Policy Interventions to Tackle the Obesogenic Environment
Table 2.2 Classification of overweight and obesity in adults [3] Disease
Relative risk for women
Relative risk for men
Type II diabetes
12.7
5.2
Hypertension
4.2
2.6
Myocardial infarction
3.2
1.5
Cancer of the colon
2.7
3.0
Angina
1.8
1.8
Gall bladder disease
1.8
1.8
Ovarian cancer
1.7
–
Osteoarthritis
1.4
1.9
Stroke
1.3
1.3
(Source: National Audit Office 20012)
In addition to increasing the risks of ill health, obesity significantly increases the risk of mortality at any given age. For midlife adults (50 to 71 years old), who have never smoked, the all cause mortality risk increases by 20% to 40% in overweight persons and by 200% to 300% in those who are obese [5]. There is also a link between mortality risk and the duration of overweight, with those who have been overweight for longest being at the highest risk. Severely obese individuals are likely to die on average 11 years earlier (13 years for a severely obese man between 20 and 30 years of age), than those of a healthy weight. This risk is comparable to, and in some cases worse than, the reduction in life expectancy from smoking. Extrapolations in the government’s recent Foresight report [2], suggest that by 2025 for the UK population as a whole, something in the region of 40% of adults could be obese.
2.3
The epidemiology of obesity in Scotland
The Scottish Public Health Observatory report in 2007 [6] confirmed the status of obesity as one of Scotland’s most serious public health problems (as is also the case for the rest of the UK). The report sets out how obesity levels in both adults and children have risen steadily over the last 10 years with marked increases in men aged 35–64 years and in women aged 35–44 years. Among its key findings are: • The prevalence of obesity (BMI>30 kg/m2) in Scotland has increased over the past two decades, reaching 22% in men and 24% in women in 2003, with marked increases in (working age) men aged 35–64 years and in women aged 35–44 years • The prevalence of obesity clearly increases with age throughout most of the life-course in both men and women (figure 2.1).
2
16
Tackling Obesity in England. National Audit Office 2001. http://www.nao.org.uk/publications/0001/tackling_obesity_in_england.aspx