Planning for the worst: estimates of obesity and comorbidities in school-age children in 2025.

BACKGROUND: Member states of the World Health Organization have adopted resolutions aiming to achieve 'no increase on obesity levels' by 2025 (based on 2010 levels) for infants, adolescents and adults. OBJECTIVES: We aimed to assess the scale of the problem facing health planners and service providers. METHODS AND RESULTS: Using data prepared by the Global Burden of Disease collaborative for 2000 and 2013, we have estimated that by 2025 some 268 million children aged 5-17 years may be overweight, including 91 million obese, assuming no policy interventions have proven effective at changing current trends. We have also estimated the likely numbers of children in 2025 with obesity-related comorbidities: impaired glucose tolerance (12 million), type 2 diabetes (4 million), hypertension (27 million) and hepatic steatosis (38 million). A supplemental table provides estimates for each of 184 nations. CONCLUSION: The 2025 targets are unlikely to be met, and health service providers will need to plan for a significant increase in obesity-linked comorbidities.

Modelling obesity outcomes: reducing obesity risk in adulthood may have greater impact than reducing obesity prevalence in childhood.

A common policy response to the rise in obesity prevalence is to undertake interventions in childhood, but it is an open question whether this is more effective than reducing the risk of becoming obese during adulthood. In this paper, we model the effect on health outcomes of (i) reducing the prevalence of obesity when entering adulthood; (ii) reducing the risk of becoming obese throughout adult life; and (iii) combinations of both approaches. We found that, while all approaches reduce the prevalence of chronic diseases and improve life expectancy, a given percentage reduction in obesity prevalence achieved during childhood had a smaller effect than the same percentage reduction in the risk of becoming obese applied throughout adulthood. A small increase in the probability of becoming obese during adulthood offsets a substantial reduction in prevalence of overweight/obesity achieved during childhood, with the gains from a 50% reduction in child obesity prevalence offset by a 10% increase in the probability of becoming obese in adulthood. We conclude that both policy approaches can improve the health profile throughout the life course of a cohort, but they are not equivalent, and a large reduction in child obesity prevalence may be reversed by a small increase in the risk of becoming overweight or obese in adulthood.