T P Gill, University of Sydney, Sydney, NSW, Australia

© 2005 Elsevier Ltd. All rights reserved.

There can be little doubt that obesity has become a major public health and economic problem of global significance. According to World Health Organization (WHO) estimates, approximately 1 billion people throughout the world were overweight in 2002 and more than 300 million of these were obese. Prevalence rates continue to rise rapidly in all areas of the world, including low-income countries, and obesity-associated illness are now so common that they are replacing the more traditional public health concerns, such as undernutrition and infectious disease, as the most significant contributors to global ill health.

The health impact of obesity is considerable, and obesity impacts on both quality and length of life. Overweight and obesity are associated with a wide range of chronic conditions, such as diabetes, hypertension, cardiovascular disease (CVD), and certain cancers, as well as non-life-threatening but painful conditions, such as arthritis, back pain, and breath-lessness. Obesity also places enormous financial burdens on governments and individuals and accounts for a significant proportion of total health care expenditure in developed countries. Analyses suggest that obesity is fast approaching cigarette smoking as the major preventable cause of mortality.

In recent years, our understanding of the epidemiology and causation of obesity has improved dramatically and there is an acceptance that urgent action is required to address the problem. However, there are very few examples of successful, large-scale obesity prevention initiatives from any area of the world. Despite these limitations, sufficient understanding has been gained from smaller scale obesity prevention initiatives together with experiences from the management of other epidemics of noncommunicable diseases to allow effective planning and implementation of obesity prevention programs to proceed.

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