Epidemiology of Obesity in the Western Hemisphere

CONTEXT: Obesity has emerged as a global public health challenge. The objective of this review was to examine epidemiological aspects of obesity in the Western Hemisphere. EVIDENCE ACQUISITION: Using PubMed, we searched for publications about obesity (prevalence, trends, correlates, economic costs) in countries in North America, Central America, South America, and the Caribbean. To the extent possible, we focused on studies that were primarily population based in design and on four countries in the Western Hemisphere: Brazil, Canada, Mexico, and the United States. EVIDENCE SYNTHESIS: Data compiled by the International Obesity Task Force show a substantial level of obesity in all of or selected areas of the Bahamas, Barbados, Canada, Chile, Guyana, Mexico, Panama, Paraguay, Peru, St. Lucia, Trinidad and Tobago, the United States, and Venezuela. Furthermore, countries such as Brazil, Canada, Mexico, and the United States have experienced increases in the prevalence of obesity. In many countries, the prevalence of obesity is higher among women than men and in urban areas than in rural areas. The relationship between socioeconomic status and obesity depends on the stage of economic transition. Early in the transition, the prevalence of obesity is positively related to income whereas at some point during the transition the prevalence becomes inversely related to income. CONCLUSIONS: Like other countries in the Western Hemisphere, the four countries that we focused on have experienced a rising tide of obesity. The high and increasing prevalence of obesity and its attendant comorbidities are likely to pose a serious challenge to the public health and medical care systems in these countries.