Obesity a triple pandemic, the trillion dollar disease: Prevention is imperative

Obesity is a major global preventable condition. The prevalence in children and adolescents is high and increasing globally.It is associated with serious complications and very expensive morbidity. These include the metabolic syndrome, type 2 diabetes which is more aggressive in children than in adults and an increased prevalence of cancer. In addition, obstetric complications occur along with the development of a cycle of obesity associated with trans generational epigenetic changes associated with obese infants leading to obesity in childhood and later life.The management and treatment of obesity is difficult including changes in established life style. Medications for children are limited and surgery is invasive, generally irreversible and requires lifelong nutritional support. There is a paucity of long-term outcome data relating to both medications and surgery.Prevention at all ages is imperative particularly during the first 1000 days of life, during adolescence and in those who have predisposing factors relating to type 2 diabetes. It requires national governments, communities and health services to promote diet, exercise, early childhood care, school health and expert weight management services.