ABSTRACT
At the same time that problems of undernutrition have not been solved in much of the world, overweight and obesity have emerged in the last quarter century as major public health problems globally. For most developing countries, there is thus now a double burden of malnutrition with associated costs to health and quality of life. More than a billion adults worldwide are now overweight, and a third of these are overweight to a degree that classifies them as obese. The health consequences include premature deaths and chronic diseases that reduce quality of life and threaten to overwhelm the resources of health care systems widely. The causes of the obesity epidemic include changes in the age structure of many populations, with more adults and fewer children as fertility is reduced in most countries; rapid urbanization with consequent decreases in energy expenditure; and globalization of food supplies with rapid change toward diets higher in animal products, oil, and sugars in many countries. It will require committed effort on a large scale to turn the
Abstract .................................................................................................................. 129 The Emergence of Obesity as a Global Public Health Problem ............................ 130
Defining Overweight and Obesity ..................................................................... 130 Etiology of Obesity ........................................................................................... 131 Prevalence and Recent Trends in Obesity among Populations ......................... 131
The Real Causes of the Obesity Epidemic ............................................................. 133 Changing Population Structures ........................................................................ 134 Urbanization ...................................................................................................... 134 Globalization of Food Systems ......................................................................... 135
Consequences of the Obesity Epidemic ................................................................. 135 Nutrition-Related Noncommunicable Diseases: Why Does Obesity Matter? ................................................................................................. 135 Impact on Social Disparities in Health.............................................................. 136 Impact on Costs and Health Care Systems ....................................................... 136
Controlling the Problem: The Prevention Imperative ............................................ 137 Conclusions and Study Topics ............................................................................... 138 References .............................................................................................................. 138
epidemic around, with attention to changes in social and physical environments as well as individual behavior.
