DIABETES IN OVER-WEIGHT PEOPLE IN THE U.K.

The prevalence of diabetes in over-weight people in the U.K. and its associated risk factors



The prevalence of diabetes in over-weight people in UK and its associated risk factors

Obesity, defined as body mass index (BMI)=30 kilograms (kg)/meters (m)2 or BMI=95th percentile of the age-and sex-specific Centers for Disease Control and Prevention (CDC) growth charts, affects one third of all individuals in the U.S. though is disproportionately more common among certain race/ethnic minorities. Notably, in females, 49.6% of blacks and 45.1% of Mexican Americans are obese in comparison to 33.0% of whites . Obesity is associated with numerous adverse health outcomes including mortality and morbidity from diabetes, hypertension, dyslipidemia, stroke, coronary heart disease and certain cancers. There are substantial indirect and direct costs, with an estimated 2.8% of total UK health care costs are attributed to obesity alone. Given the recent epidemic of obesity, and its adverse health and economic consequences, there is a critical need to address obesity. (Bray 2004 pp.2583-2589)

SEVERE OBESITY

Severe obesity, defined as BMI=40 or BMI=120% of 95th percentile of the age-and sex-specific CDC growth charts, has also risen substantially, and appears to be rising at a faster rate than moderate obesity. In 2000, 2.2% of American adults, or 4.8 million individuals, were estimated to be severely obese, but there is significant variation by sex and race/ethnicity. Medical consequences of obesity are more common among individuals with severe obesity, and thus, the total medical costs are approximately 50% higher in individuals with severe obesity compared to those with moderate obesity. Further, there are few reasonably affordable and successful treatment options for severe obesity, emphasizing the need for effective prevention measures. (Despres 2001 pp.716-720)

NATURAL PROGRESSION OF SEVERE OBESITY

The natural progression of weight patterns of over the life course is not well documented. The few longitudinal studies regarding natural history of weight gain find that the transition from adolescence to young adulthood is associated with a doubling of obesity and an average weight gain of 12.91kg . Obesity onset significantly varies by sex and race/ethnicity with black females becoming obese twice as fast as white women. Further, black females have been shown to have significantly higher BMI changes between childhood and adulthood. While these studies have documented the natural history of obesity, there are no known studies documenting the natural history of severe obesity or how adolescent obesity predicts future severe obesity risk. Most epidemiological research on severe obesity comes from repeated cross-sections, such as the National Health and Nutrition Examination Survey (NHANES), or from databases using self-reported height and weight, such as the Behavioral Risk Factor Surveillance System (BRFSS). Such sources are adequate for identifying secular trends but are not well-suited to understand natural history of adolescent weight gain and how earlier weight status predicts severe obesity onset. In particular, large, prospective cohort studies are needed to capture changes in weight and to capture the age range during which severe obesity becomes most ...