Obesity is a leading risk factor for global mortality, with the World Health Organization (WHO) estimating that 3.4 million people die each year as a result of being overweight or obese. Previously thought of as a problem of high-income countries, obesity is now rising dramatically in low- and middle-income countries, particularly in urban areas. Adult obesity is now more common globally than under-nutrition.
Overweight and obesity increase the risk of a range of non-communicable diseases, including a number of cancers, type 2 diabetes and cardiovascular disease. Globally, it is estimated between 7 and 41% of certain cancer burdens, including those of the bowel, kidney, oesophagus, endometrium and breast (in post-menopausal women) are attributable to overweight and obesity.
Obesity rates have nearly doubled worldwide since 1980. In 2008, it was estimated that more than 1.4 billion adults were overweight, and that over 500 million of these, or more than 10% of the world’s adult population, were obese.
Rising rates of childhood obesity are of particular concern. In 2012, over 40 million children under age five were overweight or obese; more than 30 million of these were living in low- and middle-income countries.
Obesity and overweight primarily result from an imbalance between energy intake and energy expenditure. Globally, changes in modes of work and transport associated with urbanization and development have contributed to decreasing physical activity levels. At the same time there has been an increase in intake of energy-dense food.
Overweight and obesity are largely preventable, yet there are no recognised examples of national success in turning around increases in obesity and diet-related NCDs.
In the 2011 United Nations Political Declaration on NCDs States noted with concern the rising levels of obesity in different regions, particularly among children and youth, and committed to a range of actions to reduce the impact of unhealthy diet and physical inactivity through education, legislative, regulatory and fiscal measures. In 2012, the World Health Assembly (WHA) adopted an overall target of a 25 per cent reduction in premature mortality from NCDs by 2025, and in 2013, the WHA adopted targets related to overweight and obesity, including:
- halting the rise in diabetes and obesity;
- a 10 per cent relative reduction in prevalence of insufficient physical activity;
- a 30 per cent relative reduction in mean population intake of salt; and,
- a 25 per cent relative reduction in the prevalence of raised blood pressure, or contain the prevalence of raised blood pressure, according to national circumstances.
The WHO Global Action Plan for the Prevention and Control of Non-Communicable Diseases (WHO Global Action Plan), endorsed by the World Health Assembly in 2013, calls on Member States to promote healthy diets and physical activity, including by implementing the Global Strategy on Diet, Physical Activity and Health, the Global Strategy for Infant and Young Child Feeding, the Comprehensive implementation plan on maternal, infant and young child nutrition and WHO’s Set of recommendations on the marketing of foods and non-alcoholic beverages to children.
The WHO Global Action Plan provides a portfolio of policy options for Member States, actions to be taken by the WHO secretariat, and proposed actions for international partners to improve diets and physical activity patterns at a population level. Proposed policy options include legal and regulatory interventions on food labelling, pricing, and advertising restrictions to reduce exposure to marketing of unhealthy food and beverages, particularly among children, as part of comprehensive national policies to address overweight and obesity.
The global crisis of childhood obesity and the urgent need for global leadership was recognised at the World Health Assembly (WHA) in 2014, with the announcement of a high-level Commission on Ending Childhood Obesity. The Commission will draw on expert input from a range of disciplines to prepare a report with recommendations on specific approaches and interventions likely to be most effective in reducing childhood obesity in different contexts around the world, and suitable frameworks for monitoring and accountability. The report will be provided to the WHO Director-General in early 2015, so that recommendations can be conveyed to the 2015 session of the WHA.
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