Obesity is a serious, common and growing problem. It is calculated that there are currently over 1.6 billion people who are over their ideal weight, 500 million of whom are obese. There is surprisingly high prevalence in regions that have historically been considered as undernourished regions. This does not only include various countries in Latin America, but also, and in particular, countries in the Middle East and Oceania, China, Australasia, Vietnam and the Pacific Islands. Noteworthy prevalence is also emerging in Africa and Asia. In general, obesity is more prevalent among women, and in Europe it is more so in Mediterranean countries. In the US, 66.7% of the population is overweight or obese, a factor that contributes to 300,000-plus deaths each year, with estimated costs for the country´s annual health bill of over 100 billion dollars.

In view of the growing concern for this situation, in 2001 the WHO admitted that obesity amounts to a pandemic that it coined “globesity”, in an attempt to draw attention to the global problem, and, what is more worrying in terms of public health, to its continuing expansion and growth, especially among children and adolescents.

Thus, predictions for the UK, issued by the UK Foresight Report, indicate that by the year 2050, 60% of men and 50% of women will be obese, apart from those who are overweight, which poses a health risk in itself. Based on this estimate, the number of British men and women with an ideal weight will fall from 30 and 40% to 10 and 15%, respectively.

“Globesity” could endanger the gain in life expectancy that has been experienced in the last century.

Concern about obesity is not a new subject, and much effort has been put into obesity treatment for many centuries. However, it has only recently been regarded as a disease, in the sense of identifying it as a specific target for medical treatment. As a result, much progress has been made in furthering our understanding of obesity, research developments, industrial applications, and in different types of treatment - including diets, exercise and finding useful drugs.

Again, data from the US show that over 4 billion dollars are spent each year on drugs and surgical procedures to treat obesity, while over 50 million dollars are spent on the OTC market for weight loss remedies.

Obesity treatment, however, should not be a serious problem because we have known how to deal with it for a long time. It is simply a question of achieving an adequate balance between energy input and output. This simplification has brought obesity to be considered as a personal problem based on an individual´s lack of willpower to maintain his/her ideal weight.

However, this perception is undergoing a dramatic change, and all the “blame” that has been placed on the individual is now being shifted. In the US, the advisory committee for the 2010 Dietary Guidelines for Americans noted that obesity is the “biggest threat to public health” and stressed that “basic nutrition advice has not changed substantially over the last 30 years...”, but added that “it is becoming harder and harder to eat well...” And, it continued, “until there is a change in the food environment, people will find it very hard to follow dietary guidelines and advice.”

In the UK, the aforementioned UK Foresight Report transmits a similar message: “Obesity is one of the penalties of the modern world, where energy-dense food is abundant and labour-saving technologies abound...” In this environment, “excessive and unhealthy weight is often related to individual choice of diet, giving up exercise and so-called lifestyle.” We are therefore faced with a complex web of social and biological factors that make us more vulnerable to weight gain, and that means that the goal should be oriented towards limiting the obesogenic environment in which we are immersed and to which we are exposed.

The topics covered in detail in the chapters of “Obesity” examine facets of this multifactorial disease that involve genetic determinants, the harmful consequences of obesity as a result of complicated interactions with other diseases, and the mechanisms - complex in themselves - by which patients deteriorate and complications appear.

The book was written with the intention of providing scientific rigour and balance to the problem of obesity. This was achieved by bringing together the contributions of many of the most world-renowned scientists who offer readers the most relevant aspects, from physiopathology to prevention and treatment, without neglecting aspects of genetics and society.

“Obesity” was designed with the participation of 30 scientists from both sides of the Atlantic. Its 386 pages, published by Elsevier, includes a Preface by the coordinators; a section on General Aspects, consisting of 7 chapters, a second section on the Physiopathology of obesity with 7 chapters, and a third section on Prevention and Treatment with 8 chapters. Readers are also provided with an extensive glossary of terms and an index.

In view of its great prevalence and importance in health and society, obesity is of interest to researchers and specialists - especially internists, endocrinologists and cardiologists - as well as other doctors and researchers who wish to learn more about the subject.

Diabetes, together with obesity, is the true pandemic of the 21st Century, entailing a considerable risk of other diseases such as cardiovascular disease and even cancer. The aim of Fundación Lilly (www.fundacionlilly.com), in keeping with its statutory objectives, is to work to further knowledge of these concepts. We are confident that we have achieved this, as a result, I repeat, of the eminent group of collaborators who accepted our invitation to share their knowledge and opinions in each chapter.

José A. Gutiérrez Fuentes