The extent of the obesity epidemic

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The extent of the obesity epidemic

• Dr Tim Gill

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Estimated Prevalence of Obesity throughout the
world
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Number of people affected by Obesity throughout
the world
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WHAT DO WE MEAN BY OBESITY ?
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DEFINITIONS

• OBESITY
• A condition of abnormal or excessive fat
  accumulation in adipose tissue, to the extent
  that health may be impaired
• WHO, 1998

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Obesity is usually defined in terms ofbody mass
index (BMI)
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Waist circumference is a surrogate marker of
visceral fat
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OBESITY PREVALENCE AND TRENDS IN AUSTRALIA
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The prevalence of overweight and obesity in men
and women in 2000 (Ausdiab Study 2001)
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Prevalence of Obesity (Males)

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Obesity Prevalence (Females)
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The burden of obesity is not shared equally among
the community
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Prevalence of self-reported overweight and
obesity by State, 2001
AIHW, 2004
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Prevalence of overweight and obesity within the
most and least disadvantage quintiles of social
disadvantage. 1995 and 2001
AIHW, 2003
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Overweight and obesity in Indigenous people
compared to general population
AIHW, 2003
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Prevalence of obesity in Urban and Rural and
remote areas of Australia
AIHW, 2003
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Prevalence of overweight and obesity by age group
in Australia, 2000
AusDiab Study 2001
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Average weight of participants in the Australian
Longitudinal Study of Women's Health 1996 2003.
1996 1999 2002
1996 1998 2001
1996 2000 2003
--- Rural and Remote women ______ Urban women
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Abdominal fatness in Australian adults 25 years,
2000
Waist circumference malesgt94cm females
gt80cm Source AusDiab Study Report
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Weight Status of children 7-12 years from 3
separate Australian studies
Booth et al, 2001
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Trends in overweight obesity in children
1970-2000
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30
25
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Prevalence
15
10
5
0
1970
1980
1990
2000
IOTF definition of OO Lobstein, Baur, Uauy. Obes
Rev 2004 5(Suppl 1)4-104
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Australian children versus England and USA
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Donath, MJA 2000
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The burden of obesity
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OBESITY AND MORTALITY RISK
American Cancer Society Study of 750,000 Men and
Women
2.5
Digestive andPulmonaryDisease
Cardiovascular andGallbladder Disease Diabetes
Mellitus
2.0
?
?
MortalityRatio
1.5
?
?
?
?
?
?
?
?
1.0
?
?
?
?
VeryLow
VeryHigh
Moderate
Low
Moderate
High
0
MenWomen
20
25
30
35
40
?
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BMI
Reprinted from Gray. Med Clin North Am.
198973(1)1-13, based on statistical information
from Lew et al. J Chron Dis. 197932563-576.
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Obesity Increases Risk for Developing Comorbid
Diseases (Especially Diabetes)
Type 2 diabetes Cholelithiasis Hypertension Corona
ry heart disease
Women
Men
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5
4
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Relative Risk
3
3
2
2
1
1
0
0
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lt21
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29
30
lt21
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25
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30
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25
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BMI (kg/m2)
BMI (kg/m2)
Willett WC et al. N Engl J Med. 1999341427-434.
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Age gender prevalence of diabetesAUSDIAB 2000
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International Agency for Research into cancer -
2001
Estimates of the percentage of weight-related
cancer across the European Union
Int J Cancer 2001 Feb 191(3)421-30 Overweight
as an avoidable cause of cancer in Europe.
Bergstrom A, Pisani P, Tenet V, Wolk A, Adami HO.

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Obesity and Osteoarthritis

• In the Framingham Osteoarthritis Study, the risk
  of osteoarthritis of the knees in women increased
  40 for each 10-pound (4 kg) weight gain
• Avoiding obesity would lead to a decrease of
  25-50 of osteoarthritis

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Psychological impact of obesity

• Social isolation
• Decreased sexual life
• Low self-esteem
• Depression
• Anxiety
• Back pain

Fontaine KR, Bartlett SJ. Dis Manage Health
Outcomes 199836170
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Proportion of total burden attributable to
selected risk factors, by sex, Australia 1996
Dietary dependent
Total 15
DALYs disability life years lost
From Mathers et al. The Burden of Disease and
Injury in Australia - Summary Report, 1999.
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Childhood obesity leads to adult obesity
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Minimum Total Costs of Obesity to Australia
1994/95

• Direct 680 - 1239 million
• Indirect 272 million
• Intangible 17.5 billion
• TOTAL 18.4 - 19.0 billion