To the content
2020 . 4

Obesity as a global challenge of the 21st century: clinical medical nutrition, prevention and therapy


The article presents modern data on the prevalence of overweight and obesity, provides updated information on personalized programs for managing body weight, individual recommendations for a healthy diet, adequate physical activity and long-term lifestyle changes. It is shown that dietary therapy is the basic treatment method in weight loss programs and is aimed at long-term maintenance of a negative energy balance in the patient's organism by limiting the calorie intake. A significant place in the article is devoted to the use of diets modified by calorie value and macronutrient content which are recommended for obese patients. A strategy for the prevention of obesity and its associated diseases is presented.

Keywords:dietary therapy, overweight, obesity, type 2nd diabetes, low-calorie diet

Funding. The research was carried out at the expense of the subsidy for the implementation of the state task.

Conflict of interest. Authors declare no conflict of interest.

Contribution. All authors participated in concept development, analysis and interpretation of the data, and finally approved the manuscript for publication.

For citation: Sharafetdinov Kh.Kh., Plotnikova O.A. Obesity as a global challenge of the 21st century: clinical medical nutrition, prevention and therapy. Voprosy pitaniia [Problems of Nutrition]. 2020; 89 (4): 161-71. DOI: (in Russian)


1. Ametov A.S. Obesity. A modern view of pathogenesis and therapy: A training manual. Moscow: GEOTAR-Media, 2019; 1: 384 p. (in Russian)

2. Blüher M. Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol. 2019; 15 (5): 288–98. DOI:

3. Bray G.A., Kim K.K., Wilding J.P.H. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev. 2017; 18 (7): 715–23. DOI:

4. WHO. Obesity and Overweight, 2020. URL:

5. Hales C.M., Carroll M.D., Fryar C.D., Ogden C.L. Prevalence of obesity and severe obesity among adults: United States, 2017–2018. NCHS Data Brief, No. 360. Hyattsville, MD: National Center for Health Statistics. 2020. URL:

6. Federal State Statistics Service. Selective observation of the diet of the population. URL:

7. Balanova Yu.A., Shal’nova S.A., Deev A.D., et al. Obesity in the Russian population - prevalence and associations with risk factors for chronic noncommunicable diseases. Rossiyskiy kardiologicheskiy zhurnal [Russian Journal of Cardiology]. 2018; 23 (6): 123–30. DOI: (in Russian)

8. Owen C.G., Kapetanakis V.V., Rudnicka A.R., et al. Body mass index in early and middle adult life: prospective associations with myocardial infarction, stroke and diabetes over a 30-year period: the British Regional Heart Study. BMJ Open. 2015; 5 (9): e008105. DOI:

9. Joshy G., Korda R.J., Attia J., et al. Body mass index and incident hospitalisation for cardiovascular disease in 158 546 participants from the 45 and Up Study. Int J Obes (Lond). 2014; 38 (6): 848–56. DOI:

10. Azimi A., Charlot M.G., Torp-Pedersen C., et al. Moderate overweight is beneficial and severe obesity detrimental for patients with documented atherosclerotic heart disease. Heart. 2013; 99 (9): 655–60. DOI:

11. Guh D.P., Zhang W., Bansback N., et al. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009; 9: 88. DOI:

12. Kyrou I., Tsigos C., Mavrogianni C., et al. Sociodemographic and lifestyle-related risk factors for identifying vulnerable groups for type 2 diabetes: a narrative review with emphasis on data from Europe. BMC Endocr Disord. 2020; 20 (1): 134. DOI:

13. Ackerman I.N., Osborne R.H. Obesity and increased burden of hip and knee joint disease in Australia: results from a national survey. BMC Musculoskelet Disord. 2012; 13: 254. DOI:

14. Li C., Ford E.S., Zhao G., Croft J.B., et al. Prevalence of self-reported clinically diagnosed sleep apnea according to obesity status in men and women: National Health and Nutrition Examination Survey, 2005–2006. Prev Med. 2010; 51 (1): 18–23. DOI:

15. Dobbins M., Decorby K., Choi B.C. The association between obesity and cancer risk: a meta-analysis of observational studies from 1985 to 2011. ISRN Prev Med. 2013; 2013: 680536. DOI:

16. Arnold M., Pandeya N., Byrnes G., et al. Global burden of cancer attributable to high body-mass index in 2012: a population-based study. Lancet Oncol. 2015; 16 (1): 36–46. DOI:

17. Lee S.M., Choi I.S, Han E., et al. Incremental treatment costs attributable to overweight and obesity in patients with diabetes: quantile regression approach. Obesity (Silver Spring). 2018; 26 (1): 223–32. DOI:

18. Anis A.H., Zhang W., Bansback N., et al. Obesity and overweight in Canada: an updated cost-of-illness study. Obes Rev. 2010; 11 (1): 31–40. DOI:

19. WHO. Obesity and Overweight. Geneva: World Health Organization, 2015. URL:

20. Fadeeva M.I., Cavel’eva L.V., Golubkina Yu.Yu., et al. Correction of eating disorders in obese patients. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2018; 7 (2): 51–9. DOI: DOI: (in Russian)

21. Cheskin L.J., Poddar K.H. Obesity management. In: Catharine Ross A., et al. (eds). Modern Nutrition in Health and Disease. 11th ed. Lippincott Williams and Wilkins; Wolters Kluwer, 2014: 786–99.

22. May M., Schindler C., Engeli S. Modern pharmacological treatment of obese patients. Ther Adv Endocrinol Metab. 2020; 11: 1–19. DOI:

23. Clinical guidelines for the treatment of morbid obesity in adults. Federal Electronic Medical Library, 2014. URL: http:// (in Russian)

24. Jensen M.D., Ryan D.H., Apovian C.M., et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014; 129 (25, suppl 2): S10238. DOI:

25. Expert Panel Report: Guidelines (2013) for the management of overweight and obesity in adults. American College of Cardiology/American Heart Association Task Force on Practice Guidelines, Obesity Expert Panel, 2013. Obesity (Silver Spring). 2014; 22 (2): S41–410. DOI:

26. Raynor H.A., Champagne C.M. Position of the Academy of Nutrition and Dietetics: interventions for the treatment of overweight and obesity in adults. J Acad Nutr Diet. 2016; 116 (1): 129–47. DOI:

27. Yumuk V., Fruhbeck G., Oppert J.M., et al. An EASO position statement on multidisciplinary obesity management in adults. Obes Facts. 2014; 7: 96–101. DOI:

28. Samsonov M.A. The main stages of the scientific activity of the Clinical Nutrition Clinic of the Institute of Nutrition RAMS (1930–2005). Voprosy pitaniia [Problems of Nutrition] 2005; 74 (5): 37. (in Russian)

29. Wadden T.A., Byrne K.J., Krauthamer-Ewing S. Obesity: management. In: M.E. Shils (ed.). Modern Nutrition in Health and Disease. 10th ed. 2006: 1029–42.

30. Bogdanov A.R. Diagnosis and personalized diet therapy of chronic heart failure in obese patients: Autoabstract of Diss. Moscow, 2017 (in Russian)

31. Koliaki C., Spinos T., Spinou M., et al. Defining the optimal dietary approach for safe, effective and sustainable weight loss in overweight and obese adults. Healthcare. 2018; 6: 73. DOI:

32. Gapparova K.M., Pilipenko V.I., Zeigarnik M.V., et al. Effect of low-calorie diets with the inclusion of protein substitutes for food on anthropometric and clinical-biochemical parameters in obese patients. Voprosy dietologii [Problems of Dietology]. 2011; 1 (1): 24–30. DOI: (in Russian)

33. Li Z., Treyzon L., Chen S., et al. Protein-enriched meal replacements do not adversely affect liver, kidney or bone density: an outpatient randomized controlled trial. Nutr J. 2010; 9: 72. DOI:

34. Flechtner-Mors M., Boehm B.O., Wittmann R., et al. Enhanced weight loss with protein-enriched meal replacements in subjects with the metabolic syndrome. Diabetes Metab Res Rev. 2010; 26 (5): 393–405. DOI:

35. Chen W., Liu Y., Yang Q., et al. The effect of protein-enriched meal replacement on waist circumference reduction among overweight and obese Chinese with hyperlipidemia. J Am Coll Nutr. 2016; 35 (3): 236–44. DOI:

36. Atallah R., Filion K.B., Wakil S.M., et al. Long-term effects of 4 popular diets on weight loss and cardiovascular risk factors: a systematic review of randomized controlled trials. Circ Cardiovasc Qual Outcomes. 2014; 7 (6): 815–27. DOI:

37. Selezneva K.S., Isakov V.A., Sentsova T.B., Kirillova O.O. An analysis of the efficacy of low-calorie and isocaloric diets in obese patients with non-alcoholic steatohepatitis. Voprosy pitaniia [Problems of Nutrition] 2014; 83 (5): 72–8. (in Russian)

38. Nutrition and Type 2 Diabetes: Etiology and Prevention. In: M.A. Pereira (ed.). CRC Press, 2014.

39. Goff L.M., Cowland D.E., Hooper L., Frost G.S. Low glycaemic index diets and blood lipids: a systematic review and meta-analysis of randomised controlled trials. Nutr Metab Cardiovasc Dis. 2013; 23 (1): 1–10. DOI:

40. Ma X.Y, Liu J.P., Song Z.Y. Glycemic load, glycemic index and risk of cardiovascular diseases: meta-analyses of prospective studies. Atherosclerosis. 2012; 223 (2): 491–6. DOI:

41. Bonfrate L., Wang D.Q., Garruti G., Portincasa P. Obesity and the risk and prognosis of gallstone disease and pancreatitis. Best Pract Res Clin Gastroenterol. 2014; 28 (4): 623–35. DOI:

42. Look AHEAD Research Group. Eight-year weight losses with an intensive lifestyle intervention: The Look AHEAD Study. Obesity (Silver Spring). 2014; 22: 5–13. DOI:

43. Look AHEAD Research Group. Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes. One-year results of the Look AHEAD trial. Diabetes Care. 2007; 30 (6): 1374–83. DOI:

44. EFSA Panel on Dietetic Products, Nutrition and Allergies. Essential composition of total diet replacements for weight control. EFSA J. 2015; 13 (1): 3957. DOI:

SCImago Journal & Country Rank
Viktor A. Tutelyan
Full Member of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Scientific Director of the Federal Research Centre of Nutrition, Biotechnology and Food Safety (Moscow, Russia)

Medicine today

Московская урологическая школа Урология - область медицинской науки, которая интенсивно развивается. Ежегодно появляются новые научные данные, обнародуются результаты исследований и разработок, меняются алгоритмы диагностики и лечения пациентов с теми или иными болезнями...

24-25 ноября 2020 г. состоится Юбилейная научно-практическая конференция с международным участием "120 лет кафедре оториноларингологии с клиникой ПСПбГМУ им. акад. И.П. Павлова". Мероприятие, посвященное 120-летию со дня основания второй в России кафедры, пройдет в...

Всероссийская научно-практическая конференция "Левитановские чтения" - 2020 27-28 ноября 2020 г. состоится Всероссийская научно-практическая конференция "Левитановские чтения", посвященная различным аспектам организации медицинской помощи пациентам с язвенным колитом и...

Journals of «GEOTAR-Media»