FIRSTNON-CONTAGIOUS EPIDEMIC

SMART & LIGHT

Obesity has not stopped progressing. A recent national ObEpi study in France by the Roche institute and Sofres, in collaboration with the Inserm and the Hotel Dieu de Paris, revealed that obesity and overweight have continued to progress in France since 1997. The proportion of overweight or obese in the population has increased from 36.7% to 41.6% between 1997 and 2003, which represents a 13% increase. At the same time, the French have gained on average 1.7 kg, and severe obesity (also called morbid obesity) has doubled.

More and more children are affected (19% in France). Past 65 years old, obesity is about equally distributed between men and women (about 15%). France numbers more than 5.3 million obese adults and 14.4 million overweight people (according to an Insee study in 2002 on people aged 15 and older). Obesity is a public health issue and affects all ages and all professions.

In France, where 16% of the 6-15 year olds have some overweight (compared to 5% in 1980), including 3.8% of obese, obesity is considered to be “epidemic” by the National Health and Research Institute (Inserm). After a tense struggle and under the pressure of agribusiness, some measures have been obtained and inscribed in articles 29 and 30 of the law of August 9th, 2004, on public health policy, and should soon be applied.

The AOA (American Obesity Association), the Inserm and INS have all raised a cry of alarm against the stupefying increase of obesity in the world, particularly among children. Today, in France, 1 out of 10 children is obese at the age of 10, double what it was in 1980. Among children from 6 to 12, the rate is 10 to 12%. It is estimated that if obesity appears before puberty, its rate of persistence in adults will be 20 to 50%, and from 50 to 70% if obesity appears after puberty.

But obesity is not a problem that only affects the United States and France, it affects all developed countries and is now expanding like a plague in all developing countries, with medium or low incomes, and where the “economic transition” is generating a “nutrition transition”, which is a transformation of eating habits and behaviors, a reduction of physical activity, and a catastrophic quality of foods (agribusiness and industrial junk food). Too many fats, too many sugars, too many calories, and not enough exercise.

The WHO (World Health Organization) considers obesity to be an epidemic. In the world, 300 million adults have overweight and, in most cases, they suffer from weight-related pathologies. A third of overweight people live in developing countries.

November 11th, 2004 | Geneva. It is estimated that, in the world, obesity or overweight affect 22 million children of ages 5 or less, of which 17 million are in developing countries. As the WHO and the IDF (International Diabetes Federation) indicate, each one of these children has an increased risk of developing Type 2 Diabetes (also called adult diabetes or maturity onset diabetes).

“The struggle against child obesity is a very effective way of preventing diabetes in the future”, explains Dr Catherine le Galès-Camus, assistant manager at the WHO on non-contagious diseases and mental health, a few days before the World Diabetes Day on November 4th, 2004.

It is estimated that , in the world, 10% of children from 5 to 17 years old have overweight or are obese, and the situation is getting worse. In the United Sates for example, the rate of obesity and overweight in children and adolescents from 6 to 18 years has increased from 15% in the 70´s to more than 25% in the 90´s.

Such increases are not limited to developed countries. In China, a study determined that the frequency of overweight and obesity among children of school-going ages in urban areas has increased from 8% in 1991 to 12% six years later. In Brazil, the proportion of overweight of obese children of ages 6 to 18 has tripled: 4% in the 70´s to 13% in 1997.

OBESITY IN THE WORLD

COUNTRY
MEN (BMI > 30)
WOMEN (BMI > 30)

Angleterre (1995)
M 15 %
W 16 %

Allemagne (1995)
M 17 %
W 19 %

France (1997)
M 8 %
W 9 %

USA (1995)
M 19,7 %
W 24.7 %

Japon (1993)
M 1,7 %
W 2.7 %

Suisse (1994-1995)
M 6,1 % (33 % BMI 25-29)
W 4.7 % (17 % BMI 25-29)
Obesity has increased from 10 to 40% in all European countries in the last ten to fifteen years. It should be noted that this increase is more obvious among children and adolescents. 20% of children are obese at the age of 1, and 60% of obese adolescents will become obese adults (the risk is further increased if one of the parents is obese). The cost of obesity in France represented 4% of health expenses in 1995 (4% in the Netherlands, 6% in the USA) and has increased constantly ever since.

Some numbers: In China, 12% of women and 10% of men are obese; in Malaysia, 3 out of 10 men are obese; in Mexico, 23% of the population is obese and 58% overweight; in Kuwait, 32% of men and 40% of women are obese; In Saudi Arabia, 16% of men and 24% of women.

Obesity affects 1.1 billion people in the world.

NUTRITION TRANSITION AND OBESITY

Obesity in the developing world is the result of a series of changes linked to eating habits, exercise, health, and nutrition, called “nutrition transition”. As poor nations become wealthier, they gain access to certain benefits but also to many problems of the developed countries, among them obesity.

THE PRICE OF UNHEALTHY EATING

People suffering from underweight or overweight all have high instances of diseases or infirmities, a reduced life span and lesser productivity. Obesity increases the risks of chronic diseases such as diabetes, high blood pressure, cardiovascular diseases, diseases of the gallbladder and some forms of cancer.

The developing world risks getting the lion´s share of these new diseases. For example, the number of people suffering from weight-related diabetes should double and reach 300 million between 1998 and 2025 – three quarters of which would be in the developing world. For countries whose economic and social resources are already strained, the result could be catastrophic.

Socially, it has been proven that overweight people suffer from discrimination during hiring. Many employers hesitate to give responsibilities to someone – particularly a woman – who “doesn´t have enough willpower to keep a normal waistline” and “lets herself grow fat”. And sociologists note that marriage works as a marshalling yard that sends obese women to the bottom of the social scale because rich men don´t want them.

An other inequality: the lower classes are more affected by obesity because eating well (healthily) is more expensive.

From a sanitary point of view, obesity is about to become, according to the World Heart Federation, the principal risk factor of cardiovascular and related diseases. In France already, 55.000 deaths each year are related to overweight or its consequences.