**5. Key patterns describing obesity**

A set of factors have been associated with obesity, such as age, gender and social and economic status. In developed countries, the natural pattern seen in the elders is an enhancement in body mass, especially in 50–60-year-old men but in women as well. However, the relationship between "unhealthy" obesity and "old" age is similar in the main part of developing countries. Interestingly, one may observe that maximum rates of weight gain seem to appear at an earlier age (i.e. around 40 years of age). The drop in prevalence, when this obesity peak is reached or passed, seems to be partly attributed to a decline in the survival rate of obese individuals. A clear-cut difference between genders is now emerging in an increasing number of countries, showing that (in fact) more women than men are developing obesity (BMI > 30). Contrastingly, the proportion of men who tend to develop overweight (BMI 25.0–29.9) seems to be greater than for women. Certain patterns also seem to emerge, "transversing" socioeconomic groups. Within developed countries, levels of obesity tend to be elevated in the lower socioeconomic spheres, while in most developing countries/areas around the globe, this relationship is reversed. The transition from rural to urban lifestyles is heavily associated with an increase in the prevalence of obesity, which has been associated with marked and overt changes in lifestyles (e.g. enhanced intake of highenergy-dense alimentary based, as well as a decrease in physical activity, whether NEAT (non-exercise activity thermogenesis) based or exercise "induced"). Furthermore, ethnicity is also believed to feature associated with a marked spectrum, reflecting a large variation in levels of obesity [6].

#### **5.1. Social, health and economic costs of obesity**

Obesity comes with a large spectrum of negative health-related, social and economic consequences. The rates of mortality and morbidity tend to be far much higher amongst overweight and obese people than lean individuals. An increased BMI value is closely linked with a greater risk of disease states like CHD, hypertension, hyperlipidaemia, NIDDM and certain cancers. Additionally, obesity has since long (20 years) been established as a major independent risk factor for the development of CHD by the American Heart Association [7]. In this context, modest weight reduction has been shown to significantly reduce the risk of these serious health conditions. Furthermore, as an additional impact on anyone's health, obesity represents a major social burden. The obesity "condition" has been denominated as the "last remaining socially acceptable form of prejudice", which not only exists amongst the general public but also resides within the majority of healthcare professionals. Tragically, negative attitudes of some healthcare professionals may seriously impede or postpone the treatment of overweight and obese individuals.

Often, one may observe that the serious health and social consequences of obesity are overshadowing the economic cost to society and to the individual. For instance, as long back as in 1995 in the USA, the rough cost attributable to obesity was estimated at \$99 billion. Furthermore, in several developed countries, the obesity epidemics have been estimated to account for as much as 2–7% of the total healthcare costs. Additionally, in addition to the direct costs of obesity come financial obligations related to individuals (i.e. health deterioration and reduced life quality = intangible costs) and the society, in terms of productivity loss, with increased sick leave and premature pensions (serving as indirect costs). The prevention incurred turn out to be more cost-effective than offering treatments, as far as economy is concerned. And in addition, healthcare providers, as well as policymakers, should acknowledge the importance of the obesity epidemic and its prevention, as well as develop cost-effective policies and programmes, in order to prevent this increasing worldwide epidemic to conquer the whole world.
