Obesity Worldwide

Obesity has tripled worldwide since 1975 in all divisions of society. In 2016, the World Health Organisation (WHO) estimated there were 1.9 billion overweight adults in the world, 650 million of which were obese. This equates to 13% of the global adult population.[1]

In 2010, overweight and obesity were estimated to cause 3.4 million deaths, 3.9% of years of life lost, and 3.8% of disability-adjusted life-years worldwide, with major healthcare costs implicated. If recent trends continue, it is estimated that there will be 2.16 billion individuals classified as overweight and 1.12 billion as obese by 2030.[2] [3]

Obesity in the UK

England:

In 2016 in England, 40% of men and 30% of women were overweight and 26% of adults were classified as obese, which is a 15% rise since 1993. In 2016/17, 1/5 of children in Year 6 and 1/10 of children in Reception were classified as obese.

Obesity prevalence varies by sex, age and by deprivation. In 2016/17, 38% of women in the most deprived areas in England were obese, compared with 20% of women in the least deprived areas. 13% of reception age children living in the most deprived areas were obese compared to 6% of those living in the least deprived areas.[4]

Scotland:

In 2017 in Scotland, 65% of those aged 16 and over were overweight, including 29% who were obese. There was a significant increase between 2003 and 2008, when prevalence increased from 62% to 65%. Since 2008, prevalence has stabilised, fluctuating between 64% and 65%. In 2017, 26% of children aged 2-15 were at risk of overweight in Scotland, including 13% at risk of obesity.[5]

Wales:

In 2016 in Wales, 23% of adults were obese, and a further 36% were overweight. 65% of men were either overweight or obese, compared with 53% of women. According to the 2015/16 Child Measurement Programme for Wales, 11.7% of children aged 4-5 are obese, and a further 14.5% are overweight.[6]

Northern Ireland:

According to the Health Survey Northern Ireland, in 2016/17 27% of those aged 16 and over were obese and a further 36% were overweight, meaning a total of 63% who are either overweight or obese. Men are more likely to be obese or overweight than women. In 2016/17, the survey recorded 8% of children aged 2-10 and 7% of children aged 11-15 as being obese.⁶

Cost of obesity

Obesity costs the NHS more than £6 billion every year, with indirect costs at an estimated £27 billion. More than £14 billion is spent on treatment of type 2 diabetes.[7] More is spent each year on the treatment of obesity and diabetes than is spent on the police, fire and judicial system combined.[8] In 2016/17 there were 617,000 admissions to hospital related to obesity, this has increased by 17% since 2015/16.[9]

If obesity rates were to continue unchecked, it is estimated that 60% of adult men, 50% of adult women, and 25% of children in the UK could be obese by 2050. The McKinsey group estimated in 2014 that the total annual economic cost of obesity globally is £1 trillion, and £47 billion in the UK.[10]

Causes of obesity

Obesity occurs when energy intake from food or drink consumption is greater than the energy expenditure through metabolism or exercise.[11] There are many ways in which we can classify a person’s health in relation to their weight, but the most widely used is Body Mass Index (BMI). Generally, a person is thought to be obese when their BMI exceeds 30 kg/m2. To calculate your BMI, click here. 

Although a high BMI does not support a definitive diagnosis of obesity, as some people can have excessive muscle, which increases their weight significantly, it is generally a good indication of whether someone is overweight.[12]

How does sugar fit in with the obesity epidemic?

Excessive unhealthy food and sugars-sweetened soft drink consumption has been linked to weight gain, as it provides a major and unnecessary source of calories with little or no nutritional value.

In 2010, WHO commissioned a systematic literature review to answer a series of questions relating to the effects of sugars on excess adiposity.[13] These questions asked whether reducing or increasing intake of dietary sugars influences measures of body fatness in adults and children, and whether the existing evidence provides support for the recommendation to reduce intake of free sugars to less than 10% of total energy. Body fatness was selected as an outcome in view of the extent to which comorbidities of obesity contribute to the global burden of non-communicable disease.

The result of the meta-analysis suggests that intake of sugars is a determinant of body weight in free living people consuming ad libitum diets. The data suggest that the change in body fatness that occurs with modifying intake of sugars results from an alteration in energy balance rather than a physiological or metabolic consequence of monosaccharides or disaccharides.

Owing to the multifactorial causes of obesity, it is unsurprising that the effect of reducing intake is relatively small. However, when considering the rapid weight gain that occurs after an increased intake of sugars, it seems reasonable to conclude that advice relating to sugars intake is a relevant component of a strategy to reduce the high risk of overweight and obesity in most countries.

Furthermore, the Scientific Advisory Committee on Nutrition (SACN) reviewed randomised control trials, which indicated that consumption of sugars-sweetened beverages, as compared with non-calorically sweetened beverages, results in weight gain and an increase in BMI in children and adolescents.  Prospective cohort studies also generally confirm the link between sugars-sweetened beverages and increased obesity.[14]

Current dietary advice:

We currently consume far too much sugar in the UK diet. The report published by WHO and by SACN highlight the need for a reduction in sugar intake to 5% of our energy intake.[15] This is equivalent to 7 teaspoons/cubes or 30g of sugar per day for an adult. The recommendation for children is 24g for children aged 5-11 and 19g for children aged 4-6. This 5% limit is far below the current intake which is of 11.9% in children aged 1.5 to 3; 14.7% in children aged 4 to 10; and 15.6% in children 11 to 18. It is also thought that adherence to the 5% recommended sugar intake would halt the increase in obesity.[16]

To further reduce the increase in obesity, doctors recommend that patients:

Eat a lower calorie diet. For most men, this means sticking to a calorie limit of no more than 1,900kcal a day, and 1,400kcal for most women. To maintain a healthy weight it is recommended that women consume around 2000 calories per day and men consume around 2500 calories. It is important to reduce calorie intake from sugary, fatty foods and increase intake from vegetables and complex carbohydrate foods.[17]

Keep active. Adults aged 19 to 64 should be active daily and should be doing 150 minutes of moderate aerobic activity every week. To stay healthy or improve health, adults need to do 2 types of physical activity each week: aerobic and strength exercises.[18]

Join a counselling or support group. It has been shown that supportive communities are key in shaping people’s lifestyle and dietary choices.¹³

For more information on achieving a healthy balanced diet, click here.

References:

[1] WHO.2018.Obesity and overweight: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

[2] Mokdad et al.2016. Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30168-1/fulltext

[3] Kelly et al.2008.Global Burden of Disease: https://www.ncbi.nlm.nih.gov/pubmed/18607383

[4] NHS Digital.2018. Statistics on Obesity, Physical Activity and Diet – England: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-obesity-physical-activity-and-diet/statistics-on-obesity-physical-activity-and-diet-england-2018

[5]Scottish Government. 2018 Health of Scotland's population – Obesity: https://www2.gov.scot/Topics/Statistics/Browse/Health/TrendObesity

[6] UK Government.2018.Obesity Statistics: https://researchbriefings.files.parliament.uk/documents/SN03336/SN03336.pdf

[7] Diabetes.co.uk. Cost of Diabetes: https://www.diabetes.co.uk/cost-of-diabetes.html

[8]UK Government. 2017. Health matters: obesity and the food environment:  https://www.gov.uk/government/publications/health-matters-obesity-and-the-food-environment/health-matters-obesity-and-the-food-environment--2

[9] NHS Digita;.2018.  Statistics on Obesity, Physical Activity and Diet - England: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-obesity-physical-activity-and-diet/statistics-on-obesity-physical-activity-and-diet-england-2018

[10] Dobbs et al.2014. "How the world could better fight obesity." Mckinsey&Company: http://www.mckinsey.com/insights/economic_studies/how_the_world_could_better_fight_obesity

[11] SACN.2015. Carbohydrates and Health Report: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/445503/SACN_Carbohydrates_and_Health.pdf

[12] NHS Choices, 2016. Obesity.http://www.nhs.uk/Conditions/Obesity/Pages/Introduction.aspx

[13] Te Morenga et al. 2013.Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies: http://www.bmj.com/content/346/bmj.e7492

[14] NHS Choices, 2016. Obesity: http://www.nhs.uk/Conditions/Obesity/Pages/Introduction.aspx

[15] Health and Social Care Information Centre (HSCIC). 2014. Statistics on Obesity, Physical Activity and Diet: http://www.hscic.gov.uk/catalogue/PUB13648/Obes-phys-acti-diet-eng-2014-rep.pdf

[16] UK Government.2018. NDNS: results from years 7 and 8 (combined): https://www.gov.uk/government/statistics/ndns-results-from-years-7-and-8-combined

[17] NHS.2016. Healthy weight: https://www.nhs.uk/live-well/healthy-weight/start-the-nhs-weight-loss-plan/

[18] NHS.2018. Exercise: https://www.nhs.uk/live-well/exercise/