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Obesity epidemic

22 percent will have obesity and 12.5 percent T2DM by 2045

One in eight people will have type 2 diabetes and increase from up from one in 11 from 2017

In 27 years from now, almost a quarter of the global population will be obese, according to research presented at the European Congress on Obesity in Vienna, if current trends continue 22 percent of people in the world will be obese by 2045, up from 14 percent in 2017. In addition, one in eight people (12.5%) will have type 2 diabetes and increase from up from one in 11 from 2017.

"These numbers underline the staggering challenge the world will face in the future in terms of numbers of people who are obese, or have type 2 diabetes, or both," said researcher, Dr Alan Moses of Danish healthcare company Novo Nordisk's research and development department, who along with colleagues analysed population data for all countries in the world obtained from a World Health Organization database. "As well as the medical challenges these people will face, the costs to countries' health systems will be enormous.”

If current trends in the USA continue, obesity will increase from 39% in 2017 to 55% in 2045, and diabetes rates from 14% to 18%

For each country, the population was divided into age groups. From 2000-2014 (chosen because data is most reliable from 2000 onwards) the population in each age group was divided into body mass index (BMI) categories. For each country and age group, the share of people in each BMI class was projected. The diabetes risk for each age and BMI group was then applied, allowing estimations of diabetes prevalence for each country each year. The prevalence for each country was calibrated to match International Diabetes Federation's regional estimates thereby taking into account differences in way of life, nutrition and genetic disposition for diabetes.

In 2014, these three institutions collaborated to launch the Cities Changing Diabetes programme to accelerate the global fight against urban diabetes. The programme began with eight cities: Copenhagen, Rome, Houston, Johannesburg, Vancouver, Mexico City, Tianjin, Shanghai. These have since been joined by a further seven cities: Beijing, Buenos Aires, Hangzhou, Koriyama, Leicester, Mérida and Xiamen.

In order to stabilise global diabetes prevalence at 10%, obesity prevalence must fall steadily and in total by around a quarter, from the current level of 14% to just over 10% by 2045

The programme has established local partnerships in these 15 cities to address the social factors and cultural determinants that can increase type 2 diabetes vulnerability among people living in their cities. Part of this work included projections of obesity and diabetes based on both current trends and on a global target scenario. The research has led to an increased understanding of the different challenges each city is faced with regarding genetic, environmental and social determinants of diabetes in that city.

The startling projections globally are that, based on current trends obesity prevalence worldwide will rise from 14% in 2017 to 22% in 2045. Diabetes prevalence will increase from 9.1% to 11.7% across the same period, placing further massive strain on health systems which already spend huge sums just to treat diabetes.

Although immediate action will not result in reversing the epidemic of diabetes and obesity quickly, it is essential to being work now to prevent new cases of obesity and diabetes. The authors' model suggests that, in order to stabilise global diabetes prevalence at 10%, obesity prevalence must fall steadily and in total by around a quarter, from the current level of 14% to just over 10% by 2045.

The authors note that the above numbers are for the 'global' scenario. Individual countries display individual trends and should have their own targets. For example, if current trends in the USA continue, obesity will increase from 39% in 2017 to 55% in 2045, and diabetes rates from 14% to 18%. To keep diabetes rates in the USA stable between 2017 and 2045, obesity must fall from 38% today to 28%. And in the United Kingdom, current trends predict that obesity will rise from 32% today to 48% in 2045, while diabetes levels will rise from 10.2% to 12.6%, a 28% rise. To stabilise UK diabetes rates at 10%, obesity prevalence must fall from 32% to 24%.

The researchers said turning the tide on obesity would require "aggressive and coordinated action".

"Each country is different based on unique genetic, social and environmental conditions which is why there is no 'one size fits all' approach that will work," he added. "Individual countries must work on the best strategy for them."

The research results have not yet been published in a scientific journal but were peer reviewed for selection at the congress. A global survey in 2016 said the ratio of obese adults had more than doubled in the 40 years since 1975 and from the five billion adults alive in 2014, 641 million were obese.

"The global prevalence of obesity and diabetes is projected to increase dramatically unless prevention of obesity is significantly intensified. Developing effective global programmes to reduce obesity offer the best opportunity to slow or stabilise the unsustainable prevalence of diabetes. The first step must be the recognition of the challenge that obesity presents and the mobilisation of social service and disease prevention resources to slow the progression of these two conditions,” he concluded. "Despite the challenge all countries are facing with obesity and diabetes, the tide can be turned - but it will take aggressive and coordinated action to reduce obesity and individual cities should play a key role in confronting the issues around obesity, some of which are common to them all and others that are unique to each of them."

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