First Propaedeutic Department of Internal Medicine and Diabetes Center, Laiko General Hospital, Medical School, National Kapodistrian University of Athens, Agiou Thoma 17 Street, 11527, Athens, Greece.
Department of Biologic Chemistry, Medical School, National Kapodistrian University of Athens, Mikras Asias 75 Street, 11527, Athens, Greece.
Curr Obes Rep. 2023 Dec;12(4):514-527. doi: 10.1007/s13679-023-00527-y. Epub 2023 Oct 2.
To provide an update on current obesity prevalence trends and summarize the available evidence suggesting a possible plateau or stabilization in obesity rates after the previous sudden global rise.
The escalating global obesity epidemic represents one of the most serious public health challenges. There have been some indications that in high-income populations, the rate of obesity increase in adults has been stabilized after the decade 2000-2010, suggesting a possible plateau. Current evidence also suggests that obesity rates have been stabilized in children and adolescents of most economically advanced countries since 2000, which is possibly related to healthier dietary habits and increased levels of physical activity. On the other hand, there is a steady uninterrupted rise in low-income nations, and the universal trend is obesity escalation rather than slowdown, mainly driven by sharp increases in the obesity prevalence of low-income populations. Furthermore, an increasing number of high- and middle-income countries are currently experiencing an epidemic of severe obesity. In high-income populations, severe obesity is expected to double its prevalence from 10 to 20% between 2020 and 2035, posing an enormous threat for healthcare systems. Even if transiently stabilized, the obesity prevalence remains globally at unacceptably high levels, and there is no guarantee that the current stability (if any) will be maintained for long. In this review, we explore the underlying drivers of the global obesity epidemic; we provide possible explanations for the reported slowdown of the obesity rates in some countries; and we overall take a critical perspective on the obesity plateau hypothesis, emphasizing the urgent need for immediate effective actions at population and regional level in order to halt the alarming obesity escalation and its serious health risks.
综述目的：提供当前肥胖流行趋势的最新信息，并总结现有证据，这些证据表明，在之前全球肥胖率突然上升之后，肥胖率可能已经趋于平稳或稳定。
最新发现：不断升级的全球肥胖流行是最严重的公共卫生挑战之一。有一些迹象表明，在高收入人群中，成年人的肥胖增长率在 2000-2010 年这十年后已经稳定下来，表明可能已经达到了一个平台期。目前的证据还表明，自 2000 年以来，大多数经济发达国家的儿童和青少年肥胖率已经稳定下来，这可能与更健康的饮食习惯和更高水平的身体活动有关。另一方面，低收入国家的肥胖率仍在稳步上升，且全球趋势是肥胖率不断上升，而不是放缓，这主要是由于低收入人群的肥胖率急剧上升所致。此外，越来越多的高收入和中等收入国家目前正经历着严重肥胖的流行。在高收入人群中，预计严重肥胖的患病率将在 2020 年至 2035 年间翻一番，达到 10%至 20%，这对医疗保健系统构成了巨大威胁。即使暂时稳定下来，肥胖的流行率在全球仍处于不可接受的高水平，不能保证目前的稳定（如果有的话）会长期保持。在这篇综述中，我们探讨了全球肥胖流行的潜在驱动因素；我们为一些国家报告的肥胖率下降提供了可能的解释；我们总体上对肥胖率稳定的假设持批评态度，强调迫切需要在人群和区域层面立即采取有效行动，以阻止令人震惊的肥胖率上升及其严重的健康风险。
