The increase in obesity prevalence became evident in high-income countries during the 1980s, when eating habits and movement patterns changed dramatically [Flegal et al. 2010
]. The availability of refined carbohydrates and fats increased during this time at a rapid pace. Energy dense, processed foods become cheaper and therefore available to most people [Swinburn et al. 2011
]. Although physical activity energy expenditure may not have declined to the degree that it really fuels the obesity epidemic [Westerterp and Speakman, 2008
], labor-intensive work, such as farming and lumberjacking, have become mechanized through improved technology, making workers less physically active. Even ordinary tasks in daily life have become easier to perform, requiring less physical effort. Elevators, remote controls, computers and increased transportation by various vehicles, even for shorter distances, contribute to decreased physical activity. For example, Canadian children of today only expend one quarter of the energy their counterparts did 40 years ago [Pipe, 2002
There seems to be a predictable pattern in the spreading of obesity. Middle- and low-income countries are now going through the same rapid transition as industrialized countries already have done. Groups of high socioeconomic status in urban areas are the first to increase their obesity prevalence. Later, obesity is also spread to groups of lower socioeconomic status in suburban and rural areas. When gross domestic product (GDP) increases, there is also a faster increase in obesity prevalence among low-income groups [Jones-Smith et al. 2011
Thus, obesity is no longer a problem only in industrialized countries. It has now reached urban and rural areas in the poorest countries of sub-Saharan Africa and South Asia [Popkin et al. 2012
]. Local traditions of foods with high fiber content have been exchanged for processed foods and sugar sweetened soft drinks as a sign of wealth. In fact, not only do many countries suffer from the double burden of both nutrient malnutrition and its related diseases, they also face the comorbidities associated with obesity and being overweight in parallel [Swinburn et al. 2011
Although obesity is not an infectious disease, and consequently cannot correctly be entitled a pandemic, it is rapidly spreading across regions and continents, making it a worldwide concern. Perhaps it is time to question the definition of a pandemic, and upgrade the commonly called obesity epidemic to the new pandemic? By definition, a pandemic disease threatens the whole of society and, therefore, powerful measures have been taken on when a pandemic warning has been issued. Possibly, this upgrade could make politicians react and take command as promptly as they did with the outbreak of swine flu, H1N1. The goal was to nip it in the bud before the situation got worse.
Awareness about the obesity situation has improved, at least in terms of the number of policy programs, guidelines and strategic plans. However, translation into action has not followed. In 2010, the US Surgeon General pointed out that there is a need for dedicated and compassionate citizens involved in grass root efforts [U.S. Department of Health and Human Services, 2010
]. These grass roots are thought to find their own creative ways to implement changes for healthier behaviors in their families and communities. Parents, child care professionals and teachers are encouraged to prevent and intervene even before a child enters the path to obesity. To resolve the obesity epidemic we also need concerted action involving not only the civil society, but also the private sector, professional networks, media and international organizations and last, but not least, the governments [Deitel, 2007
Obesity is one of the most difficult conditions to overcome. The forces that make us enjoy energy-dense food and a sedentary lifestyle are strong. There is a general agreement that prevention of obesity, already from childhood, would be an optimal strategy. When prevention fails, there are in principle three tools to counter obesity: lifestyle modification, pharmacotherapy and bariatric surgery.
This nonsystematic, brief review addresses prevention, as well as current approaches to manage the rising tide of obesity, from patient-centered individual therapies to community-based interventions.