Best approaches in the battle against Globesity? Learning lessons from our experience tackling HIV-AIDS and tobacco smoking

Abstract

In 2008, two-thirds of the annual global death toll was attributable to non-communicable diseases (NCDs). Defined as chronic conditions often caused or exacerbated by non-obligated lifestyle behaviours, the NCD epidemic has been fuelled by a combination of risk factors, including tobacco use, an unhealthy diet combined with lack of physical activity and overweight-obesity, and harmful alcohol use. The health consequences are mainly seen as cardiovascular diseases, diabetes, cancers and chronic respiratory problems. Generally associated with the West, they are now recognized as a global threat to public health. They are also an unsupportable global health economic burden. NCDs incidence can be significantly reduced through the adoption of proven and affordable interventional measures which are complementary to global health efforts already underway. To head off the certain future surge in morbidity and mortality, at record costs to health budgets worldwide, there is a pressing need to change global population's behaviours and choices in relation to these risk factors. The most pressing challenge in NCD prevention is combating the rise in overweight-obesity, which threatens individuals, communities and countries as never before. If not overcome, this may undo much of the progress seen in reducing the incidence of myocardial infarctions, strokes and some cancers evident from the 1960s onwards.

For a Step Change to Curb the Obesity Epidemic

“…Misperception of obesity as a cosmetic or lifestyle issue, rather than a serious health problem, has been a significant hurdle to mobilizing patients, communities, and payers to embrace prevention and treatment initiatives [19,20]. Many researchers, including those in this issue, note the need for (1) more comprehensive, multi-factorial interventions [17,22,24], and (2) treatment as opposed to purely preventive approaches (to both address the needs of the already obese and the limited effectiveness of prevention) [25], as key learnings from past failed experience in obesity prevention/management.…”

“…Many commentators suggest that more comprehensive, systemic, multi-factorial programs are needed to answer the obesity epidemic challenge [2,17,20,21,24,47]. While such programs would undoubtedly help, they may not be realistic or achievable without substantial increases in funding.…”

Obesity: A United States Strategic Imperative

“…Obesity and overeating messaging must include targeting of adolescent to middle aged individuals as the weight risk is climbing in this group. 237 Additionally, parents should receive healthy cooking and childhood obesity messaging, while informing businesses of the profitability of healthy products and a healthy workforce. Dedicated research on the group psychology of overeating and prevention is also needed.…”

The Paradox of Knowledge: Health Benefits of Being Active

“…Even though this area still requires further research, one thing is clear: chronic exercise exerts a positive effect on our body's immune system by decreasing the prevalence of chronic diseases. These illnesses -cardiovascular diseases, cancers, chronic respiratory diseases and dementia -not only compose over 80% of global deaths from noncommunicable diseases [5,6], but all have the same predictor of risk: a chronic low grade inflammatory state.According to the World Health Organization statistics 2012 [6] 13% of global deaths can be attributed to raised blood pressure, 6% to raised blood glucose, 6% to physical inactivity and 5% to being overweight/obese. Physical activity can be considered a medicine because it can reverse all of the above [5], not to mention the other health benefits of being fit [7,8].…”

“…These illnesses -cardiovascular diseases, cancers, chronic respiratory diseases and dementia -not only compose over 80% of global deaths from noncommunicable diseases [5,6], but all have the same predictor of risk: a chronic low grade inflammatory state.…”