Obesity and the Global Burden of Disease

Last week, The Lancet published the first part of a monumental effort to describe the global burden of disease – I have not read the report.

But, from what I can garner by a cursory look at the abstracts and the many news articles, deaths from starvation are down, whereas deaths from obesity are up (the ratio apparently is now one to three – at least according to some media reports).

I cannot say that I am in any way surprised, not should any one else be.

It is also not surprising that when obesity rates increase hand-in-hand with increases in life-expectancy, then more people will be living longer with obesity related health problems (see my previous post on this).

While the report is descriptive and can neither make nor claim insights into what drives all of this, the warnings for our health systems and policy makers are clear – ignore obesity at your own risk.

In the same manner that obesity did not appear overnight, no public health measures can be expected to make it disappear any time soon (some predict this may be take several decades short of catastrophic and disruptive global events).

Over the last 50 years, we have made considerable strides in our ability to treat diabetes, hypertension, dyslipidemia, heart disease, and other obesity related health problems – one reason why people with these conditions live so much longer today than ever before.

The biology of glucose homeostasis is complex – yet we have effective treatments for diabetes.

The biology of blood pressure regulation is complex – yet we have effective treatments for hypertension.

The biology of cholesterol synthesis is complex – yet we have effective treatments for dyslipidemia.

The biology of coagulation is complex – yet we have effective treatments for blood clots.

The biology of energy homeostasis is complex – why do we not have effective treatments for obesity?

Is it because we simply don’t like fat people and think they deserve less?

AMS
Edmonton, Alberta