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Obesity and diabetes: the slow-motion disaster Keynote address at the 47th meeting of the National Academy of Medicine
Dr Margaret Chan
Director-General of the World Health Organization
Washington, DC, USA
17 October 2016
Members of the National Academy of Medicine and your distinguished guests, ladies and gentlemen,
The world has 800 million chronically hungry people, but it also has countries where more than 70% of the adult population is obese or overweight.
Until the late 20th century, dietary issues in developing countries focused on the health consequences of undernutrition, especially stunting and wasting in children and anaemia in women of child-bearing age.
That situation has changed dramatically. In just a few decades, the world has moved from a nutrition profile in which the prevalence of underweight was more than double that of obesity, to the current situation in which more people worldwide are obese than underweight.
Once considered the companions of affluent societies, obesity and overweight are now on the rise in low- and middle-income countries, particularly in urban areas, where the increase is fastest.
Since 1980, WHO estimates that the worldwide prevalence of obesity has more than doubled, with significant increases seen in every region. In sub-Saharan Africa, the number of overweight children grew from 4 million in 1990 to 10 million in 2012.
Though adiposity is increasing everywhere, the epidemiology differs according to the age of the obesity epidemic. In North American and Europe, the prevalence of obesity is highest among lower-income groups, who often live in urban areas blighted by food deserts and littered with fast-food outlets.
In countries more recently affected by the obesity epidemic, as in the Asia-Pacific region, obesity is seen first in wealthy urban residents, and then later in impoverished rural areas and urban slums.
This shift to population-wide obesity is occurring with terrifying speed. In Mexico City, adult obesity increased from 16% of the city?s population in 2000 to 26% in 2012. By that year, 35% of the city?s children, aged 5 to 11 years, were obese or overweight. For the country as a whole, seven out of ten Mexicans are now overweight, with a third of them clinically obese.
In India, the prevalence of overweight increased from 9.7% near the turn of the century to nearly 20% in studies reported after 2010. For children and adolescents, these studies show that obesity and overweight are rapidly increasing, not just in the higher income groups but also in the rural poor, where undernutrition and underweight remain major health concerns.
Many other rapidly developing countries show a similar pattern. Obesity and undernutrition can occur side-by-side in the same country, the same community, even the same household.
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Dr Margaret Chan
Director-General of the World Health Organization
Washington, DC, USA
17 October 2016
Members of the National Academy of Medicine and your distinguished guests, ladies and gentlemen,
The world has 800 million chronically hungry people, but it also has countries where more than 70% of the adult population is obese or overweight.
Until the late 20th century, dietary issues in developing countries focused on the health consequences of undernutrition, especially stunting and wasting in children and anaemia in women of child-bearing age.
That situation has changed dramatically. In just a few decades, the world has moved from a nutrition profile in which the prevalence of underweight was more than double that of obesity, to the current situation in which more people worldwide are obese than underweight.
Once considered the companions of affluent societies, obesity and overweight are now on the rise in low- and middle-income countries, particularly in urban areas, where the increase is fastest.
Since 1980, WHO estimates that the worldwide prevalence of obesity has more than doubled, with significant increases seen in every region. In sub-Saharan Africa, the number of overweight children grew from 4 million in 1990 to 10 million in 2012.
Though adiposity is increasing everywhere, the epidemiology differs according to the age of the obesity epidemic. In North American and Europe, the prevalence of obesity is highest among lower-income groups, who often live in urban areas blighted by food deserts and littered with fast-food outlets.
In countries more recently affected by the obesity epidemic, as in the Asia-Pacific region, obesity is seen first in wealthy urban residents, and then later in impoverished rural areas and urban slums.
This shift to population-wide obesity is occurring with terrifying speed. In Mexico City, adult obesity increased from 16% of the city?s population in 2000 to 26% in 2012. By that year, 35% of the city?s children, aged 5 to 11 years, were obese or overweight. For the country as a whole, seven out of ten Mexicans are now overweight, with a third of them clinically obese.
In India, the prevalence of overweight increased from 9.7% near the turn of the century to nearly 20% in studies reported after 2010. For children and adolescents, these studies show that obesity and overweight are rapidly increasing, not just in the higher income groups but also in the rural poor, where undernutrition and underweight remain major health concerns.
Many other rapidly developing countries show a similar pattern. Obesity and undernutrition can occur side-by-side in the same country, the same community, even the same household.
READ MORE