Abstract
Aims: The purpose of this research was to describe the current prevalence and historic trends in overweight, obesity and severe obesity in Sweden. Methods: Data on BMI, age, gender, education and geographic region were obtained in n=447,925 Swedish adults through a nationwide screening test (1995–2017). To account for sampling variations, we quantified prevalence estimates and time trends using standardized values (direct method) to all 18–74-year-old Swedes, using nationwide databases. Rates of overweight (BMI ⩾25 kg/m2), obesity (BMI ⩾30 kg/m2) and severe obesity (BMI ⩾35 kg/m2) were calculated across gender, age, education and geographic categories. Years were grouped into two-year sampling periods (except the first period where we used three years) for increased power. We used multivariable logistic regression to quantify independent associations between age, gender, education and region with obesity development and current prevalence rates. Results: In 2016/17 the unstandardized prevalence of overweight, obesity and severe obesity were 55.1%, 16.6% and 4.2%, respectively. Factors associated with a higher obesity prevalence were male gender, older age, lower education and residing in a rural region (all P<0.001). Between 1995 and 2017 the prevalence of severe obesity increased by 153%, compared to obesity (+86%) and overweight (+23%). While there were similar increases in obesity across gender and age groups, people with low education (vs high) and rural areas (vs urban) had a higher prevalence increase (both P<0.001). Conclusions: Rates of overweight, obesity and severe obesity have increased markedly in Swedish adults since 1995. Priority groups for prevention efforts include individuals with low education and those living in rural areas.
Highlights
Obesity is a major threat to public health through its association with many of our leading causes of morbidity and mortality [1,2]
Previous limitations in studies on obesity prevalence and time trends in Sweden include self-report data, which tend to provide biased results, as well as having samples that may include an insufficient number of individuals across important obesity prognostic variables to allow for a detailed assessment of how obesity
We aimed to describe the current (2016–2017) prevalence estimate of obesity (BMI ⩾30 kg/m2) and severe obesity (BMI ⩾35 kg/m2) using objective data in a large cohort of Swedish adults, with accompanying time trends in obesity and severe obesity between 1995 and 2017
Summary
Obesity is a major threat to public health through its association with many of our leading causes of morbidity and mortality [1,2]. Obesity is associated with huge costs to society through increased health care expenditures, sick leave and reduced productivity [3], and individuals with obesity suffer pervasive stigmatization and discrimination [4]. There are clear indications that most Western societies experience greater increases of obesity in lower socioeconomic position (SEP) groups compared to high SEP groups, and that this effect may be increasing [5,6,7]. Previous limitations in studies on obesity prevalence and time trends in Sweden include self-report data (primarily height and weight), which tend to provide biased results (underestimations), as well as having samples that may include an insufficient number of individuals across important obesity prognostic variables (gender, education, socioeconomic position, etc.) to allow for a detailed assessment of how obesity.
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