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The Danish Fitness and Nutrition Council has proposed a model to monitor the prevalence of overweight and obesity in Denmark. The model should make it possible to assess whether different initiatives reduce the prevalence of obesity and to gain knowledge on how to prevent obesity. The prevalence of obesity should be estimated in a non-biased randomly selected sample of the population once yearly, using all available data from routine measurements and encouraging new measurements conducted in professional settings where routine data are not available.

Obesity is increasing globally. Lifestyle and genetic factors alone cannot explain this increase. This review study describes possible associations between environmental chemicals and the growing prevalence of obesity. The review mainly focuses on halogenated organic compounds and their possible effect on obesity development. The literature is, however, limited and knowledge of the mechanisms insufficient. Consequently, it is difficult to describe the risks from these chemicals on obesity development.

The prevalence of obesity and obesity-related co-morbidities in the Danish adult population is continuously rising and demands on the Danish health care system are consequently increasing. Quantitative measures of the economic costs related to obesity constitute a necessary basis for the organization of treatments, health promotion and for health policies.On the basis of studies of the prevalence of obesity in the Danish adult population and estimates of the increased risk of co-morbidity among obese, the number (and a sensitivity-interval) of hospital contacts in 2003 was calculated. Based on the results of these calculations and on treatment rates for the identified diagnosis-groups, the costs related to the treatment of obesity and obesity-related co-morbidities were estimated.In 2003 177,703 hospital contacts in Denmark were related to obesity. The costs related to these contacts summed up to euro 137.3 mill. (euro 88.8-174.0 mill.), corresponding to 2.8% (1.8-3.6%) of the running costs at Danish hospitals.The results of this analysis are equivalent to the results from similar analyses from other European countries with comparable health care systems. The health-economic costs related to obesity in Denmark depend on the prevalence of obesity and as a consequence are expected to rise as the current obesity epidemic further develops.

The Danish Fitness and Nutrition Council has evaluated the basis for recommending strategies to prevent obesity among children and adolescents. There is limited evidence of a preventive effect from large population based interventions. It is possible, though, to change to a healthier lifestyle. Currently, many different Administrations conduct interventions against obesity, and it is suggested that an independent authority should be established whose primary aim is to reduce the prevalence of obesity and which will be responsible for the effort against obesity.

In the last 10 years, there has been a marked increase in the prevalence of obesity in children beginning at 3-4 years of age. The only realistic solution to the problem is prevention. Although there is limited evidence for the effectiveness of preventive programmes, there is a consensus that multisectorial action is urgently needed. This should include intervention at the family, school, municipal, regional and national levels, including the commercial sector and food companies. Treating childhood obesity has not been very successful, but some comprehensive community-based treatment programmes have shown reasonable long-term results. There is a need to establish such community-based treatments with emphasis on psychological aspects.

In the last 25-30 years, there has been a marked increase in the prevalence of obesity within almost all age groups of the Danish population. The largest increase has been documented in studies based on objective data from total populations, and the latest data show the increase as continuing. The Danish studies show heterogeneity in the development of the obesity epidemic within various birth cohorts over time. This indicates a need for further etiological research, not only into behavioural factors but also into early life factors that may explain some of this pattern.