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Mathematical modelling of social

obesity epidemic in the region of
Valencia, Spain
a b b
F.-J. Santonja , R.-J. Villanueva , L. Jódar & G. Gonzalez-
c
Parra
a
Departamento de Estadística e Investigación Operativa ,
Universidad de Valencia , Valencia, España
b
Instituto de Matemática Multidisciplinar, Universidad Politécnica
de Valencia , Valencia, España
c
Departamento de Cálculo , Universidad de los Andes , Mérida,
Venezuela
Published online: 25 Feb 2010.

To cite this article: F.-J. Santonja , R.-J. Villanueva , L. Jódar & G. Gonzalez-Parra (2010)
Mathematical modelling of social obesity epidemic in the region of Valencia, Spain, Mathematical
and Computer Modelling of Dynamical Systems: Methods, Tools and Applications in Engineering and
Related Sciences, 16:1, 23-34, DOI: 10.1080/13873951003590149

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 Mathematical and Computer Modelling of Dynamical Systems
Vol. 16, No. 1, February 2010, 23–34

Mathematical modelling of social obesity epidemic

in the region of Valencia, Spain
F.-J. Santonjaa*, R.-J. Villanuevab, L. Jódarb and G. Gonzalez-Parrac
a
Departamento de Estadística e Investigación Operativa, Universidad de Valencia, Valencia, España;
b
Instituto de Matemática Multidisciplinar, Universidad Politécnica de Valencia, Valencia, España;
Downloaded by [Ondokuz Mayis Universitesine] at 06:07 13 November 2014

c
Departamento de Cálculo, Universidad de los Andes, Mérida, Venezuela
(Received 11 March 2009; final version received 23 November 2009)

In this article, we analyse the incidence of excess weight in 24- to 65-year-old residents in
the region of Valencia, Spain, and predict its behaviour in the coming years. In addition,
we present some possible strategies to prevent the spread of the obesity epidemic.
We use classical logistic regression analysis to find out that a sedentary lifestyle and
unhealthy nutritional habits are the most important causes of obesity in the 24- to 65-year-
old population in Valencia. We propose a new mathematical model of epidemiological
type to predict the incidence of excess weight in this population in the coming years.
Based on the mathematical model sensitivity analysis, some possible general strategies to
reverse the increasing trend of obesity are suggested.
The obese population in the region of Valencia is increasing (11.6% in 2000 and
13.48% in 2005) and the future is worrisome. Our model predicts that 15.52% of the
population in Valencia will be obese by 2011. Model sensitivity analysis suggests that
obesity prevention strategies (healthy advertising campaigns) are more effective than
obesity treatment strategies (physical activity) involving the obese and overweight
subpopulation in controlling the increase of adulthood obesity in the region of Valencia.
Keywords: preventing adulthood obesity; mathematical modelling; differential equa-
tions; dynamical system; mathematical simulation
AMS Subject Classification: 37N25;81T80;91D10;91B74;93A30.

1. Introduction
Being overweight and obesity are important problems in developed countries, and are
becoming a serious health concern not only from the individual-health point of view but
also from a public socioeconomic one. In [1], SEEDO (Spanish Society for the Study of
Obesity) indicates the importance of addressing it on a high-priority basis: on the one hand,
evaluating its magnitude and determining factors, and, on the other hand, trying to start up
effective strategies that allow the reverse of its tendency to increase, in the coming years.
In recent times, obesity has been considered a social epidemic [2]. The main idea behind
this obesity epidemic is that fatness can spread from one person to another. In [3] there
is consistent evidence that obesity is a health concern that spreads by social peer pressure or
social contact. The authors find that gains in weight appear to spread through a population
(with friends and relatives apparently influencing other friends and relatives, for example)
in a way reminiscent of a contagious disease [4]. In [5,6] the authors assume that people

*Corresponding author. Email: francisco.santonja@uv.es

ISSN 1387-3954 print/ISSN 1744-5051 online

© 2010 Taylor & Francis
DOI: 10.1080/13873951003590149
http://www.informaworld.com
 24 F.-J. Santonja et al.

like to have a weight close to other people’s weight. In addition, in [7] it is argued that people
rationally choose a weight after observing the weights of their peers. Moreover, in [4] cross-
sectional evidence that overweight perceptions and dieting are influenced by a person’s
relative BMI and longitudinal evidence that well-being is influenced by relative BMI are
provided.
In this article we assume the challenge posed in [1] regarding the prevalence of obesity
and the strategies to reduce it. We study the evolution of the 24- to 65-year-old overweight
and obese populations of the region of Valencia, Spain, in the coming years. The main aim of
this article is to predict the future prevalence of excess weight (overweight and obesity) in
24- to 65-year-olds from the region of Valencia, Spain, and to propose strategies to reduce it.
In addition, we identify sedentary lifestyle and unhealthy nutritional habits as the most
important predictive factors of excess weight in the Valencian adult population.
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To our knowledge, there are only two instances of modelling future behaviour of excess
weight in a certain population with differential mathematical models. The first appears in [8].
In their article Evangelista, Ortiz, Rios-Soto and Urdapilleta propose a fast-food obesity
mathematical model for the US population. The infinite-time behaviour of the obesity study
developed in [8] is based on the equilibrium points of the underlying system of differential
equations. However, the non-variance of parameters of the system in the infinite-time domain
is an unrealistic hypothesis. In addition, the parameters of the model may be improved by
means of the use of reliable data coming from local health institutions. The second mathema-
tical model appears in [9]. In this work, Jódar, Santonja and González present a differential
mathematical model to predict the future evolution of excess weight in the 3- to 5-year-old
infant population in the region of Valencia, Spain. In both these works and in this article
obesity is considered as a health concern that spreads by social peer pressure or social contact
through unhealthy lifestyle habits [3,8,9]. In addition, in the models of both the above-
mentioned articles the subpopulation of individuals on a diet is considered. However, in the
present article we also consider the transitions from obese to overweight and from overweight
to normal weight by adopting healthy habits, but the diet class is not included as in [8,9]. This
offers an advantage because values of parameters related to the transitions of individuals of the
subpopulation on diet are difficult to estimate with real data.
This article is organized as follows: Section 2 is devoted to the study methods. In this section,
we present the statistical techniques we have used to identify the predictive factors of excess
weight in the adult population of Valencia. In addition, we present the mathematical model used
to predict the obesity behaviour in the Valencian population. In Section 3, we introduce the
statistical and numerical simulation results. Conclusions are presented in Section 4.

2. Methods
Based on a statistical study focused on the target population of 24- to 65-year-old adult
residents in the region of Valencia, Spain, we have determined that a sedentary lifestyle and
unhealthy nutritional habits are the predictors of excess weight in the region of Valencia.
Hence, a three-compartmental deterministic mathematical model is used to make the excess-
weight predictions in the population and to propose strategies to reduce its incidence. This
mathematical model is based on a system of ordinary differential equations.
For the mathematical model building, the 24- to 65-year-old population of the region
of Valencia is divided into three subpopulations based on their body mass index (BMI ¼
Weight/Height2). The classes or subpopulations are individuals at a normal weight (BMI <
25) (N(t)), people who are overweight (25  BMI < 30) (S(t)) and obese individuals (BMI
 30) (O(t)) [10].
 Mathematical and Computer Modelling of Dynamical Systems 25

2.1. Predictive factors of excess weight in Valencia

In this section, we study the predictive factors of excess weight in the 24- to 65-year-old
adult population in the region of Valencia. This analysis is based on the Health Survey of the
Region of Valencia 2000 database [11] and the Health Survey of the Region of Valencia 2005
database [12]. We carried out the statistical analysis of data with SPSS14 [13].
As can be seen in Tables 1 and 2, the non-parametric contrast (χ 2 test) reveals that excess
weight (BMI > 25) in adults of the region of Valencia, Spain, depends on sedentary lifestyle
and nutritional habits (significance level 1%). To be precise, a lack of physical activity and
the consumption of cakes, buns, fat and nuts (CBFN) are predictive factors of adulthood
excess weight in Valencian adults.
In both the analyses, the food consumption variable (CBFN) is grouped by factor
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analysis [14] to create a food variable group. With a cluster analysis [14] we classify the
population according to CBFN consumption frequency: low frequency and high frequency.
Factor and cluster analyses allow us to simplify the nutritional predictive factor.
As can be seen in Tables 3 and 4, the logistic regression analysis confirmed the
correlation. In this logistic model, the dependent variable (excess weight) is a dummy
variable: 0 means BMI  25 and 1 means BMI > 25. The independent variables considered
as possible predictors are physical activity, with two categories: none or occasional and usual

Table 1. Health survey of the region of Valencia 2000 analysis.

Variables p-value χ 2 test d.f.
Physical activity 0.001 16.711 3
Consumption frequency of cakes, buns, fat and nuts 0.003 8.273 1

Table 2. Health survey of the region of Valencia 2005 analysis.

Variables p-value χ 2 test d.f.
Physical activity 0.000 23.343 1
Consumption frequency of cakes, buns, fat and nuts 0.000 18.015 1

Table 3. Health survey of the region of Valencia 2000 analysis.

β Wald test d.f. p-value eβ
CBFN (high frequency) 0.195 7.225 1 0.007 1.215
Physical activity (none–occasional) 0.269 16.254 1 0.000 1.309
Constant -0.370 29.577 1 0.000 0.690

Table 4. Health survey of the region of Valencia 2005 analysis.

β Wald test d.f. p-value eβ
CBFN (high frequency) 0.286 17.747 1 0.000 1.332
Physical activity (none–occasional) 0.318 22.740 1 0.000 1.374
Constant -0.256 17.461 1 0.000 0.774
 26 F.-J. Santonja et al.

or intense, and consumption frequency of cakes, buns, fat and nuts (CBFN), with two
categories: low consumption frequency and high consumption frequency.
A reading of the p-value columns in Tables 3 and 4 reveals us that CBFN and physical
activity have an influence on adults’ (24–65 years old) excess weight (p-value < 0.01). Note
that a high CBFN consumption frequency and a low level of physical activity increase the
risk of being overweight or obese.
Thus, based on this statistical analysis and on statistical results of [3, 8, 9], we reckon that
excess weight can be considered as a health concern prone to social transmission. We assume
that contagion in 24- to 65-year-old adults of the region of Valencia occurs by the transmis-
sion of sedentary lifestyle (low level of physical activity) and unhealthy nutritional habits
(high consumption frequency of CBFN).
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2.2. Mathematical model

We treat excess weight like a disease that spreads by social peer pressure or social contact.
These social contacts have an influence on the probability of transmission of sedentary
lifestyle and unhealthy nutritional habits. These facts lead us to propose an epidemiological-
type model to study the epidemic evolution of excess weight. In this section, let us construct
the mathematical model based on the following assumptions:
(1) Complete homogeneous mixing in which an individual can interact with all others in
the population [15].
(2) From the statistical analyses (Section 2.1), we can accept that a sedentary lifestyle
and unhealthy nutritional habits increase the individual weight of the adults. Hence,
the transition between the different subpopulations are determined as follows: Once
an adult starts an unhealthy lifestyle he/she becomes addicted to the unhealthy
lifestyle and starts a progression to being overweight S(t) because of this lifestyle.
If this adult continues with his/her unhealthy lifestyle he/she can become an obese
individual O(t). In both these classes individuals can stop his/her unhealthy lifestyle
and then move to classes N(t) and S(t), respectively.
(3) The transitions between the subpopulations N(t), S(t) and O(t) are governed by terms
proportional to the sizes of these subpopulations. Conversely, the transitions from
normal to overweight occurs through the transmission of an unhealthy lifestyle from
the overweight and obese subpopulations to the normal-interactions weight sub-
population, depending on the meetings among them. This transit is modelled using
the term β N ðtÞSðtÞ þ OðtÞ.
(4) The subpopulations’ sizes and their behaviours with time will determine the
dynamic evolution of adulthood excess weight.

Without loss of generality and for the sake of clarity, the 24- to 65-year-old adult
population is normalized to unity, and one gets for all time t,
N ðtÞ þ SðtÞ þ OðtÞ ¼ 1:
Thus, under the above assumptions, we build the following non-linear system of ordinary
differential equations:

N 0 ðtÞ ¼ μN0  μN ðtÞ  βN ðtÞ½SðtÞ þ OðtÞ þ ρSðtÞ;

S 0 ðtÞ ¼ μS0 þ βN ðtÞ½SðtÞ þ OðtÞ  ½ μ þ γs þ ρSðtÞ þ OðtÞ; (1)
0
O ðtÞ ¼ μO0 þ γsSðtÞ  ½μ þ OðtÞ;
 Mathematical and Computer Modelling of Dynamical Systems 27

μNo μSo μOo

βN(S+O) γS

N S O
ρS εO

μN μS μO

Figure 1. Flow diagram of the mathematical model for the dynamics of obesity prevalence in the
population.
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The time-invariant parameters of this system of equations are

 , the rate at which an obese adult with a healthy lifestyle becomes an overweight
individual.
 μ, average stay time in the system of 24- to 65-year-old adults.
 ρ, the rate at which an overweight individual moves to the normal-weight
subpopulation.
 β, transmission rate because of social pressure to adopt an unhealthy lifestyle (TV,
friends, family, job and so on).
 γS, the rate at which an overweight 24- to 65-year-old adult becomes an obese
individual because of unhealthy lifestyle.
 N0, proportion of normal weight coming from the 23 years age group.
 S0, proportion of overweight coming from the 23 years age group.
 O0, proportion of obese coming from the 23 years age group.

Throughout this article, we focus on the dynamics of model (1) in the following
restricted region:
ω ¼ fðN ; S; OÞ=N > 0; S > 0; O > 0; 0 < N þ S þ O ¼ 1g;
where the basic results such as usual local existence, uniqueness and continuation of
solutions are valid for the Lipschitzian system (1). The dynamic of transits between the
subpopulations is depicted graphically in Figure 1.

2.3. Parameter estimation

We obtained all parameters of the model except β using the following sources:

 Health Survey of the Region of Valencia 2000 [11].

 Health Survey of the Region of Valencia 2005 [12].
 A technical report published by Arrizabalaga et al. [16]. This work proposes some
strategies to reduce BMI.

Now, the estimation of the parameters for time t in weeks is presented:

 μ ¼ 1/2132 week-1 is inversely proportional to the mean time spent by an adult in the
system, i.e. 41 years (2132 weeks).
 28 F.-J. Santonja et al.

 γS ¼ 0.0003 week-1 is estimated using the weekly growth of the average weight of a
24- to 65-year-old adult in the region of Valencia [11,12].
  ¼ 0.000004 week-1 is estimated taking into account that an overweight individual
takes 24 weeks to transit from obese to overweight subpopulation by physical activity
and healthy nutritional habits [11,12,16].
 ρ ¼ 0.000035 week-1 is estimated taking into account the mean time that an individual
takes after he/she stops physical activity to start again [11,12,16].
 N0, S0, O0 are the proportions of the normal-weight, overweight and obese popula-
tions, respectively, in the 23 years age group.
 Each one of the parameters , μ, ρ and γS can be interpreted as the mean length of the
transit period between two subpopulations. The length of the transit period for a
subpopulations. The length of the transit period for a subpopulation is usually
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assumed to follow an exponential distribution [17].

The obtained parameters are summarized in Table 5. Parameter β is estimated by fitting

the model to the available real data of the Health Surveys of the Region of Valencia for the
years 2000 and 2005. We obtain the initial condition (year 2000, first week, i.e. t ¼ 0) and the
final condition (year 2005, last week, i.e. t ¼ 260) of the differential equations system (1)
using these two reports. Initial condition of the mathematical model (1) is N ðt ¼ 0Þ ¼ 0:522,
Sðt ¼ 0Þ ¼ 0:362 and Oðt ¼ 0Þ ¼ 0:116. Final condition to be satisfied by the proposed
model is N ðt ¼ 260Þ ¼ 0:485, Sðt ¼ 260Þ ¼ 0:378 and Oðt ¼ 260Þ ¼ 0:137.
To compute the best fit, we carried out computations with Mathematica [18] and
implemented the function
F:R!R
β ! FðβÞ;
where the function F is obtained in the following steps:
(1) Solve numerically (NDSolve[]) the system of differential equations (1) with the
initial values.
(2) For t ¼ 260, corresponding to the last week of the year 2005, evaluate the computed
numerical solution for each subpopulation N ðtÞ, SðtÞ and OðtÞ.
(3) Compute the mean square error between the values obtained in Step 2 and the real
data for the last week of the year 2005, the final condition of the system of
differential equations.

Table 5. Estimated parameters.

Parameter Value
μ 0.000469
γS 0.0003
 0.000004
ρ 0.000035
N0 0.704
S0 0.25
O0 0.046
 Mathematical and Computer Modelling of Dynamical Systems 29

Function ðFÞ takes values in ðRÞðβÞ and returns a positive real number. Hence, we can try to
minimize this function using the Nelder–Mead algorithm [19, 20], which does not need the
computation of any derivative or gradient that is impossible to compute in this case. To find a
global minimum, the chosen feasible domain is
D ¼ ½0; 1;
and it is divided into disjoint subdomains where, in each one, the Nelder–Mead algorithm is
applied. We stored all the minima obtained, and, among them, the value of β that minimizes
the function F is β ¼ 0.00085. With this obtained parameter the value of the function F is the
global minimum, i.e. the mean square error is 0.01.
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2.4. Stability analysis of the mathematical model

In this section, model (1) is analysed qualitatively to investigate the existence and stability of
its associated equilibria. This analysis allows us to study different scenarios about the obesity
epidemic spread on the populations. Model (1) can be simplified to the following equivalent
system using the constant-population assumption N ðtÞ þ SðtÞ þ OðtÞ ¼ 1:

N 0 ðtÞ ¼ μN0  μN ðtÞ  βN ðtÞ½1  N ðtÞ þ ρSðtÞ;

S 0 ðtÞ ¼ μS0 þ βN ðtÞ½1  N ðtÞ  ½μ þ μs þ ρSðtÞ þ ½1  SðtÞ  N ðtÞ: ð2Þ

It is easy to see that, with the independence of the parameter values we have, there are
overweight and obese individuals in model (1) because of the recruitment to the overweight
and obese classes, which indicates that there is no threshold value (R0) and no disease-free
equilibrium in system (1). However, it is clear that the prevalence of obesity is affected by the
parameter values of the model. Therefore, we denote by (N*, S*) the equilibrium points of
system (2). Computing the steady state, we obtain two equilibrium points; one is biologically
feasible, and the other is not feasible owing to the negative values of the point.
To study the stability of system (2) it is necessary to compute the eigenvalues of the
Jacobian evaluated at the feasible equilibrium point (N*, S*). Computing the eigenvalues we
obtain λ1 ¼ 0:000884974 and λ2 ¼ 0:000679235. Thus, the equilibrium point (N*, S*)
is locally stable. Using the Dulac–Bendixson theorem, it can be shown that at least there are
no periodic solutions for system (2).
Let DðSÞ ¼ 1=S be the Dulac function for S > 0. To apply the Dulac–Bendixson theorem
one needs to compute the following partial derivatives:

 
@
DðSÞðμN0  μN ðtÞ  βN ðtÞ½1  N ðtÞ þ ρSðtÞÞ
@N
 
@
þ DðSÞðμS0 þ βN ðtÞ½1  N ðtÞ  ½μ þ μS þ ρSðtÞ þ ½1  SðtÞ  N ðtÞÞ < 0:
@S

Using the Dulac’s criterion of [21], the inequality implies that system (2) has no closed orbit
in the first quadrant. Hence, global stability of the equilibrium point (0.3311, 0.381402) can
be inferred. Thus, the normal-weight, overweight and obese populations tend to 33.1, 38.14
and 28.76%, respectively, if the parameter values stay time-invariant. Numerical simulation
results in Section 3 support this theoretical result.
 30 F.-J. Santonja et al.

0.6

Proportions of the populations 0.5

Real data

0.4

0.3
Normal-weight
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Overweight
0.2 Obese

0.1
0 50 100 150 200 250
2000 Time (weeks) 2005

Figure 2. Numerical simulation of the fitted mathematical model (1) where the dot points represent
the real data. Notice the increasing trend of overweight and obese in the 24- to 65-year-old adult
subpopulation.

3. Numerical results
We use the proposed mathematical model with the parameters listed in Table 5 and the just-
obtained parameter β to forecast the coming 6 years (until the year 2011).
A graphical representation of the fitted model where the dot points depict the real data is
shown in Figure 2. In the figure, model (1) shows an increasing trend of obesity in the 24- to
65-year-old subpopulation. Also, there is an increase in the overweight and obese subpopula-
tions. To predict the future dynamics, we simulate model (1) up to the year 2011. It can be
observed that the increasing trend of overweight and obese in the 24- to 65-year-old sub-
population persists. Some of the numerical values represented in Figure 3 are shown in Table 6,
where in it can also be noted that there is a decrease in the normal-weight population.
Taking into account that the direct and indirect economic costs of obesity in Spain are
around €7610 per obese individual a year [22] and considering population projections
(Spanish Statistics Institute [23]), our model predicts that the economic costs of obesity in
the region of Valencia will be €3485 million in the year 2011.
We also present simulations of the mathematical model (1), varying some of the
parameters. The aim of varying the parameters is to observe how these changes affect the
final prediction. The aim of varying the parameters is to observe how these changes affect the
final prediction. This sensitivity analysis allows us to propose obseity prevention strategies.
The first simulation supposes an increase of physical activity in the overweight class S(t).
Consequently, the parameter ρ is changed by 100%, from 0.000035 to 0.00007. In this case,
the incidence of obesity in 2011 will be 15.48% and overweight will be 37.4%. In this
scenario, the economic costs of obesity will be €3475 million. Thus, this treatment strategy
on the overweight individuals produces a small improvement (Figure 4).
 Mathematical and Computer Modelling of Dynamical Systems 31

0.6

0.55

Proportions of the populations 0.5

0.45

0.4

0.35

0.3 Normal-weight
Overweight
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0.25 Obese

0.2

0.15

0.1
0 100 200 300 400 500
2000 Time (weeks) 2011

Figure 3. Numerical simulation of the mathematical model (1) up to the year 2011. It can be observed
that the increasing trend of overweight and obese in the 24- to 65-year-old subpopulation persists.

Table 6. Evolution of the proportion of normal-weight, overweight and obese sub-

populations for different years.
Year Normal-weight % Overweight % Obese %
2000 52.20 36.20 11.60
2005 49.40 37.12 13.48
2009 47.41 37.72 14.87
2010 46.94 37.86 15.20
2011 46.49 37.99 15.52

The second simulation supposes an increase of physical activity in the obese class O(t).
In this case, the parameter  is changed by 100%, from 0.000004 to 0.000008. The obesity
prediction for 2011 is 15.5% and the overweight prediction is 38.01%. The economic costs
of obesity will be €3480 million. In this case, the treatment strategy on the obese individuals
produces a small improvement (Figure 5).
The last simulation supposes a decrease in the social transmission parameter β. In this
case, the parameter β is reduced by 20%. Correspondingly, the obesity prediction for 2011 is
15.36% and the overweight prediction is 36.05%. The economic costs of obesity will be
€3450 million. In this case, the prevention strategy on the normal-weight individuals
produces a bigger improvement than those produced by the previously mentioned treatment
strategies. In fact, the overweight class does not increase anymore. Therefore, prevention
strategy is recommended for tackling the obesity social epidemic. However, a study focused
on cost-effectiveness taking into account real economic values should be done in the future
to recommend the best strategy against the spread of the social epidemic obesity (Figure 6).
 32 F.-J. Santonja et al.

0.6

0.55

Proportions of the populations 0.5

0.45

0.4

0.35

0.3
Normal-weight
Overweight
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0.25
Obese
0.2

0.15

0.1
0 100 200 300 400 500
2000 Time (weeks) 2011

Figure 4. Numerical simulation of the mathematical model (1) when the parameter ρ is changed by
100% from 0.000035 to 0.00007. This treatment strategy on the overweight individuals brings about a
small improvement.

0.6

0.55

0.5
Proportions of the populations

0.45

0.4

0.35

0.3 Normal-weight
Overweight
0.25 Obese

0.2

0.15

0.1
0 100 200 300 400 500
2000 Time (Weeks) 2011

Figure 5. Numerical simulation of the mathematical model (1) when the parameter  is changed by
100%, from 0.000004 to 0.000008. This treatment strategy on the overweight individuals brings about
a small improvement.
 Mathematical and Computer Modelling of Dynamical Systems 33

0.6

0.55

Proportions of the populations 0.5

0.45

0.4

0.35

0.3 Normal-weight
Overweight
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0.25
Obese
0.2

0.15

0.1
0 100 200 300 400 500
2000 Time (Weeks) 2011

Figure 6. Numerical simulation of the mathematical model (1) where the parameter β is reduced by
20%. The prevention strategy on the normal-weight individuals produces a bigger improvement than
those produced by the previously mentioned treatment strategies.

Table 7. Proportion of obese subpopulation for different

years.
Year Obese%
2000 11.6
2005 13.48
2011 15.52

4. Conclusions
The incidence of obesity is increasing in the region of Valencia, Spain. Health Surveys regarding
overweight and obesity show this behaviour. The numerical simulations carried out with our
proposed mathematical model and with the estimated parameters indicate an increasing trend in
obesity among the 24 to 65 year-old population in the coming few years as can be observed in
Table 7. Taking into account the numerical simulations, we can affirm that the prevention
strategy (motivating the normal-weight individuals to adopt physical activity and healthy
nutritional habits) is better than the treatment strategy (promoting physical activity and healthy
nutritional habits in the overweight and obese populations), because the reduction achieved in
the incidence of obesity is much greater in the former case. To reduce the incidence of adulthood
obesity among the 24- to 65-year-old Valencian population in the coming years, it would be
more beneficial to focus on the promotion of physical activity and healthy nutritional habits in
the normal-weight individuals than implementing these campaigns for the overweight and
obese individuals. These technical suggestions seem crude at first, but to achieve a lower obesity
prevalence, these are the necessary actions to be taken based on the numerical simulations.
 34 F.-J. Santonja et al.

Acknowledgements
We acknowledge the collaboration of the Oficina de Plan de Salud of the Conselleria de Sanitat of the
Comunidad Valenciana.

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