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Obesity and Overweight: A Global Public Health Issue

Preprint · September 2022

DOI: 10.13140/RG.2.2.15819.26400

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Md Mushtahid Salam Rabeya Yousuf

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National Defence University of Malaysia
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Brief Communication
Obesity and Overweight: A Global Public Health Issue
Obesity has become a significant public health issue worldwide
over the last four decades.[1] It is caused by excess body
fat accumulation, which is harmful to health. Obesity is
defined by the World Health Organization (WHO) as body
mass index (BMI) ≥30 kg/m2, while overweight is the BMI
of ≥25 kg/m2.[2] The prevalence of overweight and obesity is
increasing globally in both developing and developed countries
in all age groups.[3] Since 1980, globally, its prevalence is
almost doubled.[4] The WHO has reported that in 2016, more
than 1.9 billion adults were overweight; among them, 650
million were obese.[5] In the United States, the prevalence
exceeds 30% in most sex and age groups.[6] Besides, this
trend of weight gain is present in children and adolescents and
poses a significant threat to the population’s present and future
health status.[7] In Germany, overweight and obesity among
children aged 3–17 years are 15.4% and 5.9%, respectively.[8]
In developing countries, the prevalence of childhood obesity
in 5–19 years old is reported as 41.8% in Mexico, 22.1% in
Brazil, 22.0% in India and 19.3% in Argentina.[9] From 1975
to 2016, the prevalence of overweight or obese children and
adolescents aged 5–19 years increased more than four‑fold,
from 4% to 18% globally.[10]
There are several causes of overweight and obesity, including
lifestyle factors such as diet and physical activity; genetic
factors such as parental obesity, underlying disease conditions
and medication use and demographic factors such as age,
gender, place of habitat, education level and income.[11,12] The
energy imbalance between calories consumed and calories
burned is considered a significant cause of obesity. The
energy is consumed from food and drinks while energy is
burned through physical activity, body temperature regulation,
breathing, digestion, etc., If the energy intake is more by the
body than the expenditure, overweight and obesity result as
the excess amount of calories is stored as fat in the body.[3]
The modern lifestyle differs from the earlier time when
people used to be more active and struggled to obtain food.
The growing urbanisation and changing dietary habits in
modern lifestyles largely contribute to obesity of the people.
© 2022 Advances in Human Biology | Published by Wolters Kluwer - Medknow
Nowadays, people are taking foods with high‑fat content, high
sugar content and often large‑sized food causing overeating;
combined with this sedentary behaviour, television watching
and less physical activity cause a global rise in obesity.[1,11,12]
Dietary changes also include reduced intakes of complex
carbohydrates and dietary fibre and reduced fruit and vegetable
intake. Studies showed that eating quickly is associated with
overweight adolescents due to excessive energy intake.[11]
The effect of urbanisation makes people take advantage of
technologies, cars and other mechanical aids, which causes
a decline in physical activity. Urbanisation also enables a
more excellent food choice at a lower price, rich in calories
due to energy density, contributing to weight gain.[13] Several
socioeconomic factors such as knowledge, attitudes, economic
and other constraints on nutrition and physical activity are
related to child adiposity.[1] A study in Germany showed
that children who grow up with low socioeconomic status
are more likely to be overweight and obese than those with
high socioeconomic status.[8] Economic factors are related to
participation in physical activity and buying of food.[14]
There is evidence that underlying genetic component
influences the prevalence of obesity. Parental obesity is highly
related to the obesity of children, accounting for the heritability
of obesity to be between 40% and 70%.[15] In recent decades,
the combined effects of environmental factors, genetic factors
and individual lifestyle behaviour have been documented to
cause excess weight gain.[16]
In obesity, chronic, low‑grade inflammation combined with
dyslipidaemia causes vascular dysfunction, atherosclerosis
and impaired fibrinolysis. These factors make the individual
susceptible to cardiovascular disease, stroke and venous
thromboembolism. Furthermore, chronic inflammation
contributes to insulin resistance and type 2 diabetes.[17] Obesity
is the main component related to obstructive sleep apnoea
caused by fat deposition in the respiratory tract causing
narrowing of the lumen of the respiratory tract. Thereby,
reduces chest compliance due to decreased muscle activity,
leading to hypoxia and apnoeic episodes.[18] Cancers are
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Salam, et al.: Obesity and overweight
also significantly associated due to these underlying factors.
[17]
Obesity in children is related to metabolic diseases,
non‑alcoholic fatty liver disease and gastroesophageal reflux
disease. It also affects growth and sexual development and
may delay puberty in boys, advance puberty in some girls and
cause psychological problems.[17]
Obesity is a complex, multifactorial disease that leads to many
comorbidities and mortalities. Overweight and obesity are
significant contributing factors to developing several physical
and mental disorders.[3] Obesity is considered a severe public
health disease associated with non‑communicable diseases.
It is a risk factor for cardiovascular disease, type 2 diabetes,
hypertension and cancers, causing many premature mortalities
worldwide.[15] Obesity also has an excellent association with
metabolic and renal disorders that pose a significant public
health threat.[4] Stroke, kidney disease, breathing problems,
sleep apnoea, osteoarthritis, malignancy, depression and
anxiety are related to obesity and overweight. In addition
to severe illness, there is a significant relationship between
obesity and mortality. Obesity causes a decrease in life
expectancy of 5–10 years[17] and almost doubles in people
who smoke.[19] Quality of life is affected in obese people, and
their economic and psychological burdens are exacerbated
due to underlying physical and psychosocial problems.[6] It
also imposes a significant load on the economy of the country.
Healthcare cost related to obesity is also an important issue. It
is up to 10.4 billion Euros in Europe, 2.74 billion US dollars
in China and 6.0 billion US dollars in Canada.[16] In the United
States, obesity accounts for more than 20% of all annual
healthcare expenditures.[6]
It is evidenced that overweight and obese children are
more susceptible to cardiovascular disease, hypertension,
hyperinsulinaemia, dyslipidaemia and chronic kidney
damage.[20,21] These are all associated with underlying hormonal
changes and vascular dysfunction leading to cardiovascular
disease in adulthood.[21] Furthermore, overweight and obesity in
children and adolescents are related to psychological problems
such as depression, anxiety, low self‑esteem and lack of
cognitive stimulation. They are also victims of bullying with
a significant reduction in quality of life.[22]
Prevention of obesity by targeting the contributing factors,
lifestyle and active involvement of the supporting health
services is of great importance and has been advocated
in recent years. The prevention program must be adopted
at the individual, family, community and national levels.
Good eating habits and physical activity can be emphasised
by educating people at schools and workplaces and the
community. The home environment is an essential setting in
preventing overweight and obesity, the need for widespread
dissemination of knowledge to the parents and family in this
regard. Restricting time for television viewing and not taking
extra food during watching is an important strategy to bring
healthy foods, practice regular meal times and participate in
physical activities. Parents can act as role models for healthy
2 Advances in Human Biology ¦ Volume XX ¦ Issue XX ¦ Month 2022
eating.[16] At school level, knowledge dissemination can be
done through physical education teaching and inspiring them
to walk or bike to school.[6] It has been advocated that national
government should embrace new strategies by increasing taxes
on unhealthy food such as sugar sweetened beverages (SSBs)
and in contrast increase subsidizes towards healthy foods.[6]
Trained healthcare professionals must monitor the patients
regularly and motivate them to control their obesity.[6]
The American Heart Association published a comprehensive
population‑based approach to healthful eating, physical
activity and energy balance for obesity prevention.[23] In 2009,
the Centers for Disease Control and Prevention[24] issued 24
strategies divided into six categories for obesity prevention.
Individual behavioural change is the core of all strategies.
The strategies are as follows: (1) strategies to promote the
availability of affordable healthy food and beverages, (2)
strategies to support healthy food and beverage choices, (3) a
strategy to encourage breastfeeding, (4) strategies to encourage
physical activity or limit sedentary activity among children and
youth, (5) strategies to create safe communities that support
physical activity and (6) a strategy to encourage communities
to organise for change.[24]
Obesity is a complex condition that leads to several diseases
with significant mortality and morbidity. It is necessary to
educate the people with all the required information and
tools to motivate them and employ prevention strategies
at governmental, organizational, community, family, and
individual levels.
Consent for publication
The author reviewed and approved the final version and has
agreed to be accountable for all aspects of the work, including
any accuracy or integrity issues.
Md Mushtahid Salam, Rabeya Yousuf1, Md Wasek Salam2, Mainul Haque3
Centre for Data Analytics and Society, Faculty of Humanities, School of
Social Sciences, Cathie Marsh Institute for Social Research, University of
Manchester, Manchester, UK, 1Department of Diagnostic Laboratory Services,
Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Medical
Centre, 2Mohammadpur Upazila Health Complex, Magura, Bangladesh, 3Unit of
Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan
Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur,
Malaysia
Address for correspondence: Prof. Mainul Haque,
Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti
Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem
Sungai Besi, 57000 Kuala Lumpur, Malaysia.
E‑mail: runurono@gmail.com
Submitted: 06‑Jun‑2022 Revised: 30-Jun-2022
Accepted: 04‑Aug‑2022 Published: 23-Sep-2022
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