Overweight and obesity: Radical changes needed

Over the past few years I have seen a significant increase in the number of young adults with type 2 diabetes in my practice. Some have a genetic basis but a greater number do not and behave just like adult type 2 patients. This is a diagnosis that I rarely saw until a few years ago. A significant commonality is the prevalence of overweight and obesity in this population (overweight: BMI greater than 25; obese: BMI greater than 30). My pediatric colleagues are seeing similar trends and this should be raising alarms. Evidence of this rise in average weight and expanding girths appears to be becoming the norm rather than the exception, not just in doctors’ offices, but in the public arena—in classrooms, on the streets, on playgrounds, and in malls.

Obesity has become one of the world’s greatest health concerns and threatens to undo the gains made in life expectancy during the 20th century according to the World Health Organization (2015). Despite strong evidence of adverse health events associated with obesity—diabetes mellitus, hypertension, cardiovascular disease, some cancers, and now nonalcoholic fatty liver disease—the prevalence continues to rise. This prevalence has been noted to have risen substantially in one generation. Worldwide (again from WHO statistics) in 2014, 1.9 billion adults over age 18 were overweight and 600 million were obese. In 2013, 42 million children under age 5 were overweight or obese. These figures are staggering and may well be underestimated. In Canada in 2011 to 2012, one in four adults was obese, an increase of 17.5% compared with 10 years ago (Statistics Canada, 2014). Fortunately, as of 2012 BC had the lowest prevalence of obesity in Canada, but not by a lot. Newfoundland and Labrador had the highest.

Improving nutritional habits and encouraging physical activity can make a difference and are the mainstays of any attempts to control weight but need to be supported not only by parents but by schools and communities as well. I do not have young children or grandchildren myself, but I empathize with parents trying to encourage healthy behaviors in the face of a constant bombardment of fast-food industry ads touting high-calorie processed foods and drinks with very low nutritional value. I can also appreciate the difficulty that parents face in trying to get their kids moving and to restrict the amount of time kids spend on smartphones and tablets, activities that seem to consume large chunks of each day.

Overweight and obesity are potentially preventable, but radical changes and long-term planning are needed to make this happen. If not, the future demands on health care costs and resources will be exorbitant. Sadly, it is predicted that if the current trends continue, we will begin to see a generation of young people dying before their parents of diseases that have traditionally not been seen other than in older adults. 
—SEH