The obesity transition: stages of the global epidemic

Abstract

Our aim was to consolidate the evidence on the epidemiology of obesity into a conceptual model of the 'obesity transition'. Illustrative examples from the thirty most populous countries, representing 77•5% of the world's population, were used. Stage 1 of the obesity transition is characterised by a higher prevalence in women compared to men, in those with higher compared to lower socioeconomic status, and adults compared to children. Many countries in South Asia and sub-Saharan Africa are at this stage. In Stage 2, there is a large increase in the prevalence among adults, a smaller increase among children, and a narrowing of the gender gap and socioeconomic differences among women. Many Latin American and Middle Eastern countries are at this stage. High-income East Asian countries are also at this stage, albeit with a much lower prevalence of obesity. Stage 3 occurs when the prevalence of obesity among those with lower socioeconomic status surpasses that among those with higher socioeconomic status and plateaus in obesity may be observed among women with high socioeconomic status and children. Most European countries are currently at this stage. There are too few signs of countries entering into the proposed final stage of declining obesity prevalence to determine demographic patterns. This conceptual model is intended to provide guidance to researchers and policymakers in identifying the current stage of

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