Prevention Conference VII
Obesity, a Worldwide Epidemic Related to Heart Disease and Stroke: Group IV: Prevention/Treatment
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Obesity is a worldwide problem, not just an issue for industrialized nations. Therefore, we need to examine opportunities for prevention and treatment from a global perspective.
The prevalence, or epidemic, of obesity is increasing in most countries throughout the world. The issues for addressing both its prevention and treatment will differ from one country to another, according to the stage of the epidemic, cultural and economic circumstances, and the commitment of the public and politicians. In some less-affluent countries the conditions that promote the positive energy balance that leads to obesity have yet to be identified. In such instances, true primordial prevention (ie, preventing the environmental conditions for obesity from occurring) may be possible. These conditions could include promoting traditional eating patterns, preserving opportunities for active transport (walking, cycling, public transport), and protecting environments against the expansion of automobile travel. In most countries, however, those conditions are present already, and therefore the response to the epidemic will involve both primary prevention (preventing the incidence of new cases of obesity) and secondary prevention (treatment of obesity to reduce complications and prevent further weight gain).
High-Risk and Population-Based Approaches
High-risk and population-based approaches are complementary strategies that provide a continuum of interventions. Supportive environments will increase healthy food and activity choices and promote the adoption of these behaviors for the whole population, including overweight persons who are attempting to make behavioral changes. Supportive environments will increase consumer pressure for those goods, services, and environments and ensure that they will continue to be provided.
The epidemiological triad (host, vector, environment; Figure) was used originally to address infectious disease epidemics, but other, noncommunicable diseases also have benefited from this broad approach.1 Mortality from tobacco-caused diseases, cardiovascular diseases, injuries received in traffic accidents, cervical cancer, and cot death all have decreased in countries that have instituted broad medical …