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'{{short description|Recognization of obesity as an epidemic}} {{Human body weight}} {{Image frame |width=520<!-- Must be kept at this size at this point (Dec 2017) --> |content ={{Global Heat Maps by Year| title=| table=Obesity Males.tab | column=percent_overweight| columnName=Rate of BMI>25| year=2014}} |caption=Percentage of males either overweight or obese by year. Click slider to change year.<ref>{{Cite journal |last=Roser |first=Max |last2=Ritchie |first2=Hannah |date=11 August 2017 |title=Obesity |url=https://ourworldindata.org/obesity/ |journal=Our World in Data |access-date=31 December 2017}}</ref> |align=right }} [[File:World map of Male Obesity, 2016.svg|thumb|300px|World obesity prevalence among males.<ref name="WO2016">{{Cite web |url=http://www.worldobesity.org/site_media/library/resource_images/Global_prevalence_of_Adult_Obesity_November_2015_WO_25.11.15.pdf |title=www.worldobesity.org |website=Global prevalence of overweight and obesity |url-status=dead |archive-url=https://web.archive.org/web/20160305000514/http://www.worldobesity.org/site_media/library/resource_images/Global_prevalence_of_Adult_Obesity_November_2015_WO_25.11.15.pdf |archive-date=March 5, 2016 |access-date=Jan 8, 2016}}</ref> {{refbegin|3}} {{legend|#ffff65|<5%}} {{legend|#fff200|5-10%}} {{legend|#ffdc00|10-15%}} {{legend|#ffc600|15-20%}} {{legend|#ffb000|20-25%}} {{legend|#ff9a00|25-30%}} {{legend|#ff8400|30-35%}} {{legend|#ff6e00|35-40%}} {{legend|#ff5800|40-45%}} {{legend|#ff4200|45-50%}} {{legend|#ff2c00|50-55%}} {{legend|#cb0000|>55%}} {{refend}}]] [[File:World map of Female Obesity, 2016.svg|thumb|300px|World obesity prevalence among females.<ref name=WO2016/> {{refbegin|3}} {{legend|#ffff65|<5%}} {{legend|#fff200|5-10%}} {{legend|#ffdc00|10-15%}} {{legend|#ffc600|15-20%}} {{legend|#ffb000|20-25%}} {{legend|#ff9a00|25-30%}} {{legend|#ff8400|30-35%}} {{legend|#ff6e00|35-40%}} {{legend|#ff5800|40-45%}} {{legend|#ff4200|45-50%}} {{legend|#ff2c00|50-55%}} {{legend|#cb0000|>55%}} {{refend}}]] [[Obesity]] has been observed throughout human history. Many early depictions of the human form in art and sculpture appear obese.<ref name="Haslam2007">{{Cite journal |last=Haslam D |date=March 2007 |title=Obesity: a medical history |journal=Obes Rev |volume=8 Suppl 1 |pages=31–6 |doi=10.1111/j.1467-789X.2007.00314.x |pmid=17316298}}</ref> However, it was not until the 20th century that obesity became common — so much so that, in 1997, the [[World Health Organization]] (WHO) formally recognized obesity as a global [[epidemic]].<ref name="Caballero">{{Cite journal |last=Caballero B |year=2007 |title=The global epidemic of obesity: An overview |journal=Epidemiol Rev |volume=29 |pages=1–5 |doi=10.1093/epirev/mxm012 |pmid=17569676 |doi-access=free}}</ref> Obesity is defined as having a [[body mass index]] (BMI) greater than or equal to 30&nbsp;kg/m², and in June 2013 the American Medical Association classified it as a disease, with much controversy.<ref>{{Cite web |url=http://www.ama-assn.org/ama/pub/news/news/2013/2013-06-18-new-ama-policies-annual-meeting.page |title=Proceedings of the 2013 Annual Meeting of the House of Delegates}}</ref> In countries of the Organisation for Economic Co-operation and Development (OECD), one child out of five is overweight or obese.<ref name="OECD2014">{{Cite web |url=http://www.oecd.org/els/health-systems/Obesity-Update-2014.pdf |title=OBESITY Update 2014, Retrieved 25 June 2014.}}</ref> Once considered a problem only of [[World Bank high-income economy|high-income countries]], obesity rates are rising worldwide. Globally, there are now more people who are obese than who are underweight, a trend observed in every region over the world except parts of sub-Saharan Africa and Asia.<ref name=WHOfacts/> In 2013, an estimated 2.1 billion adults were overweight, as compared with 857 million in 1980.<ref name="Lancet 2014">{{Cite journal |last=Ng |first=M. |last2=Fleming |first2=T. |last3=Robinson |first3=M. |last4=Thomson |first4=B. |last5=Graetz |first5=N. |last6=Margono |first6=C. |last7=Mullany |first7=E. C. |last8=Biryukov |first8=S. |last9=Abbafati |first9=C. |last10=Abera |first10=S. F. |last11=Abraham |first11=J. P. |displayauthors=29 |date={{date|May 29, 2014}} |title=Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: A systematic analysis for the Global Burden of Disease Study 2013 |journal=[[The Lancet]] |volume=384 |issue=9945 |pages=766–781 |doi=10.1016/S0140-6736(14)60460-8 |issn=0140-6736 |pmc=4624264 |pmid=24880830 |last12=Abu-Rmeileh |first12=N. M. E. |last13=Achoki |first13=T. |last14=Albuhairan |first14=F. S. |last15=Alemu |first15=Z. A. |last16=Alfonso |first16=R. |last17=Ali |first17=M. K. |last18=Ali |first18=R. |last19=Guzman |first19=N. A. |last20=Ammar |first20=W. |last21=Anwari |first21=P. |last22=Banerjee |first22=A. |last23=Barquera |first23=S. |last24=Basu |first24=S. |last25=Bennett |first25=D. A. |last26=Bhutta |first26=Z. |last27=Blore |first27=J. |last28=Cabral |first28=N. |last29=Nonato |first29=I. C. |last30=Chang |first30=J. C.}}</ref> Of adults who are overweight, 31% are obese.<ref name="WHOfacts">World Health Organization, [http://www.who.int/mediacentre/factsheets/fs311/en/ Obesity and overweight.] Fact sheet, updated June 2016. Geneva. Retrieved 22 Sept 2017.</ref> Increases in obesity have been seen most in urban settings.<ref name="WHO2000">{{Cite book |last=World Health Organization |url=http://whqlibdoc.who.int/trs/WHO_TRS_894_(part1).pdf |title=Technical report series 894: Obesity: Preventing and managing the global epidemic. |publisher=World Health Organization |year=2000 |isbn=978-92-4-120894-9 |location=Geneva}}</ref> Since body fat can be measured in several ways, statistics on the epidemiology of obesity vary between sources. While BMI is the most basic and commonly used indicator of obesity, other measures include waist circumference, waist-to-hip ratio, skinfold thicknesses, and bioelectrical impedance.<ref>Harvard T.H. Chan School of Public Health, [https://www.hsph.harvard.edu/obesity-prevention-source/obesity-definition/how-to-measure-body-fatness/ Obesity Prevention Source.] Boston. Retrieved 22 Sept 2017.</ref> The rate of obesity increases with age at least up to 50 or 60&nbsp;years old.<ref name="Kopelman2005">{{Cite book |last=Peter G. Kopelman |url=https://books.google.com/?id=u7RvldSr5M0C |title=Clinical obesity in adults and children: In Adults and Children |last2=Ian D. Caterson |last3=Michael J. Stock |last4=William H. Dietz |publisher=Blackwell Publishing |year=2005 |isbn=978-1-4051-1672-5 |page=493}}</ref> ==Africa== {{See also|Obesity in the Middle East and North Africa}} Obesity rates in Western Africa are estimated to be 10%. Rates of obesity among women are three times those found in men. In urban West Africa rates of obesity have more than doubled in the last 15 years.<ref>{{Cite journal |vauthors=Abubakari AR, Lauder W, Agyemang C, Jones M, Kirk A, Bhopal RS |date=July 2008 |title=Prevalence and time trends in obesity among adult West African populations: a meta-analysis |journal=Obes Rev |volume=9 |issue=4 |pages=297–311 |doi=10.1111/j.1467-789X.2007.00462.x |pmid=18179616}}</ref> ===Egypt=== In Egypt, according to data from the 2016 Global Burden of Disease study, overweight and obesity (as measured by high BMI) was the country's leading risk factor driving the most death and disability combined.<ref>Institute for Health Metrics and Evaluation, [http://www.healthdata.org/egypt Global Burden of Disease Study 2016.] Washington. Retrieved 22 Sept 2017.</ref> == Asia == ===China=== {{main|Obesity in China}} China is currently facing challenges of overnutrition.<ref name=FAOChina/> This is believed to be primarily due to the rapid declines in physical activity and changing dietary habits which have occurred between the 1980s and the 2000s. The decline in physical activity is attributed to increasing technology in the workplace and changing leisure activities.<ref name="FAOChina">{{Cite web |url=http://www.fao.org/docrep/009/a0442e/a0442e06.htm |title=The double burden of malnutrition Case studies from six developing countries |website=Food and Agricultural Organization of the UN |access-date=January 11, 2009}}</ref> In 1989 65% of Chinese had jobs that required heavy labor. This decreased to 51% in the year 2000.<ref name=FAOChina/> Combined with this has been a change to a diet higher in meat and oil,<ref name=FAOChina/> and an increase in overall available calories.<ref name="faoChina2">{{Cite web |url=http://www.fao.org/statistics/compendium_2006/pdf/CPR_ESS_E.pdf |title=www.fao.org |website=Food and Agricultural Organization of the UN |url-status=dead |archive-url=https://web.archive.org/web/20090114202148/http://www.fao.org/statistics/compendium_2006/pdf/CPR_ESS_E.pdf |archive-date=2009-01-14}}</ref> Available calories per person increased from {{convert|2330|kcal|kJ}} per day in 1980 to {{convert|2940|kcal|kJ}} per day in 2002.<ref name=faoChina2/> Rates of overweight and obese adults increased 12.9% in 1991 to 27.3% in 2004.<ref>{{Cite news |last=Popkin |first=Barry |url=http://www.scientificamerican.com/podcast/episode.cfm?id=8DFF8662-E7F2-99DF-38E67664ABFF1D05 |title=The World Is Fat |date=August 22, 2007 |work=Scientific American |access-date=2008-07-24 |page=94 |issn=0036-8733}}</ref> Overall rates of obesity are below 5% in China as a whole but are greater than 20% in some cities.<ref>{{Cite web |url=http://www.who.int/dietphysicalactivity/media/en/gsfs_obesity.pdf |title=www.who.int |website=WHO |access-date=February 22, 2009}}</ref> ===India=== {{main|Obesity in India}} [[Obesity]] has reached epidemic proportions in [[India]] in the 21st century, with morbid obesity affecting 5% of the country's population.<ref>{{Cite news |url=http://hindu.com./2007/10/12/stories/2007101260940600.htm |title=India facing obesity epidemic: experts |date=2007-10-12 |work=[[The Hindu]]}}</ref> Obesity is a major risk factor for cardiovascular disease and NGOs such as the [[Indian Heart Association]] have been raising awareness about this issue.<ref name="Indian Heart">Indian Heart Association Webpage 30 April 2015. <http://indianheartassociation.org/></ref> Urbanization and modernization has been associated with obesity.<ref name="India2008">{{Cite journal |vauthors=Yadav K, Krishnan A |date=September 2008 |title=Changing patterns of diet, physical activity and obesity among urban, rural and slum populations in north India |journal=Obes Rev |volume=9 |issue=5 |pages=400–8 |doi=10.1111/j.1467-789X.2008.00505.x |pmid=18627500}}</ref> In Northern India obesity was most prevalent in urban populations (male = 5.5%, female = 12.6%), followed by the urban slums (male = 1.9%, female = 7.2%). Obesity rates were the lowest in rural populations (male = 1.6%, female = 3.8%).<ref name=India2008/> Socioeconomic class also had an effect on the rate of obesity. Women of high socioeconomic class had rates of 10.4% as opposed to 0.9% in women of low socioeconomic class.<ref>{{Cite web |url=http://www.iussp.org/Bangkok2002/S7Agrawal.pdf |title=Emerging obesity in northern Indian states: A serious threat for health |last=Praween Kumar Agrawal |date=2002-05-23 |publisher=IUSSP Conference, Bankik, 10 June–12-2002 |access-date=2008-07-24}}</ref> With people moving into urban centers and wealth increasing, concerns about an obesity epidemic in India are growing. ===Iran=== In Iran the prevalence of obesity was 26.3% in 2008. Prevalence of obesity was more among women (39.5%) than men (14.5%).<ref>{{Cite journal |vauthors=Rashidy-Pour A, Malek M, Eskandarian R, Ghorbani R |date=January 2009 |title=Obesity in the Iranian population |journal=Obes Rev |volume=10 |issue=1 |pages=2–6 |doi=10.1111/j.1467-789X.2008.00536.x |pmid=19021868}}</ref> ===Japan=== Using the WHO criteria Japan has the lowest rate of obesity among the [[Organisation for Economic Co-operation and Development|OECD]] member countries at 3.2%.<ref name="OECD"/><ref>Harden, Blaine, "Japanese Women Buck Obesity Trend", ''[[Washington Post]]'', March 10, 2010.</ref> However, as Asian populations are particularly susceptible to the health risks of excess [[adipose tissue]] the Japanese have redefined obesity as any BMI greater than 25.<ref>{{Cite journal |last=Anuurad E |last2=Shiwaku K |last3=Nogi A |last4=Kitajima |first4=Keiko |last5=Enkhmaa |first5=Byambaa |last6=Shimono |first6=Kumiko |last7=Yamane |first7=Yosuke |displayauthors=3 |date=November 2003 |title=The new BMI criteria for asians by the regional office for the western pacific region of WHO are suitable for screening of overweight to prevent metabolic syndrome in elder Japanese workers |journal=J Occup Health |volume=45 |issue=6 |pages=335–43 |doi=10.1539/joh.45.335 |pmid=14676412 |doi-access=free}}</ref> Using this cut off value the prevalence of obesity in Japan would be 20%, a threefold increase from 1962 to 2002.<ref>{{Cite journal |vauthors=Kanazawa M, Yoshiike N, Osaka T, Numba Y, Zimmet P, Inoue S |date=December 2002 |title=Criteria and classification of obesity in Japan and Asia-Oceania |journal=Asia Pac J Clin Nutr |volume=11 Suppl 8 |pages=S732–S737 |doi=10.1046/j.1440-6047.11.s8.19.x |pmid=12534701}}</ref> A 2008 report stated that 28.6% of men and 20.6% of women in Japan were considered to be obese.<ref>Fukue, Natsuko, "[http://search.japantimes.co.jp/cgi-bin/nn20100309i1.html TV gets fickle fans flocking to fads to shed fat]", ''[[Japan Times]]'', March 9, 2010, p. 3.</ref> ===Pakistan=== {{main|Obesity in Pakistan}} Changing lifestyles, owing to urbanisation, as well as diet issues are the main reasons for obesity in Pakistan. According to a recent study, approximately one out of four Pakistani adults (or 22.2% of individuals) are classified as obese.<ref>{{Cite news |url=http://gulfnews.com/news/world/pakistan/one-in-four-adults-is-overweight-or-clinically-obese-1.271000 |title=One in four adults is overweight or clinically obese |date=December 17, 2006 |work=[[Gulf News]]}}</ref><ref>{{Cite web |url=https://www.forbes.com/2007/02/07/worlds-fattest-countries-forbeslife-cx_ls_0208worldfat_2.html |title=World's Fattest Countries |last=Streib |first=Lauren |date=2 August 2007 |website=Forbes}}</ref> ===Taiwan=== In 2002, 15% of children from 6 to 12 years of age were overweight; by gender, 15.5% of males and 14.4% of females were overweight. In the same age range, 12% of children were obese; by gender, 14.7% of males and 9.1% of females were categorized as obese. In 2005, 14.9% children from 6 to 12 years of age were overweight; by gender, 15.85% of males and 14.02% of females were overweight. 10.3% were categorized as obese; by gender, 10.92% of males and 9.73% of females were categorized as obese. Based on these numbers, the trends were inconclusive, although with more than 10% of the age group being obese, obesity does appear to be a problem.<ref name="Child Obesity">{{Cite web |url=http://www.bhp.doh.gov.tw/asp/press/file/200744164312LIAOIB/960404-%E5%81%A5%E5%BA%B7%E5%B1%80-%E5%85%92%E7%AB%A5%E8%82%A5%E8%83%96%E9%99%84%E4%BB%B6.doc |title=肥胖防治要從小紮根 |last=Committee for Health and Development Promotion for Children(兒童健康推展委員會) |date=April 4, 2007 |publisher=Ministry of Health Promotion, Department of Health, Taiwan (R.O.C.)}}{{Dead link|date=December 2019 |bot=InternetArchiveBot |fix-attempted=yes }}</ref> == Europe == [[File:Obesitas in Nederland onder volwassenen (20+) 1981-2006.jpg|thumb|350px|Rates of obesity in the Netherlands between 1981 and 2006.]] Between the 1970s and the 2000s, rates of obesity in most European countries have increased. During the 1990s and 2000s, the 27 countries making up the EU reported rates of obesity from 10–27% in men and from 10–38% in women.<ref>{{Cite book |last=Tim Lobstein |url=http://ec.europa.eu/health/ph_determinants/life_style/nutrition/documents/iotf_en.pdf |title=EU platform on diet, physical activity and health: International Obesity Task Force EU Platform Briefing Paper |last2=Neville Rigby |last3=Rachel Leach |date=2005-03-15 |publisher=International Obesity Task Force |access-date=2008-07-23}}</ref> The most recent combined [[Eurostat]] statistics, for 2009, show that, among the 19 EU Member States for which data are available, the proportion of obese people in the adult population varied in 2008/9 between 8.0% (Romania) and 23.9% (UK) for women and between 7.6% (Romania) and 24.7% (Malta) for men. Overall the UK had the highest proportions, and Romania the lowest. Men, the elderly and people with lower educations also have significantly higher obesity rates.<ref name="epp.eurostat.ec.europa.eu">[http://epp.eurostat.ec.europa.eu/statistics_explained/index.php/Overweight_and_obesity_-_BMI_statistics Eurostat – Statistics Explained: Overweight and obesity – BMI_statistics, see 'Source data for tables, figures and maps']</ref> ===United Kingdom=== {{Main|Obesity in the United Kingdom}} In the UK the rate of obesity has increased about fourfold over the last 30 years, reaching levels of 22–24% in 2008/9.<ref name=Kopelman2005/><ref name="epp.eurostat.ec.europa.eu" /> The United Kingdom now has the highest rate of obesity in Europe. {| class="wikitable" |- ! Year ! Percent males obese ! Percent females obese |- | 1980 | 6% | 8% |- | 1993 | 13% | 16% |- | 2000 | 21% | 21% |- | 2008/9 | 22% | 24% |}<ref name =GB2004>{{cite book |author=Great Britain Parliament House of Commons Health Committee |title=Obesity – Volume 1 – HCP 23-I, Third Report of session 2003–04. Report, together with formal minutes |url=https://publications.parliament.uk/pa/cm200304/cmselect/cmhealth/23/2302.htm |accessdate=2007-12-17|date=May 2004|publisher=TSO (The Stationery Office) |location=London, UK |isbn=978-0-215-01737-6}}</ref> == North America == [[File:Obesity country comparison - path.svg|thumb|300px|Obesity rates as a percentage of total population in [[Organisation for Economic Co-operation and Development|OECD]] member countries in the years 1996–2003 (According to [[Body mass index|BMI]]).<ref name=OECD>{{cite book | author=Anon | title=OECD Factbook: Economic, Environmental and Social Statistics | publisher=Organization for Economic Co-operation and Development| year=2005 | isbn=978-92-64-01869-3}}</ref>]] Epidemiological data show that, among high-income countries, obesity prevalence is highest in the United States and Mexico.<ref name=OECD2014/> ===Canada=== {{main|Obesity in Canada}} The number of Canadians who are obese has risen dramatically in recent years. In 2004, direct measurements of height and weight found 23.1% of Canadians older than 18 had a BMI greater than 30. When broken down into degrees of obesity, 15.2% were class I (BMI 30–34.9), 5.1% were class II (BMI 35–39.9), and 2.7%, class III (BMI > 40). This is in contrast to self-reported data the previous year of 15.2% and in 1978/1979 of 13.8%. The greatest increases occurred among the more severe degrees of obesity; class III obesity increased from 0.9% to 2.7% from 1978/1979 to 2004. Obesity in Canada varies by ethnicity; people of Aboriginal origin have a significantly higher rate of obesity (37.6%) than the national average.<ref name=Tjepkema2005>{{cite book | author=Tjepkema M | chapter=Measured Obesity–Adult obesity in Canada: Measured height and weight | title=Nutrition: Findings from the Canadian Community Health Survey | publisher=Statistics Canada | date=2005-07-06 | location=Ottawa, Ontario | chapter-url=http://www.statcan.ca/english/research/82-620-MIE/2005001/articles/adults/aobesity.htm}}</ref> In children obesity has substantially increased between 1989 and 2004 with rates in boys increasing from 2% to 10% and rates among girls increasing from 2% to 9%.<ref>{{cite journal |vauthors=Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E |title=2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children summary |journal=CMAJ |volume=176 |issue=8 |pages=S1–13 |date=April 2007 |pmid=17420481 |pmc=1839777 |doi=10.1503/cmaj.061409 |url=}}</ref> ===Mexico=== {{main|Obesity in Mexico}} Mexico has one of the highest rates of obesity among [[OECD]] countries, second only to the United States. To combat the epidemic, in 2014 Mexico implemented new taxes levied on food with excessive energy content and on sugar-sweetened beverages.<ref name=OECD2014/> ===United States=== {{main|Obesity in the United States}} [[File:Obesity state level estimates 1985-2010.gif|thumb|250px|The increase in obesity rates in the US as seen from 1985 to 2010 to the point where every state has at least a 20% obesity rate has caused it to become a significant focus of public health in recent years.]] [[File:USA Obesity 2011.svg|thumb|250px|The percent of people per state with a BMI greater than 30 from 2011.<ref name="CDC Obesity">{{cite web|url= https://www.cdc.gov/obesity/data/trends.html#State|title= Obesity and Overweight for Professionals: Data and Statistics: Adult Obesity Facts|date= 2012-08-13|accessdate= 2012-11-05|publisher= [[Centers for Disease Control and Prevention]]|archive-url= https://web.archive.org/web/20090825130031/http://www.cdc.gov/obesity/data/trends.html#State|archive-date= 2009-08-25|url-status= dead}}</ref> {{refbegin|2}} {{legend|#ff6600|> 30%}} {{legend|#ff9400|25% to < 30%}} {{legend|#fec500|20% to < 25%}} {{legend|#ffff00|15% to < 20%}} {{legend|#8cc700|10% to < 15%}} {{legend|#0fad00|< 10%}} {{legend|#999999|No Data}}{{refend}}]] Obesity rates in the United States have nearly tripled since the 1960s. In 1962, about 13% of adult Americans were obese,<ref name="cdc_2010">https://www.cdc.gov/nchs/data/hus/2010/071.pdf</ref> and by 2002, obesity rates reached 33% of the adult population.<ref name="pmid16595758">{{cite journal |vauthors=Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM |title=Prevalence of overweight and obesity in the United States, 1999–2004 |journal=JAMA |volume=295 |issue=13 |pages=1549–55 |year=2006 |pmid=16595758 |doi=10.1001/jama.295.13.1549|doi-access=free }}</ref> According to the National Health and Nutrition Examination Study collected between the 1970s and 2004, the prevalence of overweight and obesity increased steadily among all groups of Americans.<ref>{{cite journal | author=National Institutes of Health |year=1998 |title=Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report |url=http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf |journal=Obesity Research |volume= 6 |issue=Suppl 2 |page=51S }}</ref><ref>{{cite journal | doi = 10.1001/jama.295.13.1549 | last1 = Ogden | first1 = CL | last2 = Carroll | first2 = MD | last3 = Curtin | first3 = LR | last4 = McDowell| year = 2006 | first4 = MA | last5 = Tabak | first5 = CJ | last6 = Flegal | first6 = KM | title = Prevalence of overweight and obesity in the United States, 1999–2004 | url = | journal = JAMA | volume = 295 | issue = 13| pages = 1549–1555 | pmid = 16595758 | doi-access = free }}</ref> The numbers continue to rise; as of 2007, 33% of men and 36% of women were obese,<ref name=Ben2008/> and by 2015–2016, 39.6% of the total adult population (37.9% of men and 41.1% of women) had obesity.<ref>{{Cite journal|last=Hales|first=Craig M.|last2=Carroll|first2=Margaret D.|last3=Fryar|first3=Cheryl D.|last4=Ogden|first4=Cynthia L.|date=October 2017|title=Prevalence of Obesity Among Adults and Youth: United States, 2015–2016|journal=NCHS Data Brief|issue=288|pages=1–8|issn=1941-4927|pmid=29155689}}</ref> Obesity rates vary between diverse social groups, with some racial groups and low-income individuals more likely to be obese while other minorities show lower rates. As of 2014 the rates were as low as 12% for non-Hispanic Asian women and as high as 57% among African American women.<ref>{{cite web |url=http://ec.europa.eu/health/ph_determinants/life_style/nutrition/documents/iotf_en.pdf |title=International Obesity Task Force |accessdate=2008-09-19 |website= |date=March 15, 2005 }}</ref><ref>{{cite journal|last1=Flegal|first1=KM|last2=Kruszon-Moran|first2=D|last3=Carroll|first3=MD|last4=Fryar|first4=CD|last5=Ogden|first5=CL|title=Trends in Obesity Among Adults in the United States, 2005 to 2014.|journal=JAMA|date=7 June 2016|volume=315|issue=21|pages=2284–91|doi=10.1001/jama.2016.6458|pmid=27272580|doi-access=free}}</ref> The incidence of obesity also varies with geography. The American South has been referred to as the "[[Stroke belt]]", "Obesity belt", or "Diabetes belt", to reflect the fact that residents of the region have high rates of these three conditions, compared to people of the same race/ethnicity elsewhere in the country.<ref>{{cite news|url=http://articles.latimes.com/2011/mar/08/news/lat-diabetes-belt-20110308|title=Diabetes belt: American South gets more health notoriety | work=Los Angeles Times | first=Melissa|last=Healy|date=2011-03-08}}</ref> Based on a study in 2008, estimates of obesity that rely on self-reported data arrive at a rate of 22% among non-Hispanic white females, whereas studies that involve direct measurement show that the rate was closer to 34% at that time.<ref>{{cite web|url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5827a2.htm#tab1|title=Prevalence of obesity among adults, by black/white race or Hispanic ethnicity, census region, and sex – Behavioral Risk Factor Surveillance System surveys, United States, 2006–2008}}</ref> The prevalence of class III (morbid) obesity (BMI ≥40) has increased the most dramatically, from 1.3% in the late 1970s,<ref name="FinkelsteinRuhm2005">{{cite journal|vauthors=Finkelstein EA, Ruhm CJ, Kosa KM|title=Economic Causes and Consequences of Obesity|journal=Annual Review of Public Health|volume=26|issue=1|year=2005|pages=239–257|issn=0163-7525|doi=10.1146/annurev.publhealth.26.021304.144628|pmid=15760288|doi-access=free}}</ref> to 2.9% in 1988-94, to 4.7% in 2000,<ref>{{cite journal|title=Prevalence and Trends in Obesity Among US Adults, 1999-2000|pmid=12365955|doi=10.1001/jama.288.14.1723|year=2002|last1=Flegal|first1=KM|last2=Carroll|first2=MD|last3=Ogden|first3=CL|last4=Johnson|first4=CL|volume=288|issue=14|pages=1723–7|journal=JAMA: The Journal of the American Medical Association|doi-access=free}}</ref> to 5.7% in 2008, and to 7.7% in 2014.<ref>{{cite journal|last1=Flegal|first1=KM|last2=Kruszon-Moran|first2=D|last3=Carroll|first3=MD|last4=Fryar|first4=CD|last5=Ogden|first5=CL|title=Trends in Obesity Among Adults in the United States, 2005 to 2014.|journal=JAMA|date=7 June 2016|volume=315|issue=21|pages=2284–91|doi=10.1001/jama.2016.6458|pmid=27272580|doi-access=free}}</ref> Among African American women, its prevalence is estimated to be as high as 17%.<ref>{{cite journal|last1=Flegal|first1=KM|last2=Kruszon-Moran|first2=D|last3=Carroll|first3=MD|last4=Fryar|first4=CD|last5=Ogden|first5=CL|title=Trends in Obesity Among Adults in the United States, 2005 to 2014.|journal=JAMA|date=7 June 2016|volume=315|issue=21|pages=2284–91|doi=10.1001/jama.2016.6458|pmid=27272580|doi-access=free}}</ref> The rate of increase in the incidence of obesity began to slow in the 2000s, but as of 2014, obesity, severe obesity, and obesity in children continued to rise.<ref name=Ben2008>{{cite journal |author=Bessesen DH |title=Update on obesity |journal=J. Clin. Endocrinol. Metab. |volume=93 |issue=6 |pages=2027–34 |date=June 2008 |pmid=18539769 |doi=10.1210/jc.2008-0520 |url=|doi-access=free }}</ref><ref>{{cite journal|last1=Flegal|first1=KM|last2=Kruszon-Moran|first2=D|last3=Carroll|first3=MD|last4=Fryar|first4=CD|last5=Ogden|first5=CL|title=Trends in Obesity Among Adults in the United States, 2005 to 2014.|journal=JAMA|date=7 June 2016|volume=315|issue=21|pages=2284–91|doi=10.1001/jama.2016.6458|pmid=27272580|doi-access=free}}</ref> [[File:USObesityRate1960-2004.svg|thumb|250px|Prevalence of obesity between 1960 and 2004 in the USA.]] [[Obesity]] is one of the leading health issues in the United States, resulting in about 300,000 excess deaths per year.<ref>{{cite journal | last1 = Allison | first1 = DB | last2 = Fontaine | first2 = KR | last3 = Manson | first3 = JR. | year = 1999 | title = Annual deaths attributable to obesity in the United States | url = | journal = JAMA | volume = 282 | issue = 16 | pages = 1530–8 | doi = 10.1001/jama.282.16.1530 |pmid=10546692 | last4 = Stevens | first4 = J | last5 = Vanitallie | first5 = TB | doi-access = free }}</ref> However, in 2005 using different methodology, research at the [[Centers for Disease Control and Prevention]] produced a nationwide estimate of 129,000 excess deaths per year relative to individuals with a BMI of 21 to 25.<ref>{{cite journal | author = Flegal Katherine M. | year = 2005 | title = Excess Deaths Associated with Underweight, Overweight, and Obesity | url = | journal = Journal of the American Medical Association | volume = 293 | issue = 15| pages = 1861–67 | doi=10.1001/jama.293.15.1861 | pmid=15840860|display-authors=etal| doi-access = free }}</ref> ==South America and the Caribbean== Surveys in different Caribbean countries found that 7-20% of males and 22-48% of females over the age of 15 are obese.<ref>http://www.uwi.edu/opencampus/ccdc/downloads/researchpapers/obesity%20in%20caribbean%20children.pdf</ref> Trinidad and Tobago has the highest obesity in the Caribbean, with over 30% of its adult population overweight, ranking the country sixth in the world.<ref>{{Cite web | url=http://www.caribbean360.com/news/trinidad_tobago_news/trinidad-tops-obesity-list-in-the-caribbean |title = Trinidad tops obesity list in the Caribbean}}</ref> The Bahamas have a major obesity epidemic: 48.6% of people between 15 and 64 years old are obese.<ref>"The Bahamas." FAO – Nutrition Country Profiles. FOOD AND AGRICULTURE ORGANIZATION OF THE UNITED NATIONS, 1 Aug. 2003. Web. 26 Feb. 2015. <ftp://ftp.fao.org/ag/agn/nutrition/ncp/bhsmap.pdf{{Dead link|date=April 2020 |bot=InternetArchiveBot |fix-attempted=yes }}></ref> A female adolescent from the Bahamas is more likely to be overweight than her male counterpart. In Jamaica, 7.2% of men over the age of 20 are obese, while 31.5% of women are obese.<ref>"FAO – NUTRITION COUNTRY PROFILES." Jamaica. FOOD AND AGRICULTURE ORGANIZATION OF THE UNITED NATIONS, 1 Aug. 2003. Web. 26 Jan. 2015. <http://www.fao.org/docrep/017/aq027e/aq027e.pdf></ref> == Oceania and the Pacific == [[File:Anglosphere 2007 overweight rate.png|thumb|360px|According to 2007 statistics from the World Health Organization (WHO), Australia has the third-highest prevalence of overweight adults in the [[English-speaking world]].<ref name="forbes"/>]] ===Australia=== {{Main|Obesity in Australia}} According to self-reported and measured results of the 2007–2008 National Health Survey, 61% of Australians were overweight (above a 25 [[body mass index|BMI]]), with 24% falling into the "obese" category (above a 30 BMI). Men were more likely to be overweight (67.7%) and obese (25.5%) than women (30.9% and 23.4% respectively).<ref name="stats">{{cite web|url=http://www.aihw.gov.au/diabetes-indicators/overweight-and-obesity/ |title=Body section (Overweight and Obesity 2007–08) |format=PDF |accessdate=2012-03-19}}</ref> ===New Zealand=== {{main|Obesity in New Zealand}} Obesity in New Zealand has become an important national health concern in recent years, with high numbers of people afflicted in every age and ethnic group.<ref name="development">{{cite web |url=http://www.socialreport.msd.govt.nz/health/obesity.html|title=Obesity – Social Report 2008|accessdate=2009-07-05|date=June 1, 2008|website= |publisher=Ministry of Social Development}}</ref> In 2011/12, 28.4% of New Zealand adults were obese,<ref>{{cite book|last=Ministry of Health|title=The Health of New Zealand Adults 2011/12|year=2012|publisher=Ministry of Health|location=Wellington}}</ref> a number only surpassed in the [[English-speaking world]] by the [[Obesity in the United States|United States]].<ref name="forbes">{{cite news |url= https://www.forbes.com/2007/02/07/worlds-fattest-countries-forbeslife-cx_ls_0208worldfat_2.html|title= World's Fattest Countries|accessdate=2009-02-12 |author= Lauren Streib|date= February 8, 2007|work=Forbes}}</ref><ref name="development" /> ===South Pacific=== {{main|Obesity in the Pacific}} {{see also|Obesity in Nauru}} Many of the island nations of the South Pacific have very high rates of obesity. [[Nauru]] has the highest rates of obesity in the world (94.5%) followed by [[Samoa]], the [[Federated States of Micronesia]], and the [[American Samoa]]. Being big has traditionally been associated with health, beauty, and status and many of these beliefs remain prevalent today.<ref>{{cite web |url=http://raspberryketonesfresh.com/obesityinthepacific.pdf |title=Obesity in the Pacific Too Big To Ignore |accessdate=2008-09-30 |work=Secretariat of the Pacific Community |publisher=WHO |year=2002 }}</ref> ==See also== *[[Epidemiology of childhood obesity]] *[[Epidemiology of metabolic syndrome]] *[[Obesogen]] *[[The Big Issue (website)|''The Big Issue'']] ==References== {{Reflist|colwidth=30em}} == External links == *[http://apps.who.int/bmi/ World Health Organisation Global Database on Body Mass Index] * {{cite book|last=Ogden|first=Cynthia L.|title=Prevalence of obesity among adults: United States, 2011–2012|year=2013|publisher=[[United States Department of Health and Human Services|U.S. Department of Health and Human Services]], [[Centers for Disease Control and Prevention]], [[National Center for Health Statistics]] |location=Hyattsville, Md. |url=https://purl.fdlp.gov/GPO/gpo41786|display-authors=etal}} {{Africa topic|Obesity in}} {{Asia topic|Obesity in}} {{Europe topic|Obesity in}} {{North America topic|Obesity in}} {{Oceania topic|Obesity in}} {{South America topic|Obesity in}} {{Global epidemiology}} {{DEFAULTSORT:Epidemiology Of Obesity}} [[Category:Obesity]] [[Category:Epidemiology|Obesity]]'