overweight and obesity - epidemiology forecast to 2022 · reference code gdhcer022 | publication...

REFERENCE CODE GDHCER022 | PUBLICAT ION DATE AUGUST 2013

OVERWEIGHT AND OBESITY - EPIDEMIOLOGY FORECAST TO 2022

Overweight and Obesity - Epidemiology Forecast to 2022 2 © GlobalData. This report is a licensed product and is not to be copied, reproduced, shared or resold in any form.

Executive Summary


Obesity is an escalating global public health

problem that has reached pandemic proportions. It

is caused by a combination of excessive caloric

intake and physical inactivity, which, in turn, leads

to excessive fat accumulation in the body,

negatively impacting health. Obesity is the major

cause of type 2 diabetes, coronary heart disease,

and ischemic stroke, which are increasing globally

(Larson and Wolk, 2006). The World Health

Organization (WHO) estimates that worldwide, 2.8

million people die each year due to obesity and its

associated comorbidities (WHO, 2013a).

Moreover, 35.8 million (2.3%) of global disability-

adjusted life years (DALYs) are caused by

overweight/obesity (WHO, 2013d). Globally, in

2008, 35% of adults ages 20 years and older were

overweight, as defined by a body mass index (BMI)

of ≥25 kg/m2 (includes all overweight and obese),

and 11% were obese (BMI ≥30 kg/m2) (WHO,

2013a; WHO, 2013c; WHO, 2013d). During 1980–

2008, the obesity prevalence almost doubled

globally. In 1980, only 5% of men and 8% of

women over the age of 20 years were obese, and

in 2008, these proportions almost doubled to 10%

for men and 14% for women, resulting in an

estimated 205 million and 297 million prevalent

cases of obesity in men and women, respectively

(WHO, 2013d).

This report provides an overview of the risk factors,

comorbidities, and the global trends for overweight

and obesity in the nine major markets (9MM) (US,

France, Germany, Italy, Spain, UK, Japan, Brazil,

and Canada). The report also includes a 10-year

epidemiology forecast of the prevalent cases of

overweight, obesity, obesity class I, obesity class

II, and obesity class III segmented by sex and age.

In addition, the report includes a 10-year forecast

of the prevalent cases of obesity-associated

comorbidities, such as diagnosed diabetes,

diagnosed hypertension, and dyslipidemia, among

adults with overweight/obesity in some of these

markets.

To forecast the prevalent cases of overweight,

obesity, obesity class I, obesity class II, and

obesity class III segmented by sex and age in

these major markets, GlobalData epidemiologists

used longitudinal historical data obtained from

country-specific, national-level studies using the

uniform diagnostic criteria specified by the WHO

for overweight (BMI = 25.00–29.99 kg/m2), obesity

(BMI = ≥30.00 kg/m2), obesity class I (BMI =

30.00–34.99 kg/m2), obesity class II (BMI = 35.00–

39.99 kg/m2), and obesity class III (BMI = ≥40.00

kg/m2), and applied regression methods to forecast

the prevalent cases (WHO, 2013c). GlobalData

epidemiologists used country-specific national or

regional studies that mirror the national population

to develop a forecast for the hypertension,

dyslipidemia, and type 2 diabetes comorbidities in

selected markets.



Executive Summary

As shown in the below figures, GlobalData

epidemiologists forecast that the number of

prevalent cases of overweight in the 9MM will grow

by 8.70% during the forecast period, from 250.05

million cases in 2012 to 271.86 million cases by

2022. Compared with overweight, GlobalData

epidemiologists forecast a substantial growth in the

projected number of prevalent cases of obesity in

the 9MM, with a 27.5% increase during the

forecast period, from 167.39 million cases in 2012

to 213.34 million cases in 2022. Throughout the

forecast period, the US will have the most

prevalent cases of overweight and obesity, with

80.75 million cases of overweight and 112.78

million cases of obesity by 2022, followed by

Brazil, with 63.83 million cases of overweight and

26.34 million cases of obesity.

9MM, Prevalent Cases of Overweight, Ages ≥18 Years, Both Sexes, N (Millions), 2012 and 2022

9.37

17.19

17.38

17.59

18.59

20.78

26.37

63.83

80.75

91.53

198.65

271.86

9.54

14.38

16.12

16.64

18.50

23.38

24.25

48.56

78.69

89.02

191.96

250.05

0 50 100 150 200 250 300

Canada

Spain

France

Italy

UK

Germany

Japan

Brazil

US

5EU

7MM

9MM

Prevalent Cases of Overweight (N=Millions)

2012

2022

Source: GlobalData; CCHS, 2004; Charles et al., 2008; CHMS, 2010; CHMS, 2012; Flegal et al., 2010; Flegal et al., 2012; Gallus et al., 2006; Gallus et al., 2013; Gigante et al., 2011; Hauner et al., 2008; HSE, 2011; INE, 2013a; INE, 2013b; INE, 2013c; Monteiro et al., 2007; Ogden et al., 2006; Tanaka and Kokubo, 2005; WHO, 2011; WHO, 2013b; Yoshiike et al., 2002. Note: 5EU = France, Germany, Italy, Spain, and UK; 7MM = US, 5EU, and Japan; 9MM = 7MM, Brazil, and Canada

9MM, Prevalent Cases of Obesity, Ages ≥18 Years, Both Sexes, N (Millions), 2012 and 2022

4.00

5.15

9.22

9.90

11.41

15.69

18.85

26.34

60.32

112.78

177.10

213.34

3.66

4.77

6.65

7.62

8.23

12.93

16.55

19.17

49.13

87.80

140.60

167.39

0 50 100 150 200 250

Japan

Italy

Spain

Canada

France

UK

Germany

Brazil

5EU

US

7MM

9MM

Prevalent Cases of Obesity (N=Millions)

2012

2022

Source: GlobalData; CCHS, 2004; Charles et al., 2008; CHMS, 2010; CHMS, 2012; Flegal et al., 2010; Flegal et al., 2012; Gallus et al., 2006; Gallus et al., 2013; Gigante et al., 2011; Hauner et al., 2008; HSE, 2011; INE, 2013a; INE, 2013b; INE, 2013c; Monteiro et al., 2007; Tanaka and Kokubo, 2005; WHO, 2011; WHO, 2013b; Yoshiike et al., 2002. Note: 5EU = France, Germany, Italy, Spain, and UK; 7MM = US, 5EU, and Japan; 9MM = 7MM, Brazil, and Canada

The major drivers of the substantial increase in the

projected prevalence and prevalent cases of

overweight and obesity in the 9MM is both an

increased adoption of a westernized lifestyle and

an increase in the prevalence of obesity risk

factors. As modern lifestyles typically include risk

factors such as a sedentary lifestyle and physical

inactivity combined with high caloric intake, it will

be difficult for public health organizations and

policymakers to aim for effective control measures

at a population level to curtail this fast-growing

epidemic. As a result, GlobalData epidemiologists

predict that the obesity epidemic and its associated

comorbidities will continue to increase, making

them a significant threat to public health.



Table of Contents

1 Table of Contents

1 Table of Contents .......................................................................................................................... 4

1.1 List of Tables............................................................................................................................ 8

1.2 List of Figures ........................................................................................................................ 10

2 Introduction ................................................................................................................................. 12

2.1 Catalyst .................................................................................................................................. 12

2.2 Related Reports ..................................................................................................................... 13

2.3 Upcoming Reports ................................................................................................................. 13

3 Epidemiology ............................................................................................................................... 14

3.1 Disease Overview .................................................................................................................. 14

3.2 Risk Factors and Comorbidities.............................................................................................. 15

3.2.1 Family history is a strong predictor of obesity ................................................................. 15

3.2.2 Physical inactivity is an independent predictor of obesity ................................................ 16

3.2.3 Excessive caloric intake doubles the risk for obesity ....................................................... 17

3.2.4 Hypertension is as high as 42% in obese adults ............................................................. 18

3.2.5 Dyslipidemia and type 2 diabetes are common comorbidities in obese patients ............. 19

3.3 Global Trends ........................................................................................................................ 21

3.3.1 US .................................................................................................................................. 22

3.3.2 5EU ................................................................................................................................ 24

3.3.3 Japan.............................................................................................................................. 30

3.3.4 Brazil .............................................................................................................................. 31

3.3.5 Canada ........................................................................................................................... 33

3.4 Forecast Methodology ............................................................................................................ 34



Table of Contents

3.4.1 Sources Used ................................................................................................................. 41

3.4.2 Forecast Assumptions and Methods: Prevalent Cases of Overweight, Obesity, Obesity by

Class, and Comorbidities ................................................................................................ 48

3.4.3 Sources Not Used........................................................................................................... 65

3.5 Epidemiology Forecast of Overweight (2012–2022) ............................................................... 65

3.5.1 Prevalent Cases of Overweight....................................................................................... 65

3.5.2 Age-Specific Prevalent Cases of Overweight .................................................................. 67

3.5.3 Sex-Specific Prevalent Cases of Overweight .................................................................. 69

3.5.4 Age-Standardized Prevalence of Overweight .................................................................. 72

3.6 Epidemiology Forecast of Obesity (2012–2022) ..................................................................... 73

3.6.1 Prevalent Cases of Obesity ............................................................................................ 73

3.6.2 Age-Specific Prevalent Cases of Obesity ........................................................................ 75

3.6.3 Sex-Specific Prevalent Cases of Obesity ........................................................................ 77

3.6.4 Age-Standardized Prevalence of Obesity ....................................................................... 78

3.7 Epidemiology Forecast of Obesity Class I (2012–2022) ......................................................... 79

3.7.1 Prevalent Cases of Obesity Class I ................................................................................. 79

3.7.2 Age-Specific Prevalent Cases of Obesity Class I ............................................................ 81

3.7.3 Sex-Specific Prevalent Cases of Obesity Class I ............................................................ 83

3.7.4 Age-Standardized Prevalence of Obesity Class I ............................................................ 85

3.8 Epidemiology Forecast of Obesity Class II (2012–2022) ........................................................ 87

3.8.1 Prevalent Cases of Obesity Class II ................................................................................ 87

3.8.2 Age-Specific Prevalent Cases of Obesity Class II ........................................................... 89

3.8.3 Sex-Specific Prevalent Cases of Obesity Class II ........................................................... 91



Table of Contents

3.8.4 Age-Standardized Prevalence of Obesity Class II ........................................................... 93

3.9 Epidemiology Forecast of Obesity Class III (2012–2022) ....................................................... 95

3.9.1 Prevalent Cases of Obesity Class III ............................................................................... 95

3.9.2 Age-Specific Prevalent Cases of Obesity Class III .......................................................... 97

3.9.3 Sex-Specific Prevalent Cases of Obesity Class III .......................................................... 99

3.9.4 Age-Standardized Prevalence of Obesity Class III ........................................................ 101

3.10 Epidemiology Forecast of Comorbidities among Adults with Overweight/Obesity (2012 and

2022).................................................................................................................................... 103

3.10.1 Prevalent Cases of Diagnosed Diabetes among Adults with Overweight/Obesity ......... 103

3.10.2 Prevalent Cases of Diagnosed Hypertension in Adults with Overweight/Obesity .......... 106

3.10.3 Prevalent Cases of Dyslipidemia among Adults with Overweight/Obesity ..................... 108

3.11 Discussion ........................................................................................................................... 111

3.11.1 Conclusions on Epidemiological Trends ....................................................................... 111

3.11.2 Limitations of the Analysis ............................................................................................ 112

3.11.3 Strengths of the Analysis .............................................................................................. 113

4 Appendix ................................................................................................................................... 114

4.1 Bibliography ......................................................................................................................... 114

4.2 About the Authors ................................................................................................................ 120

4.2.1 Epidemiologists ............................................................................................................ 120

4.2.2 Reviewers ..................................................................................................................... 120

4.2.3 Global Director of Epidemiology and Health Policy ....................................................... 121

4.2.4 Global Head of Healthcare ............................................................................................ 122

4.3 About GlobalData ................................................................................................................. 123



Table of Contents

4.4 About EpiCast ...................................................................................................................... 123

4.5 Disclaimer ............................................................................................................................ 124



Table of Contents

1.1 List of Tables

Table 1: The WHO Classification System of Adult Overweight and Obesity According to BMI .................... 14

Table 2: Risk Factors and Comorbidities of Obesity ................................................................................... 15

Table 3: 9MM, Age-Adjusted and Crude Prevalence (%) of Obesity, by Sex, Ages ≥20 Years, 2008 .......... 22

Table 4: JASSO and WHO Classifications of Obesity ................................................................................. 30

Table 5: Sources of Epidemiological Data Used for Forecasting the Prevalent Cases of Overweight .......... 35

Table 6: Sources of Epidemiological Data Used for Forecasting the Prevalent Cases of Obesity ................ 36

Table 7: Sources of Epidemiological Data Used for Forecasting the Prevalent Cases of Obesity Class I,

Class II, and Class III ................................................................................................................... 38

Table 8: Sources of Epidemiological Data Used for Forecasting the Prevalent Cases of Comorbidities in

Overweight/Obese ....................................................................................................................... 40

Table 9: 9MM, Prevalent Cases of Overweight, Ages ≥18 Years, Both Sexes, N (Millions), 2012–2022 ...... 66

Table 10: 9MM, Prevalent Cases of Overweight, By Age, Both Sexes, N (Millions), Row (%), 2012.............. 68

Table 11: 9MM, Prevalent Cases of Overweight, Ages ≥18 Years, By Sex, N (Millions), Row (%), 2012 ....... 70

Table 12: 9MM, Prevalent Cases of Obesity, Ages ≥18 Years, Both Sexes, N (Millions), 2012–2022 ........... 74

Table 13: 9MM, Prevalent Cases of Obesity, By Age, Both Sexes, N (Millions), Row (%), 2012 ................... 76

Table 14: 9MM, Prevalent Cases of Obesity, Ages ≥18 Years, by Sex, N (Millions), Row (%), 2012 ............. 77

Table 15: 9MM, Prevalent Cases of Obesity Class I, Ages ≥18 Years, Both Sexes, N (Millions), 2012–

2022 ............................................................................................................................................ 80

Table 16: 9MM, Prevalent Cases of Obesity Class I, by Age, Both Sexes, N (Millions), Row (%), 2012 ........ 82

Table 17: 9MM, Prevalent Cases of Obesity Class I, Ages ≥18 Years, By Sex, N (Millions), Row (%), 2012 . 84

Table 18: 9MM, Prevalent Cases of Obesity Class II, Ages ≥18 Years, Both Sexes, N (Millions), 2012–

2022 ............................................................................................................................................ 88

Table 19: 9MM, Prevalent Cases of Obesity Class II, By Age, Both Sexes, N (Millions), Row (%), 2012 ....... 90

Table 20: 9MM, Prevalent Cases of Obesity Class II, Ages ≥18 Years, By Sex, N (Millions), Row (%),

2012 ............................................................................................................................................ 92



Table of Contents

Table 21: 9MM, Prevalent Cases of Obesity Class III, Ages ≥18 Years, Both Sexes, N (Millions), 2012–

2022 ............................................................................................................................................ 96

Table 22: 9MM, Prevalent Cases of Obesity Class III, By Age, Both Sexes, N (Millions), Row (%), 2012 ...... 98

Table 23: 9MM, Prevalent Cases of Obesity Class III, Ages ≥18 Years, By Sex, N (Millions), Row (%),

2012 .......................................................................................................................................... 100

Table 24: 5MM*, Prevalent Cases of Diagnosed Diabetes among Adults with Overweight/Obesity, Both

Sexes, N (Millions), 2012 and 2022 ............................................................................................ 104

Table 25: 6MM*, Prevalent Cases of Diagnosed Hypertension among Adults with Overweight/Obesity,

Both Sexes, N (Millions), 2012 and 2022 .................................................................................... 107

Table 26: 4MM, Prevalent Cases of Dyslipidemia* among Adults with Overweight/Obesity, Both Sexes, N

(Millions), 2012 and 2022 ........................................................................................................... 109



Table of Contents

1.2 List of Figures

Figure 1: US, Overweight and Obesity Age-Adjusted Prevalence (%), Ages 20–74 Years, Men, 1960–

2010 ............................................................................................................................................ 23

Figure 2: US, Overweight and Obesity Age-Adjusted Prevalence (%), Ages 20–74 Years, Women, 1960–

2010 ............................................................................................................................................ 23

Figure 3: France, Overweight and Obesity Prevalence (%), Ages ≥15 Years, Men, 1997–2006 ................... 25

Figure 4: France, Overweight and Obesity Prevalence (%), Ages ≥15 Years, Women, 1997–2006 .............. 25

Figure 5: Italy, Overweight and Obesity Prevalence (%), Ages ≥18, Men, 1983–2010 ................................. 27

Figure 6: Italy, Overweight and Obesity Prevalence (%), Ages ≥18, Men, 1983–2010 ................................. 27

Figure 7: UK, Overweight and Obesity Prevalence (%), Ages ≥16 Years, Men, 1993–2011 ......................... 29

Figure 8: UK, Overweight and Obesity Prevalence (%), Ages ≥16 Years, Women, 1993–2011 .................... 29

Figure 9: Japan, Obesity Prevalence (%), Ages ≥20 Years, By Sex, 1976–2006 ......................................... 31

Figure 10: Brazil, Overweight and Obesity Prevalence (%), Ages ≥20 Years, Men, 1975–2003 ..................... 32

Figure 11: Brazil, Overweight and Obesity Prevalence (%), Ages ≥20 Years, Women, 1975–2003 ................ 32

Figure 12: Canada, Obesity Prevalence (%), Ages ≥18 Years, Both Sexes, 1978–2008 ................................ 34

Figure 13: 9MM, Prevalent Cases of Overweight, Ages ≥18 Years, Both Sexes, N (Millions), 2012–2022 ...... 67

Figure 14: 9MM, Prevalent Cases of Overweight, by Age, Both Sexes, N (Millions), 2012 ............................. 69

Figure 15: 9MM, Prevalent Cases of Overweight, Ages ≥18 Years, by Sex, N (Millions), 2012 ...................... 71

Figure 16: 9MM, Overweight Age-Standardized Prevalence (%), Ages ≥18 Years, By Sex, 2012 .................. 73

Figure 17: 9MM, Prevalent Cases of Obesity, Ages ≥18 Years, Both Sexes, N (Millions), 2012–2022 ........... 75

Figure 18: 9MM, Prevalent Cases of Obesity, By Age, Both Sexes, N (Millions), 2012 ................................... 76

Figure 19: 9MM, Prevalent Cases of Obesity, Ages ≥18 Years, by Sex, N (Millions), 2012 ............................ 78

Figure 20: 9MM, Obesity Age-Standardized Prevalence (%), Ages ≥18 Years, By Sex, 2012 ........................ 79

Figure 21: 9MM*, Prevalent Cases of Obesity Class I, Ages ≥18 Years, Both Sexes, N (Millions), 2012–

2022 ............................................................................................................................................ 81



Table of Contents

Figure 22: 9MM*, Prevalent Cases of Obesity Class I, By Age, Both Sexes, N (Millions), 2012 ...................... 83

Figure 23: 9MM*, Prevalent Cases of Obesity Class I, Ages ≥18 Years, by Sex, N (Millions), 2012 ............... 85

Figure 24: 9MM*, Obesity Class I Age-Standardized Prevalence (%), Ages ≥18 Years, by Sex, 2012.......... 86

Figure 25: 9MM*, Prevalent Cases of Obesity Class II, Ages ≥18 Years, Both Sexes, N (Millions), 2012–

2022 ............................................................................................................................................ 89

Figure 26: 9MM*, Prevalent Cases of Obesity Class II, By Age, Both Sexes, N (Millions), 2012 ..................... 91

Figure 27: 9MM*, Prevalent Cases of Obesity Class II, Ages ≥18 Years, by Sex, N (Millions), 2012 .............. 93

Figure 28: 9MM*, Age-Standardized Prevalence (%) of Obesity Class II, Ages ≥18 Years, By Sex, 2012 .... 94

Figure 29: 9MM*, Prevalent Cases of Obesity Class III, Ages ≥18 Years, Both Sexes, N (Millions), 2012–

2022 ............................................................................................................................................ 97

Figure 30: 9MM*, Prevalent Cases of Obesity Class III, By Age, Both Sexes, N (Millions), 2012 .................... 99

Figure 31: 9MM*, Prevalent Cases of Obesity Class III, Ages ≥18 Years, By Sex, N (Millions), 2012 ........... 101

Figure 32: 9MM*, Obesity Class III Age-Standardized Prevalence (%), Ages ≥18 Years, By Sex, 2012 ....... 102

Figure 33: 5MM*, Prevalent Cases of Diagnosed Diabetes among Adults with Overweight/Obesity, Both

Sexes, N (Millions), 2012 ........................................................................................................... 105

Figure 34: 6MM*, Prevalent Cases of Diagnosed Hypertension among Adults with Overweight/Obesity,

Both Sexes, N (Millions), 2012 ................................................................................................... 108

Figure 35: 4MM*, Prevalent Cases of Dyslipidemia** among Adults with Overweight/Obesity, Both Sexes,

N (Millions), 2012 ....................................................................................................................... 110



Introduction

2 Introduction

2.1 Catalyst

Overweight and obesity are diseases characterized by abnormal or excessive fat accumulation in

the body, which can increase the likelihood of developing type 2 diabetes and cardiovascular

diseases (Larson and Wolk, 2006; WHO, 2013a). The World Health Organization (WHO) classifies

overweight and obesity by body mass index (BMI). A BMI of ≥25 kg/m2 is considered overweight,

and a BMI of ≥30 kg/m2 is considered to be obese (WHO, 2013c). Obesity is an escalating public

health problem with an increasing prevalence worldwide, and it has become a well-known threat to

public health (WHO, 2013d).

To provide a thorough description of the overweight and obese (all obese, class I obesity, class

II obesity, class III obesity) patient population in each country, GlobalData epidemiologists

segmented the overweight and obesity prevalent cases by sex, age (in five-year increments,

beginning at age 18 years and ending at ≥85 years) in the nine major markets (9MM) (US,

France, Germany, Italy, Spain, UK, Japan, Brazil, and Canada).

GlobalData epidemiologists forecast that there were 250.05 million prevalent cases of

overweight adults in the 9MM in 2012, which will increase to 271.86 million cases in 2022,

increasing at an Annual Growth Rate (AGR) of 0.86%.

GlobalData epidemiologists forecast that there were 167.39 million prevalent cases of obesity

in the 9MM in 2012, which will increase to 213.34 million cases in 2022, increasing at an AGR

of 2.75%.

While the trend in the prevalent cases of overweight remains almost stable for most of the

9MM during the forecast period, a substantial growth in the prevalent cases of obesity is seen

in most of the markets.

Approximately 57% of the 250.05 million prevalent cases of overweight adults in the 9MM in

2012 were in men.

Approximately 52% of the 167.39 million prevalent cases of obese adults in the 9MM in 2012

were in women.



Appendix

4.3 About GlobalData

GlobalData is a leading global provider of business intelligence in the Healthcare industry.

GlobalData provides its clients with up-to-date information and analysis on the latest developments

in drug research, disease analysis, and clinical research and development. Our integrated business

intelligence solutions include a range of interactive online databases, analytical tools, reports and

forecasts. Our analysis is supported by a 24/7 client support and analyst team.

GlobalData has offices in New York, Boston, London, India and Singapore.

4.4 About EpiCast

EpiCast is a series of premier epidemiology reports written and developed by Masters

and PhD level epidemiologists.

EpiCast Reports are in-depth, high quality, transparent and market-driven, providing expert

analysis of epidemiological trends and forecasting of patient populations for major markets.

Specifically, the reports identify disease trends over a 10-year forecast period in six to seven major

markets (US, France, Germany, Italy, Spain, UK, Japan). Additional countries, such as Canada,

Brazil, India and China, are covered in these reports if their markets are highly relevant.

tskrishna

Text Box



Appendix

4.5 Disclaimer

All Rights Reserved.

No part of this publication may be reproduced, stored in a retrieval system or transmitted in any

form by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior

permission of the publisher, GlobalData.

overweight and obesity - epidemiology forecast to 2022 · reference code gdhcer022 | publication...

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