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Abstract
Obesity is a complex multifactorial disease. The worldwide prevalence of overweight
and obesity has doubled since 1980 to an extent that nearly a third of the world's
population is now classified as overweight or obese. Obesity rates have increased
in all ages and both sexes irrespective of geographical locality, ethnicity or socioeconomic
status, although the prevalence of obesity is generally greater in older persons and
women. This trend was similar across regions and countries, although absolute prevalence
rates of overweight and obesity varied widely. For some developed countries, the prevalence
rates of obesity seem to have levelled off during the past few years. Body mass index
(BMI) is typically used to define overweight and obesity in epidemiological studies.
However, BMI has low sensitivity and there is a large inter-individual variability
in the percent body fat for any given BMI value, partly attributed to age, sex, and
ethnicity. For instance, Asians have greater percent body fat than Caucasians for
the same BMI. Greater cardiometabolic risk has also been associated with the localization
of excess fat in the visceral adipose tissue and ectopic depots (such as muscle and
liver), as well as in cases of increased fat to lean mass ratio (e.g. metabolically-obese
normal-weight). These data suggest that obesity may be far more common and requires
more urgent attention than what large epidemiological studies suggest. Simply relying
on BMI to assess its prevalence could hinder future interventions aimed at obesity
prevention and control.