Trends in morbid obesity and in bariatric surgeries covered by the Brazilian public health system.
BACKGROUND
Obesity is an increasingly serious public health problem on a global level. Morbid obesity, defined as a body mass index greater than 40 kg/m(2), is associated with increased mortality and a high burden of obesity-related morbidities.


METHODS
To study the prevalence of morbid obesity in Brazil, three national anthropometric surveys were reanalyzed. Data about bariatric surgeries were obtained from the Ministry of Health Hospital Information System, which is available online.


RESULTS
A 255% rise in the prevalence of morbid obesity was observed, starting at 0.18% in 1975-1976 and growing to 0.33% in 1989 and 0.64% in 2002-2003. There was a higher rate in the South in the first two surveys, but the prevalence in the Southeast rose steadily, reaching 0.77% in 2002-2003 and overtaking the South. Since 1999, the Brazilian Unified Health System has covered surgical treatment for morbid obesity. From 2000 to 2006, there was a sixfold increase in the number of surgeries, which topped the 2,500 mark in 2006. The geographic distribution of these surgeries is heavily concentrated in the Southeast, the most developed region of Brazil, where there is also the highest prevalence of morbid obesity. This was followed by the Southern region.


CONCLUSIONS
The figures for the rise in morbid obesity in Brazil are startling, especially the increase among men. This is a situation that calls for further study, alongside measures to encourage the adoption of healthy lifestyles. Preventive measures aimed at slowing down or reversing the obesity epidemic are urgently required.
Department of Nutrition, University of Brasília, Brasília, Brazil. leopac@unb.br
Leonor Maria Pacheco
LM
Santos
Isabella Vasconcellos
IV
de Oliveira
Lilian Rose
LR
Peters
Wolney Lisboa
WL
Conde
D050110:Bariatric Surgery / Q000706:statistics & numerical data* / Q000639:trends*; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D003695:Delivery of Health Care / Q000639:trends; D006801:Humans; D007902:Length of Stay; D008297:Male; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D011159:Population Surveillance; D015995:Prevalence; D011634:Public Health; D017678:Sex Distribution