Obesity is on the news every day. We hear about how bad it is, that it is getting worse, that it has taken epidemic proportions and is the new pandemic of the XXI century, that this will lead to a “tsunami” of type 2 diabetes and cardiovascular disease…etcetera etcetera. We spend tons of money trying to shed the extra kilograms. Americans alone spend up to $60 billion dollars per year on weight-loss programs and products. The UK market was estimated to be worth £11.2bn in 2007. Yet, for all the money we throw at it, here or in the States (and probably in most developed nations for that matter), 50% of any weight loss is regained within one year and most, if not all, is regained within 5 years. In 2004, the House of Commons Select Committee estimated the total annual cost of obesity and overweight to be around £6.6–7.4 billion per year.
Let’s get a quick snapshot of the UK. It’s not a surprise to anyone that, as a country, we are getting bigger. According to the latest National Diet and Nutrition Survey, the average BMI for men and women (19-64y) was 27.5 and 27.0 Kg/m2, respectively. 68% of men were overweight or obese (27% obese) whilst 55% of women were overweight or obese (25% obese). Half of the “just” overweight population is likely to become obese. 34% of males and 42% of women had a very high waist circumference (meaning greater than 102cm for men and 88cm for women). What this translates into is a much greater risk of chronic disease (e.g. metabolic syndrome, diabetes type 2, and cardiovascular disease/events such as coronary heart disease and risk of stroke and myocardial infarction). The picture is not much different in those aged 2 to 18 years of age where 33-34% of all boys and girls are now overweight and/or obese (for obese only: 18-19%). 50% of obese children at age 6 become obese adults.
How quickly have things changed? For this we need to look at the latest Health Survey for England 2009 published December 2010. From 13% of obese man and 16% of obese women in 1993, we’ve gone up to 22% and 24% in 2009, respectively. Simultaneously, the proportion of individuals with a raised waist circumference increased in males from 20% in 1993 to 32% in 2009 and in women from 26% to 44%. The UK National Institute of Health and Clinical Excellence (NICE) recommends that we assess the health risks associated with overweight and obesity by combining BMI with waist circumference in adults. What this equates to is that the proportion of men at high risk of chronic disease increased from 11% in 1993 to 14% in 2009, while for women the proportion increased from 12% to 18%. A much steeper rise can be seen for the high risk category with an increase from 11% to 20% for men and 14% to 23% for women.
Is it just the UK? No but we are one of the worst in Europe (original paper here). British women now have the 3rd highest BMI out of 23 European Nations (up from 12th in early eighties – BMI went up from 24.2 to 26.9 kg/m2) whilst men now have the 5th highest BMI (up from 17th position; BMI increased from 24.7 to 26.6). How do we change this? Onwards to Part 2.