The long-term effect of the increasing obesity epidemic is one of the most closely watched and actively debated issues in public health today.1 Because of the diverse consequences of obesity, there is concern that it could reverse many of the public health successes that have occurred in recent decades and could erode the overall health status of people in the United States. The strongest validation of this fear to date is the increase in the prevalence and incidence of diabetes, which have unabatedly paralleled obesity trends.2- 4 The effect of obesity on overall mortality, cardiovascular disease (CVD), and related risk factors, however, has been weaker and may have diminished over time.4- 7 The differing influence of obesity on diabetes and CVD reveals the complex nature of chronic disease epidemics and the degree to which their effects can be influenced by the capacity of public health to respond.
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