Obesity Prevention

Excerpt

Once considered a problem only in high-income countries (HICs), obesity has become a major contributor to the global disease burden (Finucane and others 2011; Misra and Khurana 2008). Excess adiposity, particularly around the visceral abdominal region, is an important risk factor for morbidity and mortality from type 2 diabetes, cardiovascular diseases, and some cancers (Danaei and others 2009; Whitlock and others 2009; WHO 2009). Although some studies have suggested lower mortality among overweight or obese persons than among healthy-weight persons (Carnethon and others 2012), this outcome has not been observed in studies that properly account for the confounding effects of smoking, preexisting chronic conditions, and other biases (Global BMI Mortality Collaboration 2016; Tobias, Pan, and Hu 2014). The costs of obesity and comorbid conditions are staggering as measured by both health care expenditures and quality of life, underscoring the importance of implementing obesity prevention strategies and treatment strategies on a global scale.

The changes needed to reverse global trends in obesity will likely require numerous interventions and policy recommendations that target diet, lifestyle, access to care, and environmental risk factors. In this chapter, we summarize the global burden of obesity and the impact of a spectrum of obesity risk factors, ranging from sociopolitical and economic forces that are largely beyond an individual’s control to modifiable lifestyle factors, and discuss genetic and epigenetic risks. We also review the effectiveness of population-based interventions and policies for preventing obesity, some individual-level treatment options across various platforms, and the cost-effectiveness of select interventions.