Global Obesity Is Not About To Get Better Any Time Soon
Monday, April 4, 2016
World Adult Obesity 2014 – The Lancet
There are now more overweight than underweight people in the world today and there is little hope that there will be any noticeable reduction in this trend till 2025.
That essentially is the key message from a “landmark” paper with data from almost 20 million people (and a similar number of authors) from around the world published in The Lancet.
The researchers looked at data from 1698 population-based data sources from 200 countries for obesity prevalence data between 1975 and 2014.
The paper has wonderful maps and graphics that I am sure will find their way into many presentations on obesity (including mine) to demonstrate both the magnitude and ubiquity of the problem (not to say that underweight still remains a substantial problem in many parts of the world with problems at both ends of the weight spectrum often co-existing within the same countries).
Most alarmingly, as the authors point out, is the trend for severe obesity which will soon affect as many as 6-9% of the population in some high- and middle-income countries.
According to the authors,
“Even anti-hypertensive drugs, statins, and glucose-lowering drugs will not be able to fully address the hazards of such high BMI levels, and bariatric surgery might be the most effective intervention for weight loss and disease prevention and remission.”
Now may may well be true but it is also highly unrealistic.
At the rates that bariatric surgery is currently accessible in most countries, it will only take a 100 years (or more) to treat everyone who already meets the criteria today.
What we really need are better medical treatments that are effective, safe and scaleable (in the same manner that we have scaled the use of anti-hypertensive drugs, statins and glucose-lowering drugs to address hypertension, dyslipidemia or diabetes, respectively).
Better obesity treatments will be desperately needed while we wait for population interventions to hopefully begin reducing obesity rates by 2025.
@DrSharma
San Diego, CA
Monday, April 4, 2016
*sigh*
I often wonder if there will ever be any population level interventions that reverse this.
And I have NOT given up on people currently living with obesity, but perhaps the way we reduce obesity prevalence is simply by ensuring children who are born now avoid the excessive weight gain that leads to the NCDs and their morbidity.
So better treatments will (hopefully) emerge for people with obesity now, but the long-term outcome is not so much reversing obesity in those individuals but rather reducing the incidence over time. It just seems like we are nowhere on finding a scalable way to treat current patients. 🙁
Monday, April 4, 2016
I really like your point about children. They are a wonderfully unique cohort for those who are overweight and obese now, since there is still a chance for them to outgrow their obesity (growing taller with little to no change in weight). And the long term changes are most likely to be seen by molding the minds of children while we still have a reasonable amount of control/authority over them (i.e. in the school system). It’s upsetting, but true: so much biology is against those of us who need to lose weight that we’re actually fighting against evolutionarily engrained mechanisms.
Monday, April 4, 2016
I would be really interested to know your opinion on which companies show the most promise. And by that I mean, they “get” that it is not about weight loss (which is relatively easy for patients compared to many medical battles — e.g. cancer), but long-term weight-loss maintenance, which is close to impossible for 97% of people, unless they have surgery (and for some even when they do). It seems the lab rats just keep running in the same wheel, trying to solve the wrong problem, and the situation only gets worse.
Monday, April 4, 2016
I believe that this will ultimately come down to better medical treatments like we have for diabetes or hypertension – quite a few promising leads in the pharma pipelines…