of children in the Americas will be categorized as overweight.

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