Globesity TodayRichard Shriner, MD

Maxwell, K: MED Magazine, Feb 2008, Issue 49

• Term “Globesity” first coined by World Health Organization (WHO) in 2001.

• Term = blend of “global and obesity.”• WHO claims as of the year 2005, 400

million worldwide obese, to increase to 700 million by 2015.

• WHO claims that globesity is a worse health risk than cigarette smoking.

• Globesity = principle cause of type 2 diabetes = “Diabesity.”

NIH CLINICAL GUIDELINES ON THE IDENTIFICATION, EVALUATION, AND TREATMENT OF OVERWEIGHT AND OBESITY IN ADULTS, 1998

• BMI is the widest used measure for obesity.• A BMI greater than or equal to 30 = obesity.• Obesity is a major killer worldwide

increasing both morbidity (getting a disease) and mortality (dying from a disease) for the following diseases:

Diabetes (type 2 diabetes) Heart disease (hypertension/coronary artery disease) Stroke Liver disease (fatty liver) Certain cancers (endometrial, breast, prostate and colon) Osteoarthritis Sleep apnea Hypercholesterolemia

J R Soc Med Sh Rep 2012;3:45.

• Worldwide prevalence of obesity (# of cases at a given time) doubled between 1980 and 2008.

• Worldwide: 10% of men, 14% of women were obese in 2008.

• In the U.S., 70% adults classified as overweight vs. 25%, 40 years ago.

• Global Disability Adjusted Life Years (DALYs) for overweight/obese rivals or exceeds that of tobacco.

http://www.cdc.gov/obesity/data/adult.html

• More than a 1/3 of U.S. citizens are obese.

• Medical costs are $1,429/yr. more for obese.

• Non-Hispanic blacks = highest obesity (49.5%), Mexican Americans (40.4%), non-Hispanic whites (39.3%).

• No correlation between education and obesity in men, in women with better education = trend toward less obesity.

• In 2008 estimated medical costs for obesity = $147 billion.

Indian J Med Res. Nov 2010; 132(5): 598–607

• Worldwide over 22 million under age 5 are obese, 1 in 10 children overweight.

• In developing countries children from higher incomes are more obese, in developed countries opposite occurs with higher obesity rates in lower incomes.

• Worldwide urbanization (nb. fast food), oversized portions, high carb beverages, increased television time and more sedentary lifestyles are associated with higher child and adolescent obesity.

• Risk of obesity persisting into adulthood is higher among obese adolescents, some studies suggest 80% overweight adolescents may become obese adults.

Susan Z. Yanovski, M.D., and Jack A. Yanovski, M.D., Ph.D.N Engl J Med 2011; 364:987-989 March 17, 2011

• CDC NHANES Study reveals prevalence of obesity in women (35.5%) and child/adolescents from the ages or 2-19 yrs (16.9%) may be stabilizing over last 10 yrs.

• CDC NHANES Study reveals prevalence of obesity for men (32.2%) has not changed since 2003.

• CAUTION: prevalence of obesity in heaviest of boys (BMI at or above 97th percentile) continues to INCREASE for those in the CDC NHANES Study.

• Growing evidence that children now have diseases like type 2 diabetes, fatty liver disease, hypertension.

• “The trend toward stabilization of obesity rates could be temporary.”

1 Zimmermann E, Holst C, Sørensen TIA (2011) Morbidity, Including Fatal Morbidity, Throughout Life in Men Entering Adult Life as Obese. PLoS ONE 6(4):e18546. doi:10.1371/journal.pone.00185462 http://www.rawstory.com/rs/2013/05/29/obesity-growing-fastest-in-africa-and-latin-america-un/

• Some studies argue that men entering adult life obese have twice the mortality when compared with the mortality in the underlying population.1

• WHO reports that obesity is growing the fastest in Africa and Latin America.2

• Latest WHO figures show 1/3 of adults worldwide are overweight, 1 in 10 are obese.2

• Even if obesity rates are stabilizing in high-income nations, the rest are seeing obesity rates climb at an alarming rate as they adopt Western diets/lifestyles.

1 J Public Health Manag Pract 2013 Jul-Aug;19(4)2 J Sports Med Phys fitness 2013;53:177-84

• Focus on child and adolescent diet and exercise where early prevention is key.

• Increase involvement of family and community resources which have been shown to be of tremendous impact on obesity outcomes in children and adolescents.1

• Studies have clearly demonstrated that those adolescents who are engaged earlier in life with leisure time physical activity (LTPA) may enjoy greater fitness in adulthood.2

• Understand the unique vulnerabilities of adolescents to addictions3 and the possible contribution of certain addictive foods toward exacerbating obesity.4

3 Journal of Adolescent Health 52 (2013) S39–S424 Avena, N and Gold, M Addiction, 106, 1213–1220

• Globesity has the same or greater impact on global health as cigarette smoking.

• Globesity is the greatest contributor to type 2 diabetes, one of the major global killers.

• Treatment of children and adolescents will be key to defeating globesity over time.

• Implementation of modern advances in medicine, such as the science of food addiction, may offer new hope in defeating globesity, here, and the world over.