Overweight

by Ylva Köhncke

We eat excessive amounts of fatty and sweet food. Today about two-thirds of the population in the United States of America (USA) is overweight or obese. In Germany more than half of the population suffers from overweight: according to the German Federal Statistical Office, in 2009 sixty per cent of men and forty per cent of women were overweight, with obesity affecting 16 per cent of the adult male population and fourteen per cent of the adult female population. The resulting health implications are enormous.

The World Health Organization (WHO) indicates a worldwide obesity epidemic. According to their data in 2005 more than one billion adults were overweight and more than 300 million people were obese. The trend towards overweight is rising further. Forecasts predict there will 2.3 billion overweight people and 700 million obese people in 2015.

Obesity: an unbalanced world

: An obese adult is classified as having a Body Mass Index equal to or greater than 30. The above figure illustrates countries where over 20 per cent of people suffer from this form of massive overweight. An extensive propagation of obesity is noticeable in particular in North America. Other countries in Europe, South America, Asia, Africa as well as Australia are also affected by the epidemic. The Southern and Western Pacific Islands are extreme cases. In Micronesia, Tonga or on the Cook Islands approximately 70 per cent of the population is obese, and on Samoa and Palau 48 and 43 per cent respectively (Source: World Health Organisation 2005).

Indications suggest life expectancy might soon stop rising as a result of overindulgence. A study under the direction of the American demographer Jay S. Olshansky at the University of Illinois in Chicago has calculated the effects of overweight and obesity (medical term: adipositas) on the demographic development of the United States. Contrary to all expectations, the research unit came to the conclusion that life expectancy in the US will not continue to rise and will decline instead. Primarily on account of the high proportion of overweight children, the risk of suffering from diabetes, heart diseases and other obesity-related conditions at a young age is already increasing to such an extent that it could shorten the lifespan by two to five years over the next 50 years. Obesity would thereby have a greater impact than cancer. Based on these results, for the first time in modern history the younger generation would lead a shorter and less healthy life than their parents.

While some researchers concur with Olshanskys statements, others disapprove claiming his research findings are unrealistic, one-sided and excessively pessimistic, for not every overweight person has to necessarily suffer from a concomitant disease. Nevertheless, the number of massively fat people has skyrocketed over the past 30 years: almost two thirds of Americans are overweight and more than 30 per cent are obese. Impressively, the studies of the National Health and Nutrition Examination Survey (NHANES 2008) confirm these figures.

With some delay, a similar trend is appearing in Germany. This trend is confirmed by the micro-census of the German Federal Statistics Office as well as by findings by the Federal Health Survey of the Robert-Koch-Institute, which since 1998 supplies information updated regularly through telephone health surveys. Both set of data depict the eating habits and determine the weight of German citizens with alarming results. The 2009 results of the German Federal Sta-tistics Office indicate that every second German is overweight, and every sixth is actually obese. Fifteen per cent of the three to seventeen-year olds already suffer from overweight, and as much as six per cent from obesity. Strikingly, 74 per cent of men and 63 per cent of women between the age of 70 and 74 are overweight. Since the first all-German Federal health survey was carried out in 1998 and the micro-census data on overweight has only been collected since 1999 it is difficult to make out a development trend.

Body Mass Index (BMI) in Germany and the USA

: In the US overweight has taken the form of an epidemic. But Germans are likewise becoming fatter. Strikingly, Germany has a slightly higher percentage of overweight people (excluding obese people) in comparison with the US, but a lower proportion of obese people (Sources: World Health Organisation, National Center for Health Statistics, German Federal Statistical Office).

Overweight and obesity are defined via the Body Mass Index (BMI), calculated by taking the person's body weight and dividing it by their height squared. According to the WHO an opti-mal BMI for an adult lies between 18.5 and 24.9. A person is underweight if their BMI falls short of 18.5 and overweight if their BMI oscillates between 25 and 29.9. Obesity begins with a BMI exceeding 30, while a BMI over 40 is defined as morbid obesity. For children and adolescents it is harder to outline a standardised measurement for overweight and obesity. Thus, the BMI is also used in most studies as a measurement tool for non-adults, although gender and age are also taken into account. Non-adults are classified as overweight if their BMI is higher than the BMI of 90 per cent of all non-adults of the corresponding age and gender group. Children and adolescents are classified as obese if their BMI is higher than the BMI of 97 per cent of all children of the same age and sex.

What lies behind such a rise in overweight among all age-groups? On the one hand less heavy physical work and a highly nutritious diet lead to improved living conditions and a longer life. At the same time, however, these factors are the preconditions for overweight and obesity. The increasing motorisation of the everyday life accompanied by physical inactivity do the rest. As a result, people move to a lesser degree and are thereby unable to consume the total amount of calorie intake. Shortness of breath, sweating as well as lower back and joint pain are the first conditions to arise. More serious conditions include accompanying and follow-up illnesses such as high blood pressure, coronary heart diseases and type 2 diabetes. Psychosocial risk factors like anxiety disorders, reduced self-confidence, social isolation, relationship issues and job related problems are also common. Thus, the mortality risk among overweight individuals is far higher than among normal weighting people.

Risks of accompanying and follow-up illnesses according to the WHO 2008

The question as to whether there is an actual decline in the average life expectancy resulting from the constantly rising number of overweight individuals has not yet been examined in sufficient depth. Many factors need to be taken into account such as improved medical treatment, which provides for a longer life. However, it is clear that obesity represents one of the biggest health problems to our society. In view of the numerous cases of childhood and adolescent obesity, a steady rise of follow-up diseases ought to be expected. According to medical doctors, adolescents who in extreme cases are affected from old-age illnesses like joint pain or cardiovascular disorders, stand hardly any chance of reaching age 50 or above.

To avoid the worst and to put a stop to the rising costs deriving from overweight, which today accounts for over six per cent of total health expenditure in the US and between one and five per cent in the European countries, a comprehensive prevention is indispensable. On the one side, it is vital that parents and families fulfil their parental obligations also in the matter of nutrition. On the other side, schools and other institutions play an important role in supplying clarifying information and spreading comprehensive knowledge on health, food and its preparation. Moreover, schools and parents ought to ensure children exercise sufficiently. Finally, the economy and the media are exhorted not to advertise high-energy food products, nor to sell them at rock bottom prices.

Literature / Links:

Benecke, Andrea / Vogel, Heiner (2003): Übergewicht und Adipositas. Gesundheitsberichterstattung des Bundes. Heft 16. Herausgegeben vom Robert-Koch-Institut in Zusammenarbeit mit dem Statistischen Bundesamt. Berlin.

International Association for the Study of Obesity, http://www.iaso.org/.

National Center for Health Statistics, http://www.cdc.gov/nchs.

Olshansky, S. Jay et al. (2005): A Potential Decline in Life Expectancy in the United States in the 21st Century. In: The New England Journal of Medicine 352/11. S. 1138-45.

Robert-Koch-Institut, http://www.rki.de.

Statistisches Bundesamt (2009), http://www.destatis.de.

World Health Organisation (WHO), http://www.who.int.

World Health Organisation Regional Office for Europe, http://www.euro.who.int.