Part One | The effects of obesity and the links to diabetes and cardiovascular disease: now and in the future

This four-part episode takes a look at obesity and the links to serious medical conditions such as diabetes and cardiovascular disease. What are the current statistics around it and how are medical professionals tackling the obesity epidemic today and in the future.

Obesity, and the health problems that it leads to, now rank amongst the most serious global challenges facing medical professionals. According to the World Health Organisation obesity statistics, in 2016 about 13% of the world’s adult population, including 11% of men and 15% of women, were obese (defined as a body mass index, or BMI, of 30 or higher). The worldwide prevalence of obesity has nearly tripled since 1975, and continues to rise quickly in almost all countries.

Bringing you up to date: check out the new hopes for treatment in the global obesity epidemic in part two 

What makes this so serious is that there is strong evidence linking the effects of obesity with a number of other serious health conditions including diabetes and cardiovascular disease. In England, for example, obese adults are roughly five times more likely to have diabetes than adults with a healthy weight. One analysis demonstrated that a body weight gain of 2.4 to 2.9 kg may increase the risk of diabetes by 25% [Ref 1]. In addition, the risk of heart failure is 34% higher for those who are overweight and 104% higher for obese people.

Another study concluded that adults between 40 and 59 who are overweight or obese have a significantly increased risk (ranging from 21% to 85% higher) of developing cardiovascular disease as compared with their normal weight peers [Ref 2].

For obesity itself, diet and exercise are the preferred treatment paths. and in In more serious cases surgery such as gastric band or gastric bypass have also become obesity treatment options, along with therapeutics such as Roche's Xenical (orlistat) which was first approved in the 1990s, and GlaxoSmithKline's half-dose OTC version Alli. Though orlistat produces a small reduction in weight and a concomitant impact on diabetes, fears of side effects such as liver damage and steatorrhea, have kept global sales at around $650 million annually.

Once considered a problem only in high-income countries, even low- and middle-income countries are now suffering from increased obesity, particularly in urban settings. In some places in Africa and South Asia, it is possible to find under-nutrition and obesity existing side-by-side within the same town. It seems that children in low- and middle-income countries are more vulnerable to inadequate nutrition at an early age, and given that they are also exposed to high-fat, high-sugar, energy-dense foods, which tend to be cheap but of lower nutrient quality, the result is a sharp increase in childhood obesity.

But perhaps the nations most concerning health experts are China and India. The most populous nations on Earth, their obesity rates are still low, yet even a small percentage rise will lead to millions more cases of obesity. China, for example, has seen an 8% rise in men’s obesity since the mid-1990s. With under-developed healthcare systems, these countries will struggle to cope with the health impacts should the disease become more widespread.

A recent report by the McKinsey Global Institute estimates that obesity now costs the global economy $2 trillion each year, a figure only exceeded by smoking, violence, war and terrorism combined. With an improved understanding of the full impact that obesity has on health, there are now stronger reasons than ever for tackling it.

See part 2 here: New hopes for treatment in the global obesity epidemic

See part 3 here: Next generation obesity therapies.

See part 4 here: Obesity, Type 2 diabetes and cardiovascular disease: Finding the magic bullet.

Ref 1. The Evidence for an Obesity Paradox in Type 2 Diabetes Mellitus Seung Jin Han et al. Diabetes Metab J. 2018 Jun; 42(3): 179–187. Doi: 10.4093/dmj.2018.0055.
Ref 2. Association of Body Mass Index With Lifetime Risk of Cardiovascular Disease and Compression of Morbidity. Khan SS et al. JAMA Cardiol. 2018 Apr 1;3(4):280-287. doi: 10.1001/jamacardio.2018.0022.
Trends in percentage obesity in males and females living in selected emerging countries are provided with permission for use from www.worldobestiydata.org.