Magid Ezzati is the leading author of a recent article published in Lancet. The study is titled “ Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants”. The objective of this analysis involving around 200 countries is to analyze the worldwide trends in body weight over the past 40 years. The purpose of the analysis is to help public health policy makers develop strategies and implement policies to curb the obesity epidemic.

Dr. Ezzati, from the School of Public Health at Imperial College London in the United Kingdom, alarmingly concluded that if present trends continue, not only will the world not meet the World Health Organization obesity target of halting the rise in the prevalence of obesity, but more women will be severely obese (BMI greater than 35) than underweight by 2025. In 2014, about 266 million men and 375 million women were obese in the world, compared with 34 million men and 71 million women in 1975.

It is interesting to notice that results vary widely across countries. For instance women in Singapore, Switzerland, Japan, the Czech Republic, Belgium, and France had almost no increase in average BMI (less than 0.2 kg/m² per decade) over 40 years. On the other hand, more than one in four severely obese men (27.8%) and 18.3% of severely obese women in the world live in the United States. Public health officials ought to look at these numbers and start implementing new policies to control this epidemic. Bariatric surgery is currently the only effective treatment for obesity. However, in the United States only 1% of the severely obese patient population undergoes weight loss surgery every year. Obese individuals are contributing to skyrocketing rates of type 2 diabetes, hypertension, gastro-esophageal reflux disease, cancer…These rising trends are starting to affect our life expectancy as a society. New reports from the CDC are showing a rise in age-adjusted death rate for the first 9 months of 2015 compared to the same period in 2014. Stroke, diabetes and heart related disease have most notably increased. These obesity related problems would lead to dramatic consequences in health care. From a financial point of view, the cost of taking care of obesity related comorbidities have reached an astronomical level of 200 billion dollars per year in the US alone. By 2020, the cost of diabetes care alone may reach 500 billion dollars. Bariatric surgery by itself is not a solution for the billions of obese individuals all over the world. Dr. Ezzati explains that people living in countries like France and Switzerland are more likely to eat fresh and unprocessed food and to eat in moderation. Other lifestyle related factors are also at play and must be analyzed and implemented through public health policies. Prevention of weight gain should be the guiding principle. Individuals, families, communities, towns and countries must emulate a healthier lifestyle than what we currently have. For these lifestyle changes to take effect the US government must intervene to change the food environment. For today’s food environment exploits people’s biological, psychological, social, and economic vulnerabilities, making it easier for them to eat unhealthy foods… Currently, in the US, government intervention is hampered by a complex array of obstacles: Personal freedom, food industry lobby, food advertising laws, access to fresh produce… Meanwhile, the burden of obesity according to Dr. Ezzati will continue to rise unabated across the world. Today, we urgently call for regulatory actions from government along with full  cooperation from industry and society to overcome the obesity epidemic.