The Obesity and Type 2 Diabetes Epidemics

Defining CMR


The number of people suffering from type 2 diabetes is skyrocketing worldwide. This phenomenon has been closely linked to soaring obesity, which has reached epidemic proportions in populations around the world. But just why are we facing this “two-pronged assault” by overweight/obesity and type 2 diabetes? The answer is rather simple. The machines we use and the environments in which we live and work are designed to spare us from physical exertion. Unfortunately, this sedentary environment worsens the effects of the energy-dense, refined, “fast food” diet that more and more people are adopting. Taken together, our environment and our diet lead to a positive energy balance, weight gain, and obesity. As obesity reaches epidemic proportions, so too does type 2 diabetes. Unless we make significant changes to both our diet and way of life, obesity and type 2 diabetes will continue to exact a heavy toll on societies worldwide.

The Epidemiological Evidence


Key points

  • Obesity and type 2 diabetes are major cardiovascular risk factors that have reached epidemic proportions. Both diseases are increasing all over the world.
  • The “diabesity” epidemic strikes all sexes, all ages, all educational levels, and all ethnicities.
  • In 2016, more than 1.9 billion adults (18 years and older) were overweight and 650 million of them were obese.
  • The number of diabetic individuals (20-79 years) in 2019 was 463 million. This number is expected to hit 700 million in 2045.
  • Obesity and diabetes rates have increased dramatically in children and adolescents worldwide.


Read more on The Epidemiological Evidence.

The Concept of Energy Balance


Key points

  • Energy intake should be seen as a behaviour which is often influenced by social, environmental, and psychological factors.
  • The interaction between peripheral organs and the hypothalamus has an impact on hunger, motivation to eat, satiety, and energy balance.
  • The macronutrient composition of the diet also influences energy intake and energy expenditure.
  • Obesity and related comorbidities occur when energy intake exceeds energy expenditure over time.
  • In sedentary individuals, resting metabolic rate accounts for a large part of total energy expenditure.
  • Physical activity increases energy expenditure by increasing resting metabolic rate, enhancing sensitivity to specific hormones, and decreasing post-exercise energy intake.
  • Physical activity has the greatest impact on total daily energy expenditure. However, a high level of physical activity is required for this to occur.
  • Exercise benefits cardiovascular health and risk factors beyond what can be explained by increased energy expenditure.


Read more on The Concept of Energy Balance.