obesity

obesity, excessive accumulation of body fat, usually caused by the consumption of more calories than the body can use. The excess calories are then stored as fat, or adipose tissue. Overweight, if moderate, is not necessarily obesity, particularly in muscular or large-boned individuals.

Defining obesity

Obesity was traditionally defined as an increase in body weight that was greater than 20 percent of an individual’s ideal body weight—the weight associated with the lowest risk of death, as determined by certain factors, such as age, height, and gender. Based on these factors, overweight could then be defined as a 15–20 percent increase over ideal body weight. However, today the definitions of overweight and obesity are based primarily on measures of height and weight—not morbidity. These measures are used to calculate a number known as body mass index (BMI). This number, which is central to determining whether an individual is clinically defined as obese, parallels fatness but is not a direct measure of body fat. Interpretation of BMI numbers is based on weight status groupings, such as underweight, healthy weight, overweight, and obese, that are adjusted for age and sex. For all adults over age 20, BMI numbers correlate to the same weight status designations; for example, a BMI between 25.0 and 29.9 equates with overweight and 30.0 and above with obesity. Morbid obesity (also known as extreme, or severe, obesity) is defined as a BMI of 40.0 or higher. (See nutritional disease: Diet and chronic disease.)

The obesity epidemic

Body weight is influenced by the interaction of multiple factors. There is strong evidence of genetic predisposition to fat accumulation, and obesity tends to run in families. However, the rise in obesity in populations worldwide since the 1980s has outpaced the rate at which genetic mutations are normally incorporated into populations on a large scale. In addition, growing numbers of persons in parts of the world where obesity was once rare have also gained excessive weight. According to the World Health Organization (WHO), which considered global obesity an epidemic, in 2016 more than 1.9 billion adults (age 18 or older) worldwide were overweight and 650 million, representing 13 percent of the world’s adult population, were obese.

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The prevalence of overweight and obesity varied across countries, across towns and cities within countries, and across populations of men and women. In China and Japan, for instance, the obesity rate for men and women was about 5 percent, but in some cities in China it had climbed to nearly 20 percent. In 2005 it was found that more than 70 percent of Mexican women were obese. WHO survey data released in 2010 revealed that more than half of the people living in countries in the Pacific Islands region were overweight, with some 80 percent of women in American Samoa found to be obese.

Childhood obesity

Childhood obesity has become a significant problem in many countries. Overweight children often face stigma and suffer from emotional, psychological, and social problems. Obesity can adversely affect a child’s education and future socioeconomic status. In 2004 an estimated nine million American children over age 6, including teenagers, were overweight, or obese (the terms were typically used interchangeably in describing excess fatness in children). Moreover, in the 1980s and 1990s the prevalence of obesity had more than doubled among children age 2 to 5 (from 5 percent to 10 percent) and age 6 to 11 (from 6 percent to 15 percent). By 2015, 20 percent of children age 6 to 19 were obese in the United States. Further estimates in some rural areas of the country indicated that more than 30 percent of school-age children suffered from obesity. Similar increases were seen in other parts of the world. In the United Kingdom, for example, the prevalence of obesity among children age 2 to 10 had increased from 10 percent in 1995 to 14 percent in 2003, and data from a study conducted there in 2007 indicated that 23 percent of children age 4 to 5 and 32 percent of children age 10 to 11 were overweight or obese. By 2016, WHO data indicated, worldwide some 41 million children age 5 or under were overweight or obese.

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In 2005 the American Academy of Pediatrics called obesity “the pediatric epidemic of the new millennium.” Overweight and obese children were increasingly diagnosed with high blood pressure, elevated cholesterol, and type II diabetes mellitus—conditions once seen almost exclusively in adults. In addition, overweight children experience broken bones and problems with joints more often than normal-weight children. The long-term consequences of obesity in young people are of great concern to pediatricians and public health experts, because obese children are at high risk of becoming obese adults. Experts on longevity have concluded that today’s American youth might “live less healthy and possibly even shorter lives than their parents” if the rising prevalence of obesity is left unchecked.

Curbing the rise in childhood obesity was the aim of the Alliance for a Healthier Generation, a partnership formed in 2005 by the American Heart Association, former U.S. president Bill Clinton, and the children’s television network Nickelodeon. The alliance intended to reach children through a vigorous public awareness campaign. Similar projects followed, including American first lady Michelle Obama’s Let’s Move! program, launched in 2010, and campaigns against overweight and obesity were made in other countries as well.

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Efforts were also under way to develop more-effective childhood obesity-prevention strategies, including the development of methods capable of predicting infants’ risk of later becoming overweight or obese. One such tool reported in 2012 was found to successfully predict newborn obesity risk by taking into account newborn weight, maternal and paternal BMI, the number of members in the newborn’s household, maternal occupational status, and maternal smoking during pregnancy.