Study Says One-in-Five in the World
Will Have Obesity by 2025

Published in April Issue             

A major global analysis published in The Lancet has revealed a dramatic increase in the number of people with obesity in the world. The number of people with the disease went from 105 million in 1975 to 641 million in 2014. Researchers analyzed trends in body mass index (BMI) over almost two generations.

The proportion of men with obesity has more than tripled (3.2% to 10.8%), and the proportion of women with obesity has more than doubled (6.4% to 14.9%) since 1975. At the same time, the proportion of underweight people fell more modestly--by around a third in both men (13.8% to 8.8%) and women (14.6% to 9.7%).

The average BMI increased from 21.7kg/m to 24.2 kg/m in men and from 22.1kg/m to 24.4 kg/m in women), which translates to the world's population becoming on average 1.5kg heavier each decade. According to researchers, if the rate of obesity continues at this pace, by 2025 about one-fifth of men (18%) and women (21%) worldwide will have the disease of obesity, and more than 6 percent of men and 9 percent of women will have severe obesity.

"Over the past 40 years, we have changed from a world in which underweight prevalence was more than double that of obesity, to one in which more people are obese than underweight," senior study author Professor Majid Ezzati from the School of Public Health at Imperial College London, UK, commented in a news release. "If present trends continue, not only will the world not meet the obesity target of halting the rise in the prevalence of obesity at its 2010 level by 2025, but more women will be severely obese than underweight by 2025."

Researchers say their findings include, for the first time, the proportion of individuals classified as underweight (less than 18.5 kg/m), and severely obese (35 kg/m or higher) and morbidly obese (40 kg/m or higher). Data was pooled from studies, surveys, and reports that included 19.2 million adult men and women from 186 countries (covering 99% of the world's population).

The study found that among high-income English-speaking countries, the United States has the highest average BMI for both men and women (over 28 kg/m), and that here more than one-in-four men and almost one-in-five women have severe obesity.

Professor Ezzati added, "To avoid an epidemic of severe obesity, new policies that can slow down and stop the worldwide increase in body weight must be implemented quickly and rigorously evaluated, including smart food policies and improved health-care training."

According to Professor Ezzati, the epidemic of severe obesity is too extensive to be tackled with blood pressure or diabetes medications alone, or with a few extra bike lanes. He says coordinated global initiatives are needed. He suggested examining the price of healthy food in comparison to unhealthy food, or taxing high sugar and highly processed foods.

The other consideration for those with severe obesity is metabolic and bariatric surgery, a treatment option that is performed on less than 1 percent of the surgically eligible population in the U.S.

Eric DeMaria, MD

When I suggest any surgical procedure to a patient, I am required ethically and legally to have a discussion about alternative treatment options before we proceed with surgery, particularly options that avoid surgery. Why are our colleagues not held to this same level of accountability and required to discuss obesity treatment options from an evidence-based perspective, including surgery," said Eric J. DeMaria, MD, Director of Bariatric Surgery, Bon Secours Maryview Medical Center in Portsmouth, Virginia.

»»» (To read more about Dr. DeMaria's view click here.)«««

We cant be taking the same approach to the disease of obesity and expect different results, said Raul J. Rosenthal, MD, president, American Society for Metabolic and Bariatric Surgery (ASMBS). We need to think differently about the disease and its treatment and this thinking needs to extend to our colleagues in primary care, insurance, policy makers and the patients themselves. Bariatric surgery isnt the answer for everyone, but why erect false barriers that keep this lifesaving solution from those who would benefit the most?