The document discusses the global issue of obesity, termed "globesity". Key points include: - Globesity affects over 400 million people worldwide and is projected to increase to over 700 million by 2015. - It is a major global health risk and its impact rivals or exceeds that of cigarette smoking. - Globesity is the leading cause of type 2 diabetes, also called "diabesity". - Treatment and prevention efforts focused on children and adolescents will be important to addressing globesity long-term.

1. Globesity Today
Richard Shriner, MD

2. Maxwell, K: MED Magazine, Feb 2008, Issue 49
• Term “Globesity” first coined byWorld Health
Organization (WHO) in 2001.
• Term = blend of “global and obesity.”
• WHO claims as of the year 2005, 400 million
worldwide obese, to increase to 700 million by 2015.
• WHO claims that globesity is a worse health risk than
cigarette smoking.
• Globesity = principle cause of type 2 diabetes =
“Diabesity.”

3. NIH CLINICAL GUIDELINES ON THE IDENTIFICATION, EVALUATION, AND TREATMENT OF OVERWEIGHT AND OBESITY IN ADULTS, 1998
• BMI is the widest used measure for obesity.
• A BMI greater than or equal to 30 = obesity.
• Obesity is a major killer worldwide increasing both morbidity
(getting a disease) and mortality (dying from a disease) for the
following diseases:
 Diabetes (type 2 diabetes)
 Heart disease (hypertension/coronary artery disease)
 Stroke
 Liver disease (fatty liver)
 Certain cancers (endometrial, breast, prostate and colon)
 Osteoarthritis
 Sleep apnea
 Hypercholesterolemia

4. J R Soc Med Sh Rep 2012;3:45.
• Worldwide prevalence of obesity (# of cases at a
given time) doubled between 1980 and 2008.
• Worldwide: 10% of men, 14% of women were
obese in 2008.
• In the U.S., 70% adults classified as overweight vs.
25%, 40 years ago.
• Global Disability Adjusted LifeYears (DALYs) for
overweight/obese rivals or exceeds that of tobacco.

5. http://www.cdc.gov/obesity/data/adult.html
• More than a 1/3 of U.S. citizens are obese.
• Medical costs are $1,429/yr. more for obese.
• Non-Hispanic blacks = highest obesity (49.5%),
Mexican Americans (40.4%), non-Hispanic whites
(39.3%).
• No correlation between education and obesity in men,
in women with better education = trend toward less
obesity.
• In 2008 estimated medical costs for obesity = $147
billion.

6. Indian J Med Res. Nov 2010; 132(5): 598–607
• Worldwide over 22 million under age 5 are obese, 1 in 10
children overweight.
• In developing countries children from higher incomes are
more obese, in developed countries opposite occurs with
higher obesity rates in lower incomes.
• Worldwide urbanization (nb. fast food), oversized portions,
high carb beverages, increased television time and more
sedentary lifestyles are associated with higher child and
adolescent obesity.
• Risk of obesity persisting into adulthood is higher among
obese adolescents, some studies suggest 80% overweight
adolescents may become obese adults.

7. Susan Z. Yanovski, M.D., and Jack A. Yanovski, M.D., Ph.D.
N Engl J Med 2011; 364:987-989 March 17, 2011
• CDC NHANES Study reveals prevalence of obesity in women
(35.5%) and child/adolescents from the ages or 2-19 yrs
(16.9%) may be stabilizing over last 10 yrs.
• CDC NHANES Study reveals prevalence of obesity for men
(32.2%) has not changed since 2003.
• CAUTION: prevalence of obesity in heaviest of boys (BMI at
or above 97th
percentile) continues to INCREASE for those in
the CDC NHANES Study.
• Growing evidence that children now have diseases like type 2
diabetes, fatty liver disease, hypertension.
• “The trend toward stabilization of obesity rates could be
temporary.”

8. 1 Zimmermann E, Holst C, Sørensen TIA (2011) Morbidity, Including Fatal Morbidity, Throughout Life in
Men Entering Adult Life as Obese. PLoS ONE 6(4):e18546. doi:10.1371/journal.pone.0018546
2 http://www.rawstory.com/rs/2013/05/29/obesity-growing-fastest-in-africa-and-latin-america-un/
• Some studies argue that men entering adult life obese
have twice the mortality when compared with the
mortality in the underlying population.1
• WHO reports that obesity is growing the fastest in
Africa and Latin America.2
• LatestWHO figures show 1/3 of adults worldwide are
overweight, 1 in 10 are obese.2
• Even if obesity rates are stabilizing in high-income
nations, the rest are seeing obesity rates climb at an
alarming rate as they adoptWestern diets/lifestyles.

9. 1 J Public Health Manag Pract 2013 Jul-Aug;19(4)
2 J Sports Med Phys fitness 2013;53:177-84
• Focus on child and adolescent diet and exercise where early
prevention is key.
• Increase involvement of family and community resources
which have been shown to be of tremendous impact on obesity
outcomes in children and adolescents.1
• Studies have clearly demonstrated that those adolescents who
are engaged earlier in life with leisure time physical activity
(LTPA) may enjoy greater fitness in adulthood.2
• Understand the unique vulnerabilities of adolescents to
addictions3
and the possible contribution of certain addictive
foods toward exacerbating obesity.4
3 Journal of Adolescent Health 52 (2013) S39–S42
4 Avena, N and Gold, M Addiction, 106, 1213–1220

10. • Globesity has the same or greater impact on global
health as cigarette smoking.
• Globesity is the greatest contributor to type 2 diabetes,
one of the major global killers.
• Treatment of children and adolescents will be key to
defeating globesity over time.
• Implementation of modern advances in medicine, such
as the science of food addiction, may offer new hope in
defeating globesity, here, and the world over.