Tazama chanzo cha Unene wa kupindukia

{{Infobox disease
 |Name        = Obesity
 |Image       = Obesity-waist_circumference.svg
 |Alt         = Three silhouettes depicting the outlines of a normal sized (left), overweight (middle), and obese person (right).
 |Caption     = Silhouettes and waist circumferences representing normal, overweight, and obese
 |DiseasesDB  = 9099
 |ICD10       = {{ICD10|E|66|  |e|65}}
 |ICD9       = {{ICD9|E|66| |e|278}}
 |MedlinePlus = 003101
 |OMIM        = 601665
 |eMedicineSubj  = med
 |eMedicineTopic =1653
 |MeshName    = Obesity
 |MeshNumber  = C23.888.144.699.500
 |
}}
'''Unene wa kupindukia''' (kwa [[Kiingereza]] "obesity" kutokana na [[neno]] la [[Kilatini]] ''obesitas'', linalomaanisha "gumu, nono au nene” <ref name=etymol>''Ēsus'' is the past participle of ''edere'' (to eat), with ''ob'' (over) added to it. {{cite web|url=http://www.etymonline.com/index.php?term=obesity |title=Online Etymology Dictionary: Obesity |work=Douglas Harper|accessdate=December 31, 2008}}; ''[[Kamusi ya Kingereza ya Oxford]]''  ilichapisha kutumika kwake kwa mara ya kwanza mnamo mwaka wa 1611 na [[Randle Cotgrave]]. {{cite web |url=http://www.oed.com/ |title=Obesity, n |work=[[Oxford English Dictionary]] 2008|accessdate=March 21, 2009}}</ref>; [[jina la kisayansi]] kwa [[Kilatini]] ni "adipositas") ni hali mbaya ambapo [[mafuta ya ziada ya mwili]] hulimbikizana hadi kiwango kinachoweza kuathiri vikubwa [[afya]], ikipelekea ongezeko la [[maradhi]] na kupungua kwa [[matarajio ya kuishi]]. <ref name="WHO 2000 p.6">WHO 2000 p.6</ref><ref name=HaslamJames/> 

[[Kipimo]] cha [[mwili]] kuwa mnene na mzito mno ni [[uwiano]] kati ya [[urefu]] wa mtu na [[uzito]] wake. Watu hutajika kuwa na unene wa kupindukia wakati [[nambapeo ya mata ya mwili]] (NMM), kipimo kinachopatikana kwa kugawanya [[uzito]] wa mtu kwa [[kilogramu]] kwa mraba wa [[urefu]] wake katika [[mita]], kimezidi 30&nbsp;kg/m<sup>2</sup>.<ref name="WHO 2000 p.9">WHO 2000 p.9</ref>

Kuwa mneme mno kunaleta [[hatari]] ningi kwa [[afya]] na kusababisha au kuongeza uwezekano wa [[magonjwa]] kama vile: 
* [[Shinikizo la juu la damu]]
* Ugonjwa wa [[kisukari]]
* [[Maradhi ya moyo]]
* [[Ugonjwa wa kupooza]]
* Shida za kupumua na [[pumu]]<ref>http://www.medicalnewstoday.com/releases/24118.php</ref><ref name=HaslamJames/>
* Matatizo ya viungo vya [[miguu]] na ya [[uti wa mgongo]]
* [[Maradhi ya mishipa]], 
* [[Apnea pingani ya usingizi]]
* [[Osteoathritisi]]<ref name=HaslamJames/>.

Watu wakinenepa mno hufa mapema na kuwa na magonjwa mengi kuliko watu wembamba wanaokula kiasi tu, jinsi wanavyohitaji [[chakula]]. Tatizo la unene [[duniani]] hukumba [[wanaume]] zaidi ya [[wanawake]].

Unene wa kupindukia mara nyingi husababishwa na ujumuisho wa kula chakula kilicho na nguvu nyingi, ukosefu wa [[mazoezi ya mwili]], na [[urithi]] wa [[jeni]] maalumu, ingawa visa vichache vina msingi wa jeni, matatizo ya [[kiendrosini]], [[matibabu]] au [[maradhi ya akili]].

Ushahidi wa kuthibitisha dhana kuwa baadhi ya watu hunenepa ingawa hula kiasi kidogo hautoshi; kwa wastani, watu wanene hutumia nguvu nyingi kuliko watu wenye mwili mdogo kwa sababu ya nguvu zinazohitajika kuimarisha [[mata]] kubwa ya mwili.<ref>{{cite book |author=Kushner, Robert |title=Treatment of the Obese Patient (Contemporary Endocrinology) |publisher=Humana Press |location=Totowa, NJ|year=2007 |page=158 |isbn=1-59745-400-1 |url=http://books.google.com/?id=vWjK5etS7PMC&pg=PA121&lpg=PA121&dq=measurement+of+metabolism+in+obese+Bessesen |doi= |accessdate=April 5, 2009}}</ref><ref name=Anes2000>{{cite journal |author=Adams JP, Murphy PG |title=Obesity in anaesthesia and intensive care |journal=Br J Anaesth |volume=85 |issue=1 |pages=91–108 |year=2000 |month=July |pmid=10927998 |doi= 10.1093/bja/85.1.91|url=http://bja.oxfordjournals.org/cgi/content/full/85/1/91}}</ref>

[[Chakula bora]] na [[mazoezi ya mwili]] ndiyo njia kuu za kutibu unene wa kupindukia. Ubora wa chakula unaweza kuimarishwa kwa kutumia vyakula vilivyo na nguvu nyingi, kama vile vyakula vilivyo na kiwango cha juu cha mafuta na [[sukari]], na kwa kutumia [[unyuzi wa chakula]] kwa wingi zaidi. 

[[Dawa za kukabiliana na unene]] zinaweza kutumiwa kupunguza hamu ya chakula au kuzuia ufyonzaji wa mafuta, huku mtu akila chakula kinachofaa. Iwapo chakula bora, mazoezi na matibabu hayatoshi, [[mpira wa utumboni]] unaweza kusaidia kupunguza uzito wa mwili, au [[upasuaji]] unaweza kufanywa ili kupunguza ukubwa na/au urefu wa matumbo. Upasuaji huo hupelekea mtu [[kushiba]] upesi na kupunguza uwezo wa kufyonza [[virutubishi]] vilivyomo katika chakula.<ref>NICE 2006 p.10–11</ref><ref name=balloon2008>{{cite journal |author=Imaz I, Martínez-Cervell C, García-Alvarez EE, Sendra-Gutiérrez JM, González-Enríquez J |title=Safety and effectiveness of the intragastric balloon for obesity. Uchanganuzi wa kina|journal=Obes Surg |volume=18 |issue=7 |pages=841–6 |year=2008 |month=July |pmid=18459025|doi=10.1007/s11695-007-9331-8}}</ref>

Unene wa kupindukia ni [[kisababishi kinachozuilika cha kifo]] kilicho kikuu ulimwenguni kote, huku kiwango chake cha [[ueneaji]] kikiongezeka kwa watu wazima na [[watoto]]. Viongozi huamini kuwa hili ni mojawapo ya matatizo makuu zaidi ya [[afya ya umma]] katika [[karne ya 21]].<ref name=Barn1999>{{cite journal |author=Barness LA, Opitz JM, Gilbert-Barness E |title=Obesity: genetic, molecular, and environmental aspects |journal=Am. J. Med. Genet. A|volume=143A |issue=24 |pages=3016–34 |year=2007 |month=December |pmid=18000969 |doi=10.1002/ajmg.a.32035 |url=}}</ref> 

Unene wa kupindukia hufedheheshwa katika sehemu nyingi za [[ulimwengu]] wa kisasa (hasa katika [[Ustaarabu wa Magharibi]]<ref>Huko wengine wanalazimika kutumia vifaa maalum (butt wipers]) kushililia karatasi shashi wakiwa msalani</ref>), ingawa hali hii ilitazamwa na watu wengi kama [[ishara]] ya [[utajiri]] na afya bora katika nyakati za awali za [[historia]], na pia huonekana hivyo katika baadhi ya sehemu za [[dunia]].<ref name=HaslamJames/><ref name=Woodhouse/>

==Uainishaji==
Unene wa kupindukia ni hali ya kimatibabu ambapo [[mafuta ya mwili]] ya ziada hulimbikizana hadi kiwango kinachoathiri afya kwa vikubwa.<ref name="WHO 2000 p.6"/> Hali hii hufasiliwa kwa [[Kielezo cha Uzani wa Mwili]] na kukadiriwa zaidi kwa kupima ugawaji wa mafuta kupitia kwa uwiano wa kiuno na nyonga na ujumla wa vipengele hatari vya magonjwa ya mishipa na moyo.<ref>{{cite journal |journal= Nutr J |year=2007 |volume=6 |page=32 |title= Measurement and Definitions of Obesity In Childhood and Adolescence: A field guide for the uninitiated |author= Sweeting HN|doi=10.1186/1475-2891-6-32|pmid=17963490 |url=http://www.nutritionj.com/content/6/1/32  |pmc= 2164947|issue=1}}</ref><ref>NHLBI p.xiv</ref>  

Kielezo cha Uzani wa Mwili kinahusiana kwa karibu na asilimia ya mafuta ya mwili na jumla ya mafuta ya mwili.<ref>{{cite journal |author=Gray DS, Fujioka K |title=Use of relative weight and Body Mass Index for the determination of adiposity |journal=J Clin Epidemiol |volume=44 |issue=6 |pages=545–50 |year=1991 |pmid=2037859 |doi= 10.1016/0895-4356(91)90218-X|url=https://archive.org/details/sim_journal-of-clinical-epidemiology_1991_44_6/page/545}}</ref>

[[File:Obesity6.JPG|thumb|kushoto|alt=mtazamo wa mbele na upande wa kiwiliwili cha mwanamume aliye "mnene kupindukia". Alama za kuvutika kwa ngozi zinaonekana pamoja na jinakomastia.|Mwanamume "mnene kupindukia" aliye na Kielezo cha Uzani wa Mwili cha 47&nbsp;kg/m<sup>2</sup>: uzito 146&nbsp;kg (322&nbsp;lb), urefu sentimita 177&nbsp; (5&nbsp;ft 10&nbsp;in)]]
Katika [[watoto]], uzito ulio bora hutofautiana kwa sababu ya [[umri]] na [[jinsia]]. Katika watoto na [[vijana]] [[baleghe]], unene wa kupindukia hufasiliwa si kwa [[nambari]] kamili, lakini kulingana na kundi la kawaida la wakati huo, hivi kwamba unene wa kupindukia ni wa Kielezo cha Uzani wa Mwili kilichozidi [[asilimia]] 95 <ref name="cdc.gov">{{cite web|url=http://www.cdc.gov/nccdphp/dnpa/healthyweight/assessing/bmi/childrens_BMI/about_childrens_BMI.htm  |title=Healthy Weight: Assessing Your Weight: BMI: About BMI for Children and Teens|publisher=[[Center for disease control and prevention]]|accessdate=April 6, 2009}}</ref>Data ya marejeleo ambayo ilitumiwa kukadiria hesabu hii ni ya kutoka mwaka 1963 hadi 1994, hivyo haijaathiriwa na ongezeko la uzito la hivi karibuni.<ref name="Flegal KM, Ogden CL, Wei R, Kuczmarski RL, Johnson CL 2001 1086–93">{{cite journal |author=Flegal KM, Ogden CL, Wei R, Kuczmarski RL, Johnson CL|title=Prevalence of overweight in US children: comparison of US growth charts from the Centers for Disease Control and Prevention with other reference values for body mass index |journal=Am. J. Clin. Nutr. |volume=73 |issue=6|pages=1086–93 |year=2001 |month=June |pmid=11382664 |doi= |url=http://www.ajcn.org/cgi/content/full/73/6/1086}}</ref>

{| class="wikitable" style = "float: right; margin-left:15px; text-align:center"
|-
! BMI !! Classification
|-
|width=50%| < 18.5 ||underweight
|-
|18.5–24.9 || normal weight
|-
|25.0–29.9 || overweight
|-
|30.0–34.9 || class I obesity
|-
|35.0–39.9 || class II obesity
|-
|≥ 40.0 || &nbsp;&nbsp;class III obesity&nbsp;&nbsp;
|}

Kielezo cha Uzani wa Mwili hukadiriwa kwa kugawanya uzito wa mtu kwa kipeo cha uzito wake, na kwa kawaida huandikwa aidha kwa [[Mfumo wa mita]] au kwa [[vipimo vya Marekani]]:

:Metric:<math>BMI=kilograms/meters^2</math>

:US customary and [[Imperial System|imperial]]: <math>BMI=lb*703/in^2</math>

ambapo <math>lb</math> ni uzito wa mtu katika [[pauni (uzito)|pauni]] na<math>in</math> ni urefu wa mtu katika inchi.

Fasili zinazotumika mara nyingi, ambazo zilitolewa na [[Shirika la Afya Duniani]] mwaka wa 1997 na kuchapishwa mwaka wa 2000, hutoa ukadiriaji kama ilivyoorodheshwa katika jedwali lililo upande wa kulia.<ref name="WHO 2000 p.9"/>

Baadhi ya mashirika yamerekebisha kidogo fasili zilizotolewa na SAD. Habari ya kiupasuaji hugawanya unene wa kupindukia wa "daraja la 3" katika vikundi zaidi, ambavyo ukadiriaji wake ungali unakumbwa na utata.<ref name=morbid2007>{{cite journal|author=Sturm R |title=Increases in morbid obesity in the USA: 2000–2005 |journal=Public Health |volume=121 |issue=7|pages=492–6 |year=2007 |month=July |pmid=17399752 |pmc=2864630 |doi=10.1016/j.puhe.2007.01.006 |url=https://archive.org/details/sim_public-health_2007-07_121_7/page/492}}</ref>
* Any BMI ≥ 35 or 40 is ''severe obesity''
* A BMI of ≥ 35 or 40–44.9 or 49.9 is ''morbid obesity''
* A BMI of ≥ 45 or 50 is ''super obesity''

Kwa sababu watu wa asili ya [[Asia]] wameendelea kuathiriwa vibaya katika kiwango cha KUM cha chini kuliko kile cha [[Wazungu]], baadhi ya [[mataifa]] yamefasili upya unene wa kupindukia; [[Wajapani]] wameufasili kama kiwango chochote cha KUM kinachozidi 25<ref>{{cite journal |author=Kanazawa M, Yoshiike N, Osaka T, Numba Y, Zimmet P, Inoue S |title=Criteria and classification of obesity in Japan and Asia-Oceania|journal=Asia Pac J Clin Nutr |volume=11 Suppl 8 |issue= |pages=S732–S737 |year=2002 |month=December |pmid=12534701|doi= 10.1046/j.1440-6047.11.s8.19.x|url=}}</ref> huku [[China]] ikitumia kipimo cha KUM cha juu ya 28.<ref>{{cite journal|author=Bei-Fan Z |title=Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults: study on optimal cut-off points of body mass index and waist circumference in Chinese adults |journal=Asia Pac J Clin Nutr |volume=11 Suppl 8 |issue= |pages=S685–93 |year=2002 |month=December|pmid=12534691 |doi= 10.1046/j.1440-6047.11.s8.9.x|url= |author2=Cooperative Meta-Analysis Group of Working Group on Obesity in China}}</ref>

==Madhara ya kiafya==
Uzito uliozidi huhusianishwa na [[magonjwa]] mengi, hasa [[magonjwa ya moyo]] na [[mishipa]], [[kisukari aina ya 2]], [[apnea pingani ya usingizi]], aina fulani za [[saratani]], [[osteoathritisi]]<ref name=HaslamJames/> na [[pumu]]<ref>http://www.medicalnewstoday.com/releases/24118.php</ref><ref name=HaslamJames/>. Matokeo yake ni kwamba unene wa kupindukia umetambulika kupunguza [[matarajio ya kuishi]].<ref name=HaslamJames/>

===Hatari ya kufa===
{{Double image|right|MenBMIMort.png|200|WomenBMIMort.png|200|alt=(Left) A graph showing how the risk of death varies with BMI. The lowest risk is found at a BMI of 20 to 25 and increases in both directions. (Right) A graph showing how the risk of death varies with BMI. The lowest risk is found at a BMI of 20 to 25 and increases in both directions.|Relative risk of death over 10 years for White men (left) and women (right) who have never smoked in the United States by BMI.<ref name=NEJM10>{{cite journal |author=Berrington de Gonzalez A |title=Body-Mass Index and Mortality among 1.46 Million White Adults |journal=N. Engl. J. Med. |volume=363 |issue=23 |pages=2211–9 |year=2010|month=December |pmid=21121834 |doi=10.1056/NEJMoa1000367 |url= |pmc=3066051 |author-separator=,|display-authors=3}}</ref>||}}
Unene wa kupindukia ni kati ya [[visababishi vya kifo vinavyozuilika]] kote ulimwenguni.<ref name=Barn1999/><ref>{{cite journal|author=Mokdad AH, Marks JS, Stroup DF, Gerberding JL |title=Actual causes of death in the United States, 2000|journal=JAMA |volume=291 |issue=10 |pages=1238–45 |year=2004 |month=March |pmid=15010446 |doi=10.1001/jama.291.10.1238|url=http://www.csdp.org/research/1238.pdf|format=PDF}}</ref><ref name=Allison>{{cite journal |author=Allison DB, Fontaine KR, [[JoAnn E. Manson|Manson JE]], Stevens J, VanItallie TB |title=Annual deaths attributable to obesity in the United States |journal=JAMA |volume=282 |issue=16 |pages=1530–8 |year=1999 |month=October |pmid=10546692 |doi= 10.1001/jama.282.16.1530|url=http://jama.ama-assn.org/cgi/content/full/282/16/1530}}</ref> Utafiti mkuu wa Ulaya na Marekani umeonyesha kuwa hatari ya kufa iko chini zaidi katika kiwango cha KUM cha 20–25 kg/m<sup>2</sup><ref name=NEJM10/><ref name=Lancet2009>{{cite journal |author=Whitlock G |title=Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies |journal=Lancet |volume=373 |issue=9669 |pages=1083–96 |year=2009|month=March |pmid=19299006 |doi=10.1016/S0140-6736(09)60318-4 |url= |pmc=2662372 |author-separator=,|author2=Lewington S |author3=Sherliker P |display-authors=3 |last4=Sherliker |first4=P |last5=Clarke |first5=R|last6=Emberson |first6=J |last7=Halsey |first7=J |last8=Qizilbash |first8=N |last9=Collins |first9=R}}</ref> katika watu wasiovuta sigara na 24–27 kg/m<sup>2</sup> katika watu wanaoendelea kuvuta sigara, huku hatari hii ikiongezeka na mabadiliko kuelekea pande zote mbili.<ref>{{cite journal |author=Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW |title=Body-mass index and mortality in a prospective cohort of U.S. adults |journal=N. Engl. J. Med. |volume=341 |issue=15 |pages=1097–105|year=1999 |month=October |pmid=10511607 |doi= 10.1056/NEJM199910073411501|url=http://content.nejm.org/cgi/content/full/341/15/1097}}</ref><ref name=Euro2008>{{cite journal |author=Pischon T |title=General and abdominal adiposity and risk of death in Europe |journal=N. Engl. J. Med.|volume=359 |issue=20 |pages=2105–20 |year=2008 |month=November |pmid=19005195 |doi=10.1056/NEJMoa0801891 |url=|author-separator=, |author2=Boeing H |author3=Hoffmann K |display-authors=3 |last4=Bergmann |first4=M. |last5=Schulze|first5=M.B. |last6=Overvad |first6=K. |last7=Van Der Schouw |first7=Y.T. |last8=Spencer |first8=E. |last9=Moons|first9=K.G.M.}}</ref>Kipimo cha Kielezo cha Uzani wa Mwili cha zaidi ya 32 kimehusishwa na ongezeko la mara mbili la vifo kwa wanawake kwa muda wa miaka 16.<ref>{{cite journal |author=Manson JE |title=Body weight and mortality among women |journal=N. Engl. J. Med.|volume=333 |issue=11 |pages=677–85 |year=1995 |pmid=7637744| doi = 10.1056/NEJM199509143331101 |author-separator=,|author2=Willett WC |author3=Stampfer MJ |display-authors=3 |last4=Colditz |first4=Graham A. |last5=Hunter|first5=David J. |last6=Hankinson |first6=Susan E. |last7=Hennekens |first7=Charles H. |last8=Speizer |first8=Frank E.}}</ref> Nchini Marekani, inakisiwa kuwa unene wa kupindukia husababisha zaidi ya vifo 111,909 hadi 365,000 kila mwaka,<ref name=HaslamJames>{{cite journal |author=Haslam DW, James WP|title=Obesity |journal=Lancet |volume=366 |issue=9492|pages=1197–209 |year=2005 |pmid=16198769 |doi=10.1016/S0140-6736(05)67483-1}}</ref><ref name=Allison/> huku milioni 1 (7.7%) ya vifo katika nchi za Ulaya husababishwa na uzito uliozidi.<ref name=EuroG2008/><ref name=Euro2007>{{cite journal|author=Fried M |title=Inter-disciplinary European guidelines on surgery of severe obesity |journal=Int J Obes (Lond)|volume=31 |issue=4 |pages=569–77 |year=2007 |month=April |pmid=17325689 |doi=10.1038/sj.ijo.0803560 |url=|author-separator=, |author2=Hainer V |author3=Basdevant A |display-authors=3 |last4=Buchwald |first4=H |last5=Deitel|first5=M |last6=Finer |first6=N |last7=Greve |first7=J W M |last8=Horber |first8=F |last9=Mathus-Vliegen|first9=E}}</ref> Kwa wastani, unene hupunguza muda wa maisha miaka 6 hadi 7:<ref name=HaslamJames/><ref>{{cite journal |author=Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L |title=Obesity in adulthood and its consequences for life expectancy: A life-table analysis |journal=Ann. Intern. Med. |volume=138 |issue=1 |pages=24–32 |year=2003 |month=January |pmid=12513041 |doi=|url=http://www.annals.org/cgi/reprint/138/1/24  | format=PDF |last7=Nedcom}}</ref>Kielezo cha Uzani wa Mwili cha 30–35 hupunguza miaka 2 hadi 4 matarajio ya kuishi<ref name=Lancet2009/> ilhali unene uliokithiri (Kielezo cha Uzani wa Mwili&nbsp;>&nbsp;40) hupunguza miaka 10 matarajio ya kuishi <ref name=Lancet2009/>

===Hali ya kuugua===
Unene wa kupindukia huongeza hatari ya hali nyingi za kimwili na kiakili. Ambatani hizi kwa kawaida huonyeshwa sana katika [[dalili]] za magonjwa ya [[metaboli]],<ref name=HaslamJames/> kama: [[kisukari aina ya 2]], [[shinikizo la juu la damu]], [[kolestro]], and [[hypertriglyceridemia]].<ref>{{cite journal |author=Grundy SM |title=Obesity, metabolic syndrome, and cardiovascular disease |journal=J. Clin. Endocrinol. Metab. |volume=89 |issue=6 |pages=2595–600|year=2004 |pmid=15181029 |doi=10.1210/jc.2004-0372}}</ref>

Matatizo aidha husababishwa na unene moja kwa moja au kwa njia isiyo ya moja kwa moja inayohusiana kupitia utaratibu ulio na sababu sawa kama vile [[lishe duni]] au [[uzembe maishani]]. Uhusiano mkuu kati ya unene na hali maalum inatofautiana. Mojawapo ni [[kisukari aina ya 2]]. Mafuta ya ziada mwilini ndiyo kisababishi cha 64% ya kisukari kwa wanaume na 77% kwa wanawake.<ref>Seidell 2005 p.9</ref>

Madhara ya kiafya huwa katika vikundi viwili vipana: 
* yale yanayotokana na madhara ya kiasi cha mafuta kilichozidi (kama vile [[osteoarthritisi]], [[apnea pingani ya usingizi]], kutengwa na jamii) na 
* yale yanayotokana na idadi iliyozidi ya [[seli za mafuta]] ([[kisukari]], [[saratani]], [[ugonjwa wa moyo na mishipa ya damu]], [[ugonjwa wa maini iliyo na mafuta usiohusiana na pombe]]).<ref name=HaslamJames/><ref name=Bray2004>{{cite journal |author=Bray GA |title=Medical consequences of obesity |journal=J. Clin. Endocrinol. Metab. |volume=89 |issue=6 |pages=2583–9 |year=2004 |pmid=15181027|doi=10.1210/jc.2004-0535}}</ref>Ongezeko la mafuta katika mwili hugeuza hali ambavyo mwili huitikia [[insulini]] hata kusababisha [[kupinga insulini]]. Ongezeko la mafuta pia husababisha [[inflamesheni]],<ref>{{cite journal|author=Shoelson SE, Herrero L, Naaz A |title=Obesity, inflammation, and insulin resistance |url=https://archive.org/details/sim_gastroenterology_2007-05_132_6/page/2169 |journal=Gastroenterology|volume=132 |issue=6 |pages=2169–80 |year=2007 |month=May |pmid=17498510|doi=10.1053/j.gastro.2007.03.059}}</ref><ref>{{cite journal |author=Shoelson SE, Lee J, Goldfine AB|title=Inflammation and insulin resistance |journal=J. Clin. Invest. |volume=116 |issue=7 |pages=1793–801 |year=2006|month=July |pmid=16823477 |pmc=1483173 |doi=10.1172/JCI29069 |url=http://www.jci.org/articles/view/29069}}</ref> na kuandaa [[thrombosi]].<ref name=Bray2004/><ref>{{cite journal |author=Dentali F, Squizzato A, Ageno W|title=The metabolic syndrome as a risk factor for venous and arterial thrombosis |journal=Semin. Thromb. Hemost.|volume=35 |issue=5 |pages=451–7 |year=2009 |month=July |pmid=19739035 |doi=10.1055/s-0029-1234140}}</ref>

===Fumbo kuhusu kuendeleza uhai===
Ingawa madhara ya kiafya ya unene wa kupindukia miongoni mwa jumla ya watu imeungwa mkono na ushahidi uliopo, matokeo ya kiafya katika vikundi mahususi yanaonekana kuboreka kwa kiwango cha Kielezo cha Uzani wa Mwili kinachoongezeka. Tukio hilo linajulikana kama fumbo kuhusu kuendelea kuishi kwa watu walio na unene wa kupindukia.<ref name=Schmidt2007>{{cite journal |author=Schmidt DS, Salahudeen AK |title=Obesity-survival paradox-still a controversy? |journal=Semin Dial |volume=20 |issue=6 |pages=486–92 |year=2007 |pmid=17991192|doi=10.1111/j.1525-139X.2007.00349.x}}</ref> 

Mara ya kwanza fumbo hili lilielezwa mwaka 1999, likiwakumba watu wenye unene wa kupindukia waliokuwa wakisafishwa damu,<ref name=Schmidt2007/> kisha kupatikana katika watu waliokuwa na [[mshtuko wa moyo]] na [[ugonjwa wa ateri za pembeni]] (UAP).<ref name=paradox2003>{{cite journal |author=|title=Behavioral counseling in primary care to promote a healthcite journal y diet: recommendations and rationale |journal=Am Fam Physician |volume=67 |issue=12 |pages=2573–6 |year=2003 |month=June |pmid=12825847 |doi= |author1= U.S. Preventive Services Task Force }}</ref>

Katika watu waliokuwa na mshtuko wa moyo, wale wenye kipimo cha Kielezo cha Uzani wa Mwili cha kati ya 30.0. na 34.9 walikuwa na kima cha vifo cha chini kuliko wenye uzito wa kawaida. Hii ni kwa sababu watu mara nyingi hupoteza uzito kadiri wanavyoendelea kuwa wagonjwa.<ref>{{cite journal |author=Habbu A, Lakkis NM, Dokainish H |title=The obesity paradox: Fact or fiction?|journal=Am. J. Cardiol. |volume=98 |issue=7 |pages=944–8 |year=2006 |month=October |pmid=16996880|doi=10.1016/j.amjcard.2006.04.039}}</ref> 

Matokeo sawa na haya yamepatikana katika aina nyingine za magonjwa ya moyo. Watu walio na unene wa kupindukia wa daraja la 1 na magonjwa ya moyo hawana kima cha matatizo ya moyo kuliko watu walio na uzito wa kawaida ambao wana matatizo ya moyo. Hata hivyo, katika watu walio na viwango vikubwa zaidi vya unene, hatari ya kutokea kwa matatizo ya ziada huongezeka.<ref>{{cite journal |author=Romero-Corral A |title=Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: A systematic review of cohort studies |journal=Lancet |volume=368|issue=9536 |pages=666–78 |year=2006 |pmid=16920472 |doi=10.1016/S0140-6736(06)69251-9 |author-separator=,|author2=Montori VM |author3=Somers VK |display-authors=3 |last4=Korinek |first4=Josef |last5=Thomas |first5=Randal J|last6=Allison |first6=Thomas G |last7=Mookadam |first7=Farouk |last8=Lopez-Jimenez|first8=Francisco}}</ref><ref>{{cite journal |author=Oreopoulos A, Padwal R, Kalantar-Zadeh K, Fonarow GC, Norris CM, McAlister FA |title=Body mass index and mortality in heart failure: A meta-analysis |journal=Am. Heart J. |volume=156|issue=1 |pages=13–22 |year=2008 |month=July |pmid=18585492 |doi=10.1016/j.ahj.2008.02.014 |url=https://archive.org/details/sim_american-heart-journal_2008-07_156_1/page/13}}</ref> Hata baada ya [[upasuaji wa kipenyo cha moyo]], hakuna ongezeko la vifo linalotambulika katika watu walio na uzito mkubwa.<ref>{{cite journal |author=Oreopoulos A, Padwal R, Norris CM, Mullen JC, Pretorius V, Kalantar-Zadeh K|title=Effect of obesity on short- and long-term mortality postcoronary revascularization: A meta-analysis|journal=Obesity (Silver Spring) |volume=16 |issue=2 |pages=442–50 |year=2008 |month=February |pmid=18239657|doi=10.1038/oby.2007.36}}</ref> 

Utafiti mmoja ulionyesha kuwa ongezeko la muda wa kuishi kwa watu wenye unene wa kupindukia husababishwa na matibabu madhubuti ambao watu hao hupata baada ya tukio la tatizo la moyo.<ref>{{cite journal| author=Diercks DB | title=The obesity paradox in non-ST-segment elevation acute coronary syndromes: Results from the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the American College of Cardiology/American Heart Association Guidelines Quality Improvement Initiative | url=https://archive.org/details/sim_american-heart-journal_2006-07_152_1/page/140 | journal=Am Heart J | year=2006 | month=July | volume=152 |issue=1 | pages=140–8 | pmid=16824844 | doi=10.1016/j.ahj.2005.09.024| author-separator=,| author2=Roe MT|author3=Mulgund J| display-authors=3| last4=Pollack| first4=Charles V.| last5=Kirk| first5=J. Douglas| last6=Gibler|first6=W. Brian| last7=Ohman| first7=E. Magnus| last8=Smith| first8=Sidney C.| last9=Boden| first9=William E.}}</ref> Utafiti mwingine unaonyesha kuwa mtu anapouchukulia kwa makini [[ugonjwa wa muda mrefu wa kuzibika kwa mapafu]] (COPD) kwa walio na PDA, manufaa ya unene wa kupindukia hayapo tena.<ref name=paradox2003/>

==Visababishi==
Katikia kiwango cha mtu binafsi, ujumlisho wa kula [[chakula kinachotoa nguvu]] na kutofanya [[mazoezi ya kimwili]] hudhaniwa kusababisha visa vingi zaidi vya unene wa kupindukia.<ref name=CADG2006/>Matukio machache sana husababishwa hasa na jeni, sababu za kimatibabu au ugonjwa wa akili.<ref>{{cite journal |author=Bleich S, Cutler D, Murray C, Adams A |title=Why is the developed world obese? |journal=Annu Rev Public Health |volume=29 |pages=273–95 |year=2008 |pmid=18173389|doi=10.1146/annurev.publhealth.29.020907.090954}}</ref> Kinyume na matarajio, inakisiwa kuwa viwango vya unene wa kupindukia vinavyoongezeka katika jamii vinasababishwa na urahisi wa kupata chakula kinachovutia,<ref>{{cite journal |author=Drewnowski A, Specter SE|title=Poverty and obesity: the role of energy density and energy costs |journal=Am. J. Clin. Nutr. |volume=79 |issue=1|pages=6–16 |year=2004 |month=January |pmid=14684391 |doi= |url=http://www.ajcn.org/cgi/content/full/79/1/6}}</ref>ongezeko la kutegemea gari na uzalishaji wa bidhaa kwa kutumia mitambo.<ref>{{cite journal |author=Nestle M, Jacobson MF|title=Halting the obesity epidemic: a public health policy approach |journal=Public Health Rep |volume=115 |issue=1|pages=12–24 |year=2000 |pmid=10968581 |pmc=1308552 |doi= 10.1093/phr/115.1.12|url=}}</ref><ref name=James2008>{{cite journal |author=James WP |title=The fundamental drivers of the obesity epidemic |journal=Obes Rev |volume=9 |issue= Suppl 1 |pages=6–13 |year=2008 |month=March |pmid=18307693 |doi=10.1111/j.1467-789X.2007.00432.x}}</ref>

Uhakiki mmoja wa 2006 ulionyesha mambo mengine kumi yanayochangia katika ongezeko la unene wa kupindukia wa hivi majuzi: 
# kukosa usingizi wa kutosha, 
# [[matatizo ya mfumo wa mwili]] ([[vichafuzi vya mazingira]] vinavyotatiza umetaboli wa lipidi), 
# upungufu wa mabadiliko ya halijoto ya mazingira, 
# upungufu wa viwango vya [[kuvuta sigara]], kwa sababu uvutaji sigara hugandamiza hamu ya chakula, 
# kuendelea kutumia dawa zinazoweza kusababisha ongezeko la uzito wa mwili (kwa mfano, [[dawa ya kuzuia magonjwa ya akili yasiyo ya kawaida]]), 
# ongezeko la vikundi vya kikabila na umri vinavyoweza kukita zaidi, 
# ujauzito wa miaka ya uzeeni (jambo ambalo linaweza kusababisha hatari ya unene wa kupindukia katika watoto), 
# hatari za [[jenetikia|kijenetikia]]zinazoweza kupitishwa kutoka kizazi hadi kingine, 
# [[uteuzi wa kiasili]] kwa watu wenye kima cha juu zaidi cha Kielezo cha Uzito wa Mwili, na 
# [[kujamiiana kiubaguzi]] jambo ambalo huongeza vipengele hatari vya unene wa kupindukia (hii inaweza kuongezea idadi ya watu wanene sana kwa kuongezea kiwango cha tofauti kati ya idadi ya watu na uzito).<ref name="pmid16801930">{{cite journal|author=Keith SW |title=Putative contributors to the secular increase in obesity: Exploring the roads less traveled|journal=Int J Obes (Lond) |volume=30 |issue=11 |pages=1585–94 |year=2006 |pmid=16801930 |doi=10.1038/sj.ijo.0803326|url=http://www.nature.com/ijo/journal/v30/n11/full/0803326a.html |author-separator=, |author2=Redden DT|author3=Katzmarzyk PT |display-authors=3 |last4=Boggiano |first4=M M |last5=Hanlon |first5=E C |last6=Benca |first6=R M |last7=Ruden |first7=D |last8=Pietrobelli |first8=A |last9=Barger |first9=J L}}</ref> Ingawa kuna utafiti wa kutosha unaoonyesha jinsi taratibu hizi zinavyopelekea ongezeko la kutokea kwa unene wa kupindukia, utafiti huu bado haujaweza kutoa hitimisho kamili. Watafiti walioufanya wanasema kuwa inawezekana kuwa taratibu hizi zina athari ya kiwango cha chini kuliko zile zilizojadiliwa katika aya iliyotangulia.

===Chakula bora===
{{Double image|right|World map of Energy consumption 1961,2.svg|200|World map of Energy consumption 2001-2003.svg|200|alt=(Left) A world map with countries colored to reflect the food energy consumption of their people in 1961. North America, Europe, and Australia have relatively high intake, while Africa and Asia consume much less.(Right) A world map with countries colored to reflect the food energy consumption of their people in 2001–2003. Consumption in North America, Europe, and Australia has increased with respect to previous levels in 1971 Food consumption has also increased substantially in many parts of Asia. However, food consumption in Africa remains low.|Map of dietary energy availability per person per day in 1961 (left) and 2001–2003 (right) in kcal/person/day.
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{{legend|#ff8400|2600–2800}}
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[[File:World Per Person Energy Consumption.png|thumb|alt=A graph showing a gradual increase in global food energy consumption per person per day between 1961 and 2002.|Average per capita energy consumption of the world from 1961 to 2002<ref name=Earth09>{{cite web |url=http://earthtrends.wri.org/searchable_db/index.php?theme=8&variable_ID=212&action=select_countries |title=EarthTrends: Nutrition: Calorie supply per capita |work=World Resources Institute |accessdate=Oct. 18, 2009}}</ref>]]

Kima cha ugavi wa nguvu za kimlo kwa kila mtu hutofautiana pakubwa katika maeneo na nchi mbali mbali. Kima hiki pia kimebadilika pakubwa kwa muda mrefu sasa.<ref name=Earth09/> Kutoka mwanzoni wa miaka ya 1970 hadi mwishoni wa kiaka ya 1990, wastani wa kalori kwa kila mtu kila siku (kiwango cha chakula kilichonunuliwa) uliongezeka katika maeneo yote duniani ila Mashariki mwa Uropa. Nchi ya Marekani ilikuwa na kima cha juu zaidi cha upatikanaji, ikiwa ni [[kalori]] 3,654 kwa kila mtu katika mwaka wa 1996. Kima hiki kiliongezeka zaidi hadi 3,754 katika mwaka wa 2003.<ref name=Earth09/> Katika miaka ya mwisho ya 1990 Uropa ilikuwa na kalori &nbsp3,394; kwa kila mtu. Katika maeneo yanayostawi kiuchumi ya Asia kulikuwa na kalori&nbsp2,648; kwa kila mtu na katika kusin mwa jangwa la Sahara, watu walikuwa na kalori &nbsp 2,176;kwa kila mtu.<ref name=Earth09/><ref>{{cite web |url=http://www.scribd.com/doc/1470965/USDA-frsept99b|title=USDA: frsept99b |work=[[United States Department of Agriculture]] |accessdate=January 10, 2009}}</ref>  Jumla ya kalori inayotumika imetambulika kuwa inahusiana na unene wa kupindukia.<ref>{{cite web|url=http://www.statcan.gc.ca/pub/82-003-x/2009004/article/10933-eng.htm |title=Diet composition and obesity among Canadian adults |work=Statistics Canada |accessdate=}}</ref>

Upatikanaji mkubwa wa vielekezo kuhusu lishe<ref>{{cite web |author=National Control for Health Statistics | title=Nutrition For Everyone | publisher=Centers for Disease Control and Prevention | url=http://www.cdc.gov/nccdphp/dnpa/nutrition/nutrition_for_everyone | accessdate=2008-07-09}}</ref>haujafaulu kutatua shida za kula kupita kiasi na uamuzi mbaya kuhusu lishe.<ref>{{cite journal |author=Marantz PR, Bird ED, Alderman MH |title=A call for higher standards of evidence for dietary guidelines |journal=Am J Prev Med|volume=34 |issue=3 |pages=234–40 |year=2008 |month=March |pmid=18312812 |doi=10.1016/j.amepre.2007.11.017|url=https://archive.org/details/sim_american-journal-of-preventive-medicine_2008-03_34_3/page/234}}</ref> Kutoka mwaka wa 1971 hadi 2000, viwango vya unene wa kupindukia viliongezeka kutoka 14.5% hadi 30.9%.<ref name=Flegal2002>{{cite journal | author=Flegal KM, Carroll MD, Ogden CL, Johnson CL| title=Prevalence and trends in obesity among US adults, 1999–2000 | journal=JAMA | year=2002 | month=October | volume=288| pages=1723–1727 |url=http://jama.ama-assn.org/cgi/content/full/288/14/1723 | doi=10.1001/jama.288.14.1723 | pmid=12365955 |issue=14}}</ref> Katika kipindi hicho pia, wastani wa matumizi ya chakula kinachotoa nguvu yaliongezeka. Katika wanawake, wastani wa ongezeko hili ulikuwa kalori 335 kwa siku (1,542 mwaka wa 1971 na kalori 1,877 mwaka wa 2004), ilhali katika wanaume, wastani katika ongezeko hilo ulikuwa kalori 168 kwa siku (kalori 2,450 mwaka wa 1971 na kalori 2,618 mwaka wa 2004). Kiwango kikubwa cha nguvu hizi za ziada kilitokana na ongezeko la kutumia [[kabohidrati]] badala ya mafuta.<ref>{{cite journal | author=Wright JD, Kennedy-Stephenson J, Wang CY, McDowell MA, Johnson CL |title=Trends in intake of energy and macronutrients—United States, 1971–2000 | journal=MMWR Morb Mortal Wkly Rep |year=2004 | month=February | volume=53 | issue=4 | pages=80–2 |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5304a3.htm | pmid=14762332}}</ref> Vyanzo vya msingi vya kabohidrati hizi za ziada ni vinywaji vilivyo na sukari ambavyo vinakadiriwa kusababisha karibu 25% ya nguvu za kila siku katika vijana wakomavu Marekani, <ref name=Caballero>{{cite journal |author=Caballero B |title=The global epidemic of obesity: An overview|journal=Epidemiol Rev |volume=29 |issue= |pages=1–5 |year=2007 |pmid=17569676 |doi=10.1093/epirev/mxm012 |url=}}</ref>na [[chipsi]] za [[viazi]].<ref>{{cite journal|last=Mozaffarian|first=D|coauthors=Hao, T, Rimm, EB, Willett, WC, Hu, FB|title=Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men|url=https://archive.org/details/sim_new-england-journal-of-medicine_2011-06-23_364_25/page/2392|journal=The New England Journal of Medicine|date=2011 Jun 23|volume=364|issue=25|pages=2392–404|pmid=21696306|doi=10.1056/NEJMoa1014296|pmc=3151731}}</ref> Utumiaji wa vinywaji vilivyo na sukari unaaminika kuchangia katika ongezeko la viwango vya unene wa kupindukia.<ref>{{cite journal |author=Malik VS, Schulze MB, Hu FB |title=Intake of sugar-sweetened beverages and weight gain: a systematic review work=Statistics Canada | J. Clin. Nutr. |volume=84 |issue=2 |pages=274–88 |year=2006 |month=August |pmid=16895873 |doi=|url=http://www.ajcn.org/cgi/content/full/84/2/274 |pmc=3210834}}</ref><ref>{{cite journal |author=Olsen NJ, Heitmann BL |title=Intake of calorically sweetened beverages and obesity |journal=Obes Rev |volume=10 |issue=1 |pages=68–75|year=2009 |month=January |pmid=18764885 |doi=10.1111/j.1467-789X.2008.00523.x |url=}}</ref>

Jinsi jamii nyingi zinavyoendelea kutegemea [[nguvu nyingi za chakula]], viwango vikubwa vya chakula na vyakula duni, ndivyo uhusiano wa utumiaji wa vyakula duni na unene wa kupindukia unavyoendelea kusababisha madhara. <ref>{{cite journal |author=Rosenheck R|title=Fast food consumption and increased caloric intake: a systematic review of a trajectory towards weight gain and obesity risk |journal=Obes Rev |volume=9 |issue=6 |pages=535–47 |year=2008 |month=November |pmid=18346099|doi=10.1111/j.1467-789X.2008.00477.x |url=}}</ref> Nchini Marekani, utumiaji wa vyakula duni uliongezeka mara tatu huku utumiaji wa chakula chenye nguvu ukiongezeka mara nne kati ya mwaka 1977 na 1995.<ref>{{cite book |author=Lin BH, Guthrie J and Frazao E |editor=Frazão E |title=Agriculture Information Bulletin No. 750: America's Eating Habits: Changes and Consequences |url=http://www.ers.usda.gov/publications/aib750/ |year=1999 |publisher=US Department of Agriculture, Economic Research Service |location=Washington, DC |pages=213–239 |chapter=Nutrient contribution of food away from home |access-date=2013-11-28 |archive-date=2002-06-11 |archive-url=https://web.archive.org/web/20020611183104/http://www.ers.usda.gov/publications/aib750/ |dead-url=yes }}</ref>

[[Sera za kilimo]] na [[ufundisanifu]] zinazozingatia mazingira nchini Marekani na barani Uropa zimesababisha kushuka kwa bei ya vyakula. Kule Marekani, hatua ya kupunguza bei ya mahindi, soya, ngano na mchele kupitia bili ya ukulima ya Marekani imepelekea kushuka kwa bei ya chakula cha viwandani ikilinganishwa na matunda na mboga.<ref>{{cite news|author=Pollan, Michael|title=You Are What You Grow|work=New York Times|url=http://www.nytimes.com/2007/04/22/magazine/22wwlnlede.t.html?ex=1186027200&en=bbe0f6a2c10e3b3c&ei=5070|date= 22 April 2007|accessdate= 2007-07-30}}</ref>

Wakati mwingi, watu wanene kupindukia hawaripoti vyema jinsi wanavyotumia chakula ikilinganishwa na wale walio na uzito wa kawaida.<ref>Kopelman and Caterson 2005:324.</ref> Utafiti huu ni kwa mujibu wa uchunguzi wa watu uliofanyika katika chumba cha kipima kalori <ref>{{cite web|title=Metabolism alone doesn't explain how thin people stay thin |publisher=The Medical Post|work=John Schieszer|format=registration required}}</ref> na kwa kutazama moja kwa moja.

===Mwenendo wa kuzembea===
[[Mwenendo wa kuzembea]] huchangia pakubwa katika unene wa kupindukia.<ref>Seidell 2005 p.10</ref> Kote ulimwenguni, watu wengi wamegeukia kazi isiyohusisha nguvu nyingi za kimwili<ref name=WHO2009>{{cite web |url=http://www.who.int/dietphysicalactivity/publications/facts/obesity/en/ |title=WHO: Obesity and overweight |work=[[World Health Organization]] |accessdate=January 10, 2009 |archiveurl=https://web.archive.org/web/20081218104805/http://www.who.int/dietphysicalactivity/publications/facts/obesity/en/ |archivedate=2008-12-18 }}</ref><ref name=WHOExercise>{{cite web|url=http://www.who.int/dietphysicalactivity/factsheet_inactivity/en/index.html |title=WHO &#124; Physical Inactivity: A Global Public Health Problem |work=[[World Health Organization]]  |accessdate=February 22, 2009}}</ref><ref name=Ness2006>{{cite journal |author=Ness-Abramof R, Apovian CM |title=Diet modification for treatment and prevention of obesity |journal=Endocrine |volume=29 |issue=1 |pages=5–9 |year=2006 |month=February |pmid=16622287|doi=10.1385/ENDO:29:1:135 |url=}}</ref> na kwa wakati huu angalau 60% ya idadi ya watu duniani hupata mazoezi yasiyotosheleza.<ref name=WHOExercise/> Hii hasa ni kwa sababu ya ongezeko la kutumia mitambo katika uchukuzi, na teknologia inayosaidia sana kikazi huko nyumbani.T<ref name=WHO2009/><ref name=WHOExercise/><ref name=Ness2006/>  Katika watoto, viwango vya  kufanya mazoezi vinaonekana kushuka kwa sababu ya kutotembea sana na kutohusika katika somo la mazoezi ya mwili.<ref>{{cite journal |author=Salmon J, Timperio A |title=Prevalence, trends and environmental influences on child and youthphysical activity |journal=Med Sport Sci |volume=50 |issue= |pages=183–99 |year=2007 |pmid=17387258|doi=10.1159/000101391 |series=Medicine and Sport Science |isbn=978-3-318-01396-2 }}</ref>  Mienendo ya dunia katika burudani ambapo watu huusika moja kwa moja[[mazoezi ya mwili]] inaendelea kufifia.   [[Shirika la Afya Duniani]] linaonyesha kuwa, ulimwenguni kote, watu wanaendelea kuhusika katika burudani isiyohusisha maoezi, ilhali katika utafiti mmoja huko Finland<ref>{{cite journal |author=Borodulin K, Laatikainen T, Juolevi A, Jousilahti P |title=Thirty-year trends of physical activity in relation to age, calendar time and birth cohort in Finnish adults |journal=Eur J Public Health |volume=18 |issue=3 |pages=339–44 |year=2008|month=June |pmid=17875578 |doi=10.1093/eurpub/ckm092 |url=}}</ref> ulionyesha ongezeko, ilhali utafiti mwingine huko Marekani ulionyesha kuwa mazoezi katika burudani hayajabadilika sana.<ref>{{cite journal |author=Brownson RC, Boehmer TK, Luke DA |title=Declining rates of physical activity in the United States: what are the contributors?|journal=Annu Rev Public Health |volume=26 |issue= |pages=421–43 |year=2005 |pmid=15760296|doi=10.1146/annurev.publhealth.26.021304.144437 |url=}}</ref>

Katika watoto na watu wazima, kuna uhusiano kati ya kutazama runinga na hatari ya unene wa kupindukia.<ref>{{cite journal |author=Gortmaker SL, Must A, Sobol AM, Peterson K, Colditz GA, Dietz WH |title=Television viewing as a cause of increasing obesity among children in the United States, 1986–1990 |journal=Arch Pediatr Adolesc Med |volume=150 |issue=4 |pages=356–62 |year=1996 |month=April |pmid=8634729|doi=10.1001/archpedi.1996.02170290022003}}</ref><ref>{{cite journal |author=Vioque J, Torres A, Quiles J |title=Time spent watching television, sleep duration and obesity in adults living in Valencia, Spain |journal=Int. J. Obes. Relat. Metab. Disord. |volume=24 |issue=12 |pages=1683–8 |year=2000 |month=December |pmid=11126224 |doi= 10.1038/sj.ijo.0801434|url=}}</ref><ref>{{cite journal |author=Tucker LA, Bagwell M |title=Television viewing and obesity in adult females |journal=Am J Public Health |volume=81 |issue=7 |pages=908–11 |year=1991 |month=July|pmid=2053671 |pmc=1405200 |doi= 10.2105/AJPH.81.7.908|url=http://www.ajph.org/cgi/reprint/81/7/908  |format=PDF}}</ref> Ukaguzi ulitambua kuwa 63 kati ya tafiti 73 (86%) zilionyesha ongezeko katika kiwango cha unene wa kupindukia wa utotoni pindi watoto wanavyofikia vyombo vya mawasiliano, huku viwango hivi vikiongezeka kulingana na muda unaotumika kutazama runinga.ref>{{cite web |url=http://ipsdweb.ipsd.org/uploads/IPPC/CSM%20Media%20Health%20Report.pdf |title=Media + Child and Adolescent Health: A Systematic Review |publisher=Common Sense Media |year=2008 |format=PDF |work=Ezekiel J. Emanuel |accessdate=April 6, 2009 |archive-date=2012-11-22 |archive-url=https://web.archive.org/web/20121122070205/http://ipsdweb.ipsd.org/uploads/IPPC/CSM%20Media%20Health%20Report.pdf |url-status=dead }}</ref>

===Usomijeni===
[[File:La monstrua desnuda (1680), de Juan Carreño de Miranda..jpg|thumb|wima|alt=Mchoro wa msichana mweusi wa kike mwenye nywele nyeusi, mashavu ya waridi aliye uchi akiegemea meza. Msichana huyu ameshika zabibu na majani ya zabibu katika mkono wake wa kushoto ambayo yamezifunika jenitalia zake.| Mchoro uliochorwa mwaka wa 1680 na [[Juan Carreno de Miranda]], wa msichana aliyedhaniwa kuwa na [[sindromu ya Prader-Will]]<ref>{{cite web |url=http://www.esst.org/newsletter2000.htm |title=Case Study: Cataplexy and SOREMPs Without Excessive Daytime Sleepiness in Prader Willi Syndrome. Is This the Beginning of Narcolepsy in a Five Year Old?|author=Mary Jones|publisher=European Society of Sleep Technologists|accessdate=April 6, 2009}}</ref>]]
Kama magonjwa mengine mengi, unene wa kupindukia hutokana na mwingiliano kati ya vipengele vya kijeni na vya kimazingira. [[Upolimofi]] katika [[jeni]] nyingi zinazodhibiti [[hamu ya kula[[]] na [[umetaboli]]hupelekea unene wa kupindukia wakati nguvu za kutosha zinazotoka katika chakula zinapatikana.  Katika mwaka wa 2006, zaidi ya 41 za sehemu hizi zimehusishwa na kuendelea kwa unene wa kupindukia wakati mazingira mwafaka yanapokuwepo.<ref>{{cite journal |author=Poirier P |title=Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss |journal=Arterioscler. Thromb. Vasc. Biol. |volume=26 |issue=5 |pages=968–76 |year=2006 |month=May |pmid=16627822 |doi=10.1161/01.ATV.0000216787.85457.f3|url=https://archive.org/details/sim_arteriosclerosis-thrombosis-and-vascular-biology_2006-05_26_5/page/968|author-separator=, |author2=Giles TD |author3=Bray GA |display-authors=3 |last4=Hong |first4=Y |last5=Stern|first5=JS |last6=Pi-Sunyer |first6=FX |last7=Eckel |first7=RH}}</ref>  Watu walio na aina mbili za[[jeni ya FTO]]  (jeni inayohusishwa na wingi wa mafuta na unene wa kupindukia) wamepatikana kwa wastani kuwa na uzito wa kilogramu 3-4]] &nbsp; zaidi na huwa katika hatari mara1.67 zaidi ya kukumbwa na unene wa kupindukia wakilinganishwa na wale wasio na hatari hii [[aleli]].<ref>{{cite journal |author=Loos RJ, Bouchard C |title=FTO: the first gene contributing to common forms of human obesity |journal=Obes Rev |volume=9 |issue=3 |pages=246–50|year=2008 |month=May |pmid=18373508 |doi=10.1111/j.1467-789X.2008.00481.x |url=}}</ref>  Asilimia ya unene wa kupindukia unaoweza kuhusishwa visababishi vya kijeni ni ya kubadilika kutoka 6% hadi 85% kulingana na idadi ya watu waliochunguzwa.<ref>{{cite journal|author=Yang W, Kelly T, He J |title=Genetic epidemiology of obesity |journal=Epidemiol Rev |volume=29 |issue=|pages=49–61 |year=2007 |pmid=17566051 |doi=10.1093/epirev/mxm004}}</ref>

Unene wa kupindukia ni kipengele kikuu katika sindromu kadhaa kama vile [[sindromu ya Prader-Willi]], [[sindromu ya Bardet-Biedl]], [[sindromu ya Cohen]], na [[sindromu ya MOMO]]. Neno unene wa kupindukia usiosababishwa na sindromu hutumika wakati mwingine kuzitenga hali hizi.<ref name="pmid19506576">{{cite journal |author=Walley AJ, Asher JE, Froguel P |title=The genetic contribution to non-syndromic human obesity |journal=Nat. Rev. Genet. |volume= 10|issue= 7|pages= 431–42|year=2009|month=June |pmid=19506576 |doi=10.1038/nrg2594 |url=}}</ref>  Kwa watu walio na mwanzo mkali wa mapema wa unene wa kupindukia (unaofasiliwa na mwanzo kabla ya umri wa miaka 10&nbsp; na  kielezo cha uzani wa mwili zaidi ya tatu [[standard deviation]] zaidi ya kawaida), 7% huwa na kipimo kimoja cha mgeuko papale <ref>{{cite journal |author=Farooqi S, O'Rahilly S |title=Genetics of obesity in humans |journal=Endocr. Rev. |volume=27 |issue=7 |pages=710–18 |year=2006 |month=December |pmid=17122358 |doi=10.1210/er.2006-0040 |url=http://edrv.endojournals.org/cgi/content/full/27/7/710 |access-date=2013-11-28 |archive-date=2010-07-10 |archive-url=https://web.archive.org/web/20100710170521/http://edrv.endojournals.org/cgi/content/full/27/7/710 |dead-url=yes }}</ref>

Tafiti zilizolenga mitindo ya urithi badala ya jeni maalum zimetambua kuwa asilimia 80 ya watoto wa watu wawili walio wanene kupindukia walikuwa vilevile na unene wa kupindukia, ikilinganishwa na asilimia chini ya 10 ya watoto wa wazazi wawili waliokuwa na uzito wa kawaida.<ref>{{cite book |author=Kolata,Gina |title=Rethinking thin: The new science of weight loss&nbsp;– and the myths and realities of dieting |publisher=Picador |location= |year=2007 |page=122|isbn=0-312-42785-9}}</ref>

[[Nadharia tete ya jeni yenye mafanikio]] hudai kuwa watu wana uwezekano mkubwa wa kupatwa na unene wa kupindukia kutokana na ukosefu wa chakula wakati wa mageuko ya binadamu. Uwezo wao wa kujinufaisha katika vipindi visivyo vya kawaida vya wingi kwa kuweka nguvu kama mafuta unaweza kuwafaa katika nyakati ambapo upatikanaji wa chakula si yakini na watu walio na hifadhi kubwa ya mafuta wanaweza kuwa na uwezekano mkubwa wa kuongoka[[njaa]]. Hata hivyo, huenda jamii zilizo na chakula kwa wingi zisizoee kujiwekea mafuta.<ref>{{cite journal |author=Chakravarthy MV, Booth FW |title=Eating, exercise, and "thrifty" genotypes: Connecting the dots toward an evolutionary understanding of modern chronic diseases |url=https://archive.org/details/sim_journal-of-applied-physiology_2004-01_96_1/page/3 |journal=J. Appl. Physiol.|volume=96 |issue=1 |pages=3–10 |year=2004 |pmid=14660491 |doi=10.1152/japplphysiol.00757.2003}}</ref> Nadharia hii imeweza kukosolewa sana na kupelelea kupendekezwa kwa nadharia zingine za kimageuko kama vile [[nadharia tete ya jeni isiyo na mkondo]] na[[fenotipu yenye mafanikio|nadharia tete ya fenotipu yenye mafanikio]]zilizopendekezwa. <ref>{{cite doi|10.1038/ijo.2009.175}}</ref><ref>{{cite doi|10.1002/ajhb.21100}}</ref>

===Maradhi mengine===
Maradhi mengine ya mwili na akili na dawa za kifamasia zinazotumiwa kuyatibu zinaweza kuongeza hatari ya unene wa kupindukia. Maradhi yanayoongeza hatari ya unene huo ni sindromu kadhaa za kijenetikia zisizo za kawaida (zilizoorodheshwa hapo juu) na aidha magonjwa mengine ya kuzaliwa nayo au ya kujitokeza baada ya kuzaliwa: [[uhipothiroidi]], [[Sindromu ya Cushing]], [[kukosa homoni ya kukua]],<ref>{{cite journal |author=Rosén T, Bosaeus I, Tölli J, Lindstedt G, Bengtsson BA |title=Increased body fat mass and decreased extracellular fluid volume in adults with growth hormone deficiency |url=https://archive.org/details/sim_clinical-endocrinology_1993-01_38_1/page/63 |journal=Clin. Endocrinol. (Oxf) |volume=38 |issue=1 |pages=63–71 |year=1993 |pmid=8435887| doi = 10.1111/j.1365-2265.1993.tb00974.x}}</ref> na [[matatizo ya kula]]: [[matatizo ya kula yatokanayo na ulevi]] na [[sindromu ya kula usiku]].<ref name=HaslamJames/>.Hata hivyo, unene wa kupindukia hauchukuliwi kuwa tatizo la kiakili na kwa hiyo haujaorodheshwa katika Mwongozo wa Utambuzi na Takwimu za Maradhi ya Akili (DSM-IVR) kama maradhi ya akili.<ref>{{cite journal |author=Zametkin AJ, Zoon CK, Klein HW, Munson S |title=Psychiatric aspects of child and adolescent obesity: a review of the past 10 years |journal=J Am Acad Child Adolesc Psychiatry |volume=43 |issue=2 |pages=134–50 |year=2004 |month=February |pmid=14726719|doi=10.1097/00004583-200402000-00008}}</ref> Hatari ya uzito wa kupita kiasi na unene wa kupindukia iko juu kwa wagonjwa walio na maradhi ya akili kuliko kwa watu ambao hawana maradhi ya akili.<ref>{{cite journal | author=Chiles C, van Wattum PJ |title=Psychiatric aspects of the obesity crisis | journal=Psychiatr Times | year=2010 | volume=27 | issue=4 |pages=47–51}}</ref>

Matibabu mengine yanaweza kusababisha kuongezeka kwa uzito au mabadiliko katika [[mchanganyiko wa mwili]]; nayo ni [[insulini]], [[salfonyilurea]], [[thiasolidinedioni]], [[dawa za magonjwa ya kiakili]], [[dawa ya unyogovu]], [[glucocorticoids|steroidi]], aina nyingine za [[dawa za mitukutiko]] ([[fenitoini]] na [[valproeati]]), [[pisotifeni]], na za [[uzuiaji mimba wa kihomoni]].<ref name=HaslamJames/>

===Vigezo vya kijamii===
Ingawa athari za kijenetiki ni muhimu katika kuelewa unene wa kupindukia, haziwezi kuwajibikia mkondo uliopo wa ongezeko katika nchi fulani au duniani.<ref>{{cite journal |author=Yach D, Stuckler D, Brownell KD |title=Epidemiologic and economic consequences of the global epidemics of obesity and diabetes |journal=Nat. Med. |volume=12 |issue=1|pages=62–6 |year=2006 |month=January |pmid=16397571 |doi=10.1038/nm0106-62 |url=}}</ref> Ingawa imekubalika kuwa utumizi wa nguvu zaidi ya kiasi kinachostahili kutumika husababisha unene wa kupindukia kibinafsi, kisababishi cha mageuko katika vipengele hivi viwili kwa kiwango cha jamii hujadiliwa sana. Kuna nadharia kadhaa zinazohusu visababishi vya unene wa kupindukia. Hata hivyo, nadharia nyingi zimeshikilia kuwa unene husababishwa na mchanganyiko wa vipengele tofauti.

Uhusiano kati ya [[hadhi ya kijamii]] na Kielezo cha Uzani wa Mwili huwa tofauti ulimwenguni. Tathmini katika mwaka wa 1989 ilionyesha kuwa wanawake wenye hadhi ya juu ya kijamii katika nchi zinazostawii walikuwa na uwezekano mdogo wa kukumbwa na unene wa kupindukia. Hakuna tofauti muhimu zilizoonekana miongoni mwa  wanaume wa hadhi tofauti za kijamii. Katika nchi zinazostawi, wanawake, wanaume na watoto kutoka katika hadhi ya juu ya kijamii walikuwa na viwango vikubwa vya unene wa kupindukia.<ref>{{cite journal |author=Sobal J, Stunkard AJ |title=Socioeconomic status and obesity: A review of the literature |url=https://archive.org/details/sim_psychological-bulletin_1989-03_105_2/page/260 |journal=Psychol Bull |volume=105 |issue=2 |pages=260–75 |year=1989 |month=March |pmid=2648443|doi=10.1037/0033-2909.105.2.260}}</ref>. Toleo la tathmini hii uliofanyika mwaka wa 2007 ulionyesha uhusiano uo huo lakini ulikuwa dhaifu. Upungufu katika uthabiti wa uhusiano huo ulihisika kuwa uliotokana na [[utandawazi]].<ref name=McLaren2007>{{cite journal |author=McLaren L |title=Socioeconomic status and obesity |journal=Epidemiol Rev|volume=29 |issue= |pages=29–48 |year=2007 |pmid=17478442 |doi=10.1093/epirev/mxm001}}</ref> Katika nchi zilizostawi, viwango vya unene wa kupindukia kwa watu wazima, na asilimia ya watoto waliobalehe walio na uzani wa kupindukia vinahusiana na  [[tofauti za kiuchumi|tofauti za kimapato]].  Uhusiano kama huu hunekana katika majimbo ya Marekani: watu wengi wazima, hata walio katika matabaka ya juu katika jamii wana unene wa kupindukia hata katika majimbo yaliyo na tofauti za kimapato.<ref name="spirit">{{cite book|title=[[The Spirit Level: Why More Equal Societies Almost Always Do Better]]|last1=Wilkinson|first1=Richard|authorlink1=Richard G. Wilkinson|last2=Pickett|first2=Kate|publisher=Allen Lane|location=London|isbn=978-1-84614-039-6|year=2009|pages=91–101|url=http://www.equalitytrust.org.uk/why/evidence/obesity}}</ref>

Maelezo mengi yametolewa yakilinganisha Kielezo cha Uzani wa Mwili na hadhi ya kijamii. Inadhaniwa mwilia mwilizo wa kumudu vyakula bora zaidi, nao huwa katika shinikizo zaidi la kusalia wembamba kutoka kwa jamii, na wana nafasi na matumaini makubwa ya kudumisha [[siha njema ya kimwili]]. Katika [[nchi zisizostawi]] inaaminika kuwa uwezo wa kumudu chakula, utumizi mkubwa wa nguvu katika kufanya kazi za sulubu, na tamaduni zinazothamini miili mikubwa huchangia katika kuleta mitindo hii.<ref name=McLaren2007/>  Mitazamo inayoshikiliwa na watu kuhusu ukubwa wa mwili maishani pia inaweza kuchangia unene wa kupindukia. Uhusiano wa mabadiliko katika Kielezo cha Uzani wa Mwili kwa muda mrefu umeonekana miongoni mwa marafiki, ndugu na wachumba.<ref>{{cite journal |author=Christakis NA, [[James H. Fowler|Fowler JH]] |title=The Spread of Obesity in a Large Social Network over 32 Years |journal= New England Journal of Medicine|volume=357 |issue=4|pages=370–379 |year=2007 |pmid=17652652 |doi=10.1056/NEJMsa066082}}</ref>  Stress and perceived low social status appear to increase risk of obesity.<ref name="spirit" /><ref>{{cite journal|author=Bjornstop P|title=Do stress reactions cause abdominal obesity and comorbidities?|journal=Obesity Reviews|volume=2|issue=2|pages=73–86|year=2001|doi=10.1046/j.1467-789x.2001.00027.x|pmid=12119665}}</ref><ref>{{cite journal|author=Goodman E, Adler NE, Daniels SR, Morrison JA, Slap GB, Dolan LM|title=Impact of objective and subjective social status on obesity in a biracial cohort of adolescents|journal=Obesity Reviews|volume=11|issue=8|pages=1018–26|year=2003|pmid=12917508|doi=10.1038/oby.2003.140}}</ref>

Uvutaji sigara huathiri pakubwa uzani wa mtu. Watu wanaokoma kuvuta sigara huongeza uzito kwa wastani wa kilo  4.4&nbsp; 9.7&nbsp;lb) katika wanaume na kilo 5.0&nbsp;(11.0&nbsp;lb) katika wanawake kwa muda wa miaka kumi.<ref>{{cite journal |author=Flegal KM, Troiano RP, Pamuk ER, Kuczmarski RJ, Campbell SM |title=The influence of smoking cessation on the prevalence of overweight in the United States |journal=N. Engl. J. Med. |volume=333 |issue=18 |pages=1165–70 |year=1995 |month=November |pmid=7565970 |doi=10.1056/NEJM199511023331801 |url=http://content.nejm.org/cgi/content/full/333/18/1165 |access-date=2013-11-28 |archive-date=2003-04-05 |archive-url=https://web.archive.org/web/20030405192136/http://content.nejm.org/cgi/content/full/333/18/1165 |dead-url=yes }}</ref> Hata hivo mabadiliko katika viwango vya uvutaji yamekuwa na matokeo duni kwa viwango vya jumla vya unene wa kupindukia.<ref>{{cite journal |author=Chiolero A, Faeh D, Paccaud F, Cornuz J |title=Consequences of smoking for body weight, body fat distribution, and insulin resistance|journal=Am. J. Clin. Nutr. |volume=87 |issue=4 |pages=801–9 |date=1 April 2008|pmid=18400700|url=http://www.ajcn.org/cgi/content/full/87/4/801  }}</ref>

Nchini Marekani, idadi ya watoto alionao mtu inahusiana na hatarisho lao la unene wa kupindukia. Hatari ya mwanamke huongezeka kwa 7% kwa kila mtoto, ilhali hatarisho la mwanamume huongezeka kwa 4%.<ref>{{cite journal |author=Weng HH, Bastian LA, Taylor DH, Moser BK, Ostbye T |title=Number of children associated with obesity in middle-aged women and men: results from the health and retirement study |journal=J Women's Health (Larchmt) |volume=13 |issue=1 |pages=85–91 |year=2004|pmid=15006281 |doi=10.1089/154099904322836492}}</ref> Hii inaweza kuelezwa kwa kiasi fulani kutokana na ukweli kwamba kuwa na watoto wanaokutegemea hupunguza shughuli za kimwili kwa wazazi katika nchi za Ulaya na Marekani.<ref>{{cite journal |author=Bellows-Riecken KH, Rhodes RE |title=A birth of inactivity? A review of physical activity and parenthood |journal=Prev Med |volume=46|issue=2 |pages=99–110 |year=2008 |month=February |pmid=17919713 |doi=10.1016/j.ypmed.2007.08.003}}</ref>

Katika nchi zinazostawi, ukuaji wa miji unachangia katika kiwango kinachoongezeka cha unene wa kupindukia.  Nchini [[Uchina]]viwango vya jumla vya unene wa kupindukia viko chini ya asilimia 5; hata hivyo, katika miji mingine, viwango vya unene wa kupindukia ni zaidi ya asilimia 20.<ref>{{cite web|url=http://www.who.int/dietphysicalactivity/media/en/gsfs_obesity.pdf |title=Obesity and Overweight |format=PDF|publisher=[[World Health Organization]] |accessdate=February 22, 2009}}</ref>

[[Utapiamlo]] mwanzoni mwa maisha umeaminika kuchangia katika viwango vinavyoongezeka vya unene wa kupindukia katika[[nchi zinazostawi]].<ref name=DC2001>{{cite journal |author=Caballero B |title=Introduction. Symposium: Obesity in developing countries: biological and ecological factors |journal=J. Nutr. |volume=131 |issue=3 |pages=866S–870S |year=2001|month=March |pmid=11238776 |doi= |url=http://jn.nutrition.org/cgi/content/full/131/3/866S}}</ref>Mabadiliko ya endokrini yanayotokea katika vipindi vya utapiamlo yanaweza kuendeleza uhifadhiwaji wa mafuta mara tu chakula zaidi kiletacho nguvu kinapopatikana.<ref name=DC2001/>

Sawa na data za [[epidemiolojia tambuzi|epidemiolojia tambuzi]], na tafiti nyingi  huthibitisha kuwa unene wa kupindukia unahusiana na upungufu katika utambuzi. <ref name="Smith2011"> {{cite journal|doi=10.1111/j.1467-789X.2011.00920.x|url=http://onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2011.00920.x/abstract|doi_brokendate=1-1-2012|author1=<Please add first missing authors to populate metadata.>}}</ref>  Iwapo unene wa kupindukia husababisha upungufu katika utambuzi kwa vyovyote vile bado haijulikani kwa sasa.

===Vikolezo viambukizi===
Utafiti wa jinsi vikolezo viambukizi vinavyoathiri umetaboli ungali katika hatua zake za kwanza.  [[Flora ya utumbo]] imeonekana kutofautiana kati ya watu wembamba na wale walio na unene wa kupindukia. Kuna ishara kuwa flora ya utumbo katika watu wanene kupindukia na wale wembamba inaweza kuathiri uwezo wa umetaboli. Mabadiliko haya dhahiri katika uwezo wa umetaboli yanaaminika kuchangia kwa kiwango kikubwa katika kuvuna nguvu zinazosababisha unene wa kupindukia. Iwapo tofauti hizi ndizo visababishi vya  moja kwa moja au ndiyo matokeo ya unene wa kupindukia, bado haijabainishwa kwa kiasi kisichopotosha<ref>{{cite journal |author=DiBaise JK, Zhang H, Crowell MD, Krajmalnik-Brown R, Decker GA, Rittmann BE |title=Gut microbiota and its possible relationship with obesity |journal=Mayo Clinic proceedings. Mayo Clinic |volume=83 |issue=4 |pages=460–9 |year=2008 |month=April |pmid=18380992|doi=10.4065/83.4.460}}</ref>

Uhusiano kati ya [[virusi]] na unene wa kupindukia umeonekana kwa wanadamu na spishi kadhaa za wanyama. Kiasi ambacho ushirikiano huu unaweza kuwa umechangia katika kuongezeka kwa kiwango cha unene wa kupindukia bado hakijabainishwa.<ref>{{cite journal |author=Falagas ME, Kompoti M |title=Obesity and infection |journal=Lancet Infect Dis |volume=6 |issue=7|pages=438–46 |year=2006 |month=July |pmid=16790384 |doi=10.1016/S1473-3099(06)70523-0 |url=}}</ref>

==Pathofiziolojia==
[[File:Fatmouse.jpg|thumb|alt=Panya wawili weupe wenye masikio yanayotoshana, macho meusi na pua za waridi. Hata hivyo upana wa mwili wa panya aliye kushoto ni takribani mara tatu zaidi ya ule wa panya wa kulia aliye na ukubwa wa kawaida.|Ulinganisho wa panya asiyeweza kutoa [[leptini]]  na hatimaye kupelekea unene wa kupindukia (kushoto) na panya wa kawaida (kulia)]]

Flier anafupisha taratibu nyingi za [[pathofiziolojia]] zinazohusika katika ukuaji na udhibiti wa unene wa kupindukia.<ref name="flier">{{cite journal | author=Flier JS | title=Obesity wars: Molecular progress confronts an expanding epidemic Molecular progress confronts an expanding epidemic | journal=Cell | year=2004 | pages=337–50 | volume=116 | issue=2 | pmid=14744442 | doi = 10.1016/S0092-8674(03)01081-X}}</ref>  Kitengo hiki cha utafiti kilikuwa hakijaangaziwa hadi mwaka wa 1994[[leptini]] ilipogunduliwa. Tangu ugunduzi huu ulipofanyika, taratibu zingine nyingi za homoni zinazohusika katika udhibiti wa [[hamu ya kula]] na ulaji, mitindo ya uhifadhi ya [[tishu ya mafuta]] na ukuaji wa [[ukinzani kwa insulini zimefumbuliwa]]. Tangu kuvumbuliwa kwa leptini, [[grelin]], [[insulini]], [[oreksini]], [[PYY 3-36]], [[kolesistokinini]],[[adiponektini]], na vipengele vinginevyo zimechunguzwa. [[Adipokini]] ni chembe zinazoundwa na tishu ya mafuta; utendakazi wake unadhaniwa kubadilisha magonjwa mengi yanayohusiana na unene wa kupindukia.

Inachukuliwa kuwa leptini na grelini hufanya kazi pamoja katika jinsi zinavyoathiri hamu ya kula; huku grelini, inayotolewa na tumbo, ikirekebisha uthibiti wa muda mfupi wa hamu ya kula (yaani kula wakati ambapo tumbo liko tupu na kukoma tumbo inapotanuka). Leptini hutolewa na tishu ya mafuta kuchochea hifadhi za mafuta mwilini na kupatanisha uthibiti wa muda mrefu wa hamu ya kula (yaani, kula kwa wingi ambapo hifadhi za mafuta ziko chini na kula kiasi kidogo zinapokuwa juu). Ingawa utoaji wa leptini unaweza kufaa katika kikundi kidogo cha watu wenye unene wa kupindukia walio na upungufu wa leptini, watu wengi wenye unene huu hufikiriwa kuwa wenye ukinzani wa leptini na wamepatikana kuwa na viwango vya juu vya leptini.<ref>{{cite journal|author=Hamann A, Matthaei S |title=Regulation of energy balance by leptin |journal=Exp. Clin. Endocrinol. Diabetes|volume=104 |issue=4 |pages=293–300 |year=1996 |pmid=8886745 |doi=10.1055/s-0029-1211457}}</ref> Ukinzani huu hufikiriwa kueleza kwa kiasi fulani sababu inayofanya utoaji wa leptini usionekane kufaa katika kukandamiza hamu ya kula kwa watu wengi walio na unene wa kupindukia.<ref name="flier"/>

[[File:Leptin.png|thumb|kushoto|alt=Modeli ya mitazamo mitatu iliyo na jozi mbili za nguzo mkabala zilizopinda na kushikanishwa pamoja kwenye miisho na sehemu zingine zilizopangwa katika mistari.||Kielelezo cha molekuli ya leptini]]
Ingawa leptini na grelini hutolewa pembezoni, zinadhibiti hamu ya kula kupitia jinsi zinavyoathiri[[mfumo mkuu wa neva]]. Hasa, leptini na grelini, na homoni zingine zinazohusiana na hamu ya kula huichochea [[hipothalamasi]], sehemu ya ubongo iliyo muhimu zaidi katika kudhibiti ulaji na utumiaji wa nguvu. Kuna mizunguko kadhaa katika hipothalamasi inayochangia kwenye jukumu lake katika kuongeza na kudumisha hamu ya kula, ambapo[[melanokotini]] ndiyo njia inayoeleweka vizuri sana.<ref name="flier"/> Mzunguko huu huanzia katika sehemu ya  hipothalamasi iitwayo [[kiini akueti]], ambayo matokeo yake huenda kwenye [[hipothalamasi ya pembeni]] na [[hipothalamasi inayotambua shibe]], sehemu za ubongo zinazodhibiti kula na shibe mtawalia.<ref>{{cite book |author=Boulpaep, Emile L.; Boron, Walter F. |title=Medical physiologya: A cellular and molecular approach |url=https://archive.org/details/medicalphysiolog0000boro_a6j9 |publisher=Saunders|location=Philadelphia |year=2003 |page=[https://archive.org/details/medicalphysiolog0000boro_a6j9/page/n1227 1227]|isbn=0-7216-3256-4}}</ref>

Kiini akueti kina makundi mawili tofauti ya [[nyuroni]].<ref name="flier"/> Kundi la kwanza hudhirisha [[nuropeptaidi Y]] na [[peptaidi inayohusiana na agouti]] kwa pamoja na kuchangia katika kuichochea hipothalamasi ya pembeni na kuikandamiza hipothalamasi inayotambua shibe. Kundi la pili hudhihirisha [[pro-opiomelanokotini]] na [[nakala inayodhitiwa na kokeni na amfetamini]] (NIKA) na huchangia katika kuichochea hipothalamasi inayotambua shibe  na kuikandamiza hipothalamasi ya pembeni. Kwa hiyo, nyuroni za nuropetaidi Y/peptaidi inayohusiana na agouti (NPY/AgRP) huchochea kula na kuzuia kushiba, ilhali nuroni za POMC/NIKA huchochea kushiba na kuzuia kula. Makundi yote mawili ya nuroni za kiini akueti nuroni hudhibitiwa kwa kiasi fulani na leptini. Leptini hukandamiza kundi la nuropetaidi Y/peptaidi inayohusiana na agouti (NPY/AgRP) huku ikilichochea kundi la POMC/NIKA. Kwa hivyo, ukosefu wa uchochelezi wa leptini, iwe ni kutokana na ukosefu wa leptini au ukinzani kwa leptin, hupelekea kula zaidi na inaweza kusababisha unene wa kupindukia wa kijenetikia na wa kupatikana maishani.<ref name="flier"/>
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==Afya ya umma==
[[Shirika la Afya Duniani]] (WHO) linatabiri kuwa hivi karibuni, [[uzito wa kupita kiasi]] na unene wa kupindukia unaweza kuchukua nafasi ya matatizo ya jadi ya [[afya ya umma]] kama vile [[utapiamlo]] na [[magonjwa ya kuambukiza]] kama visababishi vikuu vya afya duni.<ref>{{cite book |author=Loscalzo, Joseph; Fauci, Anthony S.; Braunwald, Eugene; Dennis L. Kasper; Hauser, Stephen L; Longo, Dan L. |title=Harrison's principles of internal medicine |publisher=McGraw-Hill Medical |location=|year=2008 |pages= |isbn=0-07-146633-9 |oclc=|doi= |accessdate=}}</ref> Unene wa kupindukia ni tatizo la afya ya umma na la kisera kwa sababu yaueneaji wake, gharama na athari za kiafya.<ref>{{cite book | author=Satcher D | title=The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity | year=2001 | publisher=U.S. Dept. of Health and Human Services, Public Health Service, Office of Surgeon General | url=http://www.ncbi.nlm.nih.gov/books/NBK44206/|isbn=978-0-16-051005-2}}</ref>
Juhudi za afya ya umma hulenga kuelewa na kurekebisha mazingira yanayochangia kukithiri kwa unene wa kupindukia miongoni mwa watu. Suluhisho hutazamia kubadilisha mambo yanayosababisha utumiaji zaidi wa vyakula viletavyo nguvu na kukandamiza shughuli/mazoezi ya mwili. Juhudi ni programu za milo zinazofadhiliwa na serikali katika shule, kupunguza uuzaji wa[[chakula visivyo bora]] kwa watoto, <ref>{{cite news | author=Brook Barnes | title=Limiting Ads of Junk Food to Children |url=http://www.nytimes.com/2007/07/18/business/18food.html | work=New York Times | date=2007-07-18 |accessdate=2008-07-24}}</ref> na kupunguza upatikanaji wa vinywanji vyenye sukari katika shule.<ref>{{cite web |url=http://www.healthfinder.gov/news/newsstory.aspx?docID=625759 |title=Fewer Sugary Drinks Key to Weight Loss -healthfinder.gov |work=U.S.. Department of Health and Human Services |accessdate=Oct 18,2009 |archivedate=2012-11-16 |archiveurl=https://web.archive.org/web/20121116045620/http://www.healthfinder.gov/news/newsstory.aspx?docID=625759 }}</ref>  Juhudi zimefanywa katika uundaji wa mazingira ya miji ili kuongeza ufikiaji wa bustani na kutengeneza njia za waendao kwa miguu.<ref>{{cite journal | author=Brennan Ramirez LK | title=Indicators of activity-friendly communities: An evidence-based consensus process | journal=Am J Prev Med | year=2006 | month=December | issue=6 | pages=530–32 | pmid=17169714 | url=https://archive.org/details/sim_american-journal-of-preventive-medicine_2006-12_31_6/page/530|doi=10.1016/j.amepre.2006.07.026 | volume=31 | author-separator=, | author2=Hoehner CM | author3=Brownson RC |display-authors=3 | last4=Cook | first4=R | last5=Orleans | first5=C | last6=Hollander | first6=M | last7=Barker |first7=D | last8=Bors | first8=P | last9=Ewing | first9=R}}</ref>

Nchi nyingi pamoja na vikundi vimechapisha ripoti zinazohusu unene wa kupindukia. Mnamo mwaka wa 1998, miongozo ya kwanza ya serikali ya shirikisho ya Marekani ilichapishwa kwa jina "Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report" (Mwongozo wa Kitabibu kuhusu Utambuzi, Utathmini na Matibabu ya Unene na Unene wa Kupindukia katika Watu Wazima).<ref>{{cite book |author=National Heart, Lung, and Blood Institute|title=Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults|publisher=International Medical Publishing, Inc |location=|year= 1998 |isbn=1-58808-002-1 |oclc=|url=http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf|format=PDF}}</ref> Mnamo mwaka wa 2006 [[Mfumo wa Unene wa Kupindukia wa Kanada]] ulichapisha "Canadian Clinical Practice Guidelines (CPG) on the Management and Prevention of Obesity in Adults and Children" [Taratibu za Kitabibu za Kanada zinazohusu Udhibiti na uzuiaji wa Unene wa Kupindukia kwa Watu Wazima na Watoto] Huu ni utaratibu wa kina unaozingatia ushahidi ili kushughulikia udhibiti na uzuiaji wa uzani wa kupita kiasi na unene wa kupindukia kwa watu wazima na watoto.<ref>{{cite journal |author=Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E |title=2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children summary |journal=CMAJ |volume=176 |issue=8|pages=S1–13 |year=2007 |month=April |pmid=17420481 |pmc=1839777|doi=10.1503/cmaj.061409 |url=http://www.cmaj.ca/cgi/content/full/176/8/S1}}</ref>

Mnamo mwaka wa 2004 nchini Uingereza, [[Chuo cha Mafizishiani cha Royal]], [[Kitengo cha Afya ya Umma]] na [[Chuo cha Pediatria na Afya ya Watoto]] vilitoa ripoti, “Kuhifadhi Matatizo", iliyodokeza kuhusu kuongezeka kwa tatizo la unene wa kupindukia nchini Uingereza. <ref>{{cite book |title=Storing up problems; the medical case for a slimmer nation |date=2004-02-11|publisher=Royal College of Physicians |location= London|isbn=1-86016-200-2 |author=}}</ref> Mwaka huohuo, Kamati Teule ya Afya ya Bunge la Uingereza ilichapisha "uchunguzi wake wa kina zaidi [...] uliowahi kufanywa kuhusu athari ya unene wa kupindukia kwa afya na jamii nchini Uingereza na njia mwafaka zinazoweza kutumiwa katika kutatua tatizo hili.<ref name =GB2004>{{cite book |author=Great Britain Parliament House of Commons Health Committee |title=Obesity– Volume 1 – HCP 23-I, Third Report of session 2003–04. Report, together with formal minutes|url=http://www.publications.parliament.uk/pa/cm200304/cmselect/cmhealth/23/2302.htm|accessdate=2007-12-17|year=2004 |month=May|publisher=TSO (The Stationery Office)|location=London, UK|isbn=978-0-215-01737-6}}</ref> Mwaka wa 2006, [[Taasisi ya Kitaifa ya Afya na Ubora wa Kitabibu]] ilitoa utaratibu wa kutambua na kutibu unene wa kupindukia na vilevile athari za kisera kwa mashirika yasiyo ya kiafya kama vile mabaraza ya mitaa<ref>{{cite web|url=http://www.nice.org.uk/nicemedia/pdf/CG43NICEGuideline.pdf |title=Obesity: guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children|publisher=[[National Health Services]] (NHS)|year= 2006|format=PDF |work=National Institute for Health and Clinical Excellence(NICE)|accessdate=April 8, 2009}}</ref> Ripoti iliyotolewa na Bwana [[Derek Wanless]] mwaka wa 2007 kwa [[Hazina ya Mfalme]] ilionya kuwa iwapo hatua zaidi hazitachukuliwa, unene wa kupindukia una uwezo wa kulemaza [[Huduma ya Afya ya Kitaifa]]kifedha.<ref>{{cite book |last=Wanless |first=Sir Derek |coauthors=John Appleby, Anthony Harrison, Darshan Patel|title=Our Future Health Secured? A review of NHS funding and performance|url=http://www.kingsfund.org.uk/research/publications/our_future.html|accessdate=2007-12-17 |year=2007 |publisher=The King's Fund|location=London, UK |isbn=1-85717-562-X}}</ref>

Hatua za kina zinabuniwa ili kuthibiti viwango vinavyoongezeka vya unene wa kupindukia. Mfumo wa Sera ya Kukabiliana na Unene wa Kupindukia hugawanya hatua kwa sera za ‘juu’, sera za ‘katikati’ na sera za ‘chini’. Sera za ‘juu’ zinalenga kubadilisha jamii, sera za ‘kati’ hujaribu kubadilisha mienendo ya watutu ili kuzuia unene wa kupindukia nazo sera za ‘chini’ hujaribu kuwahudumia wale ambao tayari wameathirika.<ref>{{cite journal |author=Sacks G, Swinburn B, Lawrence M|title=Obesity Policy Action framework and analysis grids for a comprehensive policy approach to reducing obesity|journal=Obes Rev |volume=10 |issue=1 |pages=76–86 |year=2009 |month=January|pmid=18761640|doi=10.1111/j.1467-789X.2008.00524.x |url=}}</ref>

==Udhibiti==
[[File:Obesity Med2008.JPG|thumb|alt=Kifurushi cha kadibodi kinachotumika kupakia aina mbili za dawa zinazotumika kutibu unene wa kupindukia. Orlistat imeonyeshwa hapo juu chini ya jina la chapa la Xenical kwa kifurushi cheupe kilicho na nembo ya Roche kwa kona hapo chini upande wa kulia (jina Roche lililo kwenye pembe sita). Sibutramine iko hapo chini, chini ya chapa Meridia.  Kifurushi kina rangi nyeupe upande wa juu na samawati upande wa chini zilizotenganishwa na utepe wa kupima. Herufi A ya Abbott iko kwenye nusu ya chini ya kifurushi.|kulia|[[Orlistat]] (Xenical), tiba inayotumika sana katika kutibu unene wa kupindukia, na [[sibutramine]](Meridia) dawa iliyoondolewa hivi karibuni kutokana na athari zake kwa moyo]]
Matibabu makuu ya unene wa kupindukia ni [[kudhibiti jinsi unavyokula]] and [[mazoezi ya mwili]].<ref name=CADG2006>{{cite journal|author=Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E |title=2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children summary |journal=CMAJ |volume=176 |issue=8|pages=S1–13 |year=2007 |month=April |pmid=17420481 |pmc=1839777 |doi=10.1503/cmaj.061409 |url=}}</ref>Mipango ya lishe inaweza kupelekea [[kupoteza uzito]]kwa kipindi cha muda mfupi<ref name=Strychar>{{cite journal |author=Strychar I |title=Diet in the management of weight loss |journal=CMAJ |volume=174 |issue=1 |pages=56–63 |year=2006 |month=January |pmid=16389240|pmc=1319349 |doi=10.1503/cmaj.045037 |url=http://www.cmaj.ca/cgi/content/full/174/1/56}}</ref> lakini kudumisha kiwango hiki cha kupoteza uzito mara nyingi huwa vigumu na hivyo huhitaji kudumisha mwenendo wa maisha ya mazoezi ya kimwili na kula chakula kilicho na kiwango cha chini cha nguvu.<ref>{{cite journal |author=Shick SM, Wing RR, Klem ML, McGuire MT, Hill JO, Seagle H|title=Persons successful at long-term weight loss and maintenance continue to consume a low-energy, low-fat diet|journal=J Am Diet Assoc |volume=98 |issue=4 |pages=408–13 |year=1998 |month=April |pmid=9550162|doi=10.1016/S0002-8223(98)00093-5}}</ref><ref>{{cite journal |author=Tate DF, Jeffery RW, Sherwood NE, Wing RR|title=Long-term weight losses associated with prescription of higher physical activity goals. Are higher levels of physical activity protective against weight regain? |journal=Am. J. Clin. Nutr. |volume=85 |issue=4 |pages=954–9|date=1 April 2007|pmid=17413092 |url=http://www.ajcn.org/cgi/content/full/85/4/954}}</ref>Kufanikiwa kudumisha kiwango cha kupoteza uzani na mabadiliko katika mienenbo ni chini mno kati ya asilimia 2 - asilimia 20.<ref>{{cite journal |author= Wing, Rena R; Phelan, Suzanne|title=Science-Based Solutions to Obesity: What are the Roles of Academia, Government, Industry, and Health Care? Proceedings of a symposium, Boston, Massachusetts, USA, 10–11 March 2004 and Anaheim, California, USA, 2 October 2004 |journal=Am. J. Clin. Nutr. |volume=82 |issue=1 Suppl |pages=207S–273S |date=1 July 2005|pmid=16002825|url=http://www.ajcn.org/cgi/content/full/82/1/222S }}</ref>Mabadiliko ya kilishe na kimienendo ni muhimu katika kudhibiti uongezaji wa kupita kiasi wa uzani katika [[ujauzito]] na kuboresha hali ya mama na mtoto.<ref>{{cite journal|last=Thangaratinam|first=S|coauthors=Rogozinska, E; Jolly, K; Glinkowski, S; Roseboom, T; Tomlinson, JW; Kunz, R; Mol, BW; Coomarasamy, A; Khan, KS|title=Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence|journal=BMJ (Clinical research ed.)|date=2012 May 16|volume=344|pages=e2088|pmid=22596383|pmc=3355191|doi=10.1136/bmj.e2088}}</ref>

Aina moja ya dawa, [[Orlistat]] (Xenical), inapatikana kwa urahisi na imeidhinishwa kwa matumizi ya muda mrefu. Hata hivyo, kupoteza uzito ni jambo la kadri kwa wastani wa kilogramu 2.9 &nbsp;kg  (6.4&nbsp;lb) kwa mwaka 1 hadi 4&nbsp;na kuna habari kidogo kuhusu jinsi dawa hizi zinavyoathiri matatizo ya muda mrefu ya unene wa kupindukia.<ref name=Orli07>{{cite journal |author=Rucker D, Padwal R, Li SK, Curioni C, Lau DC |title=Long term pharmacotherapy for obesity and overweight: updated meta-analysis |journal=BMJ|volume=335 |issue=7631 |pages=1194–99 |year=2007 |pmid=18006966 |doi=10.1136/bmj.39385.413113.25|url=http://www.bmj.com/cgi/content/full/335/7631/1194 |pmc=2128668}}</ref> Matumizi yake yanahusiana na viwango vya juu vya athari kwa utumbo <ref name=Orli07/> and concerns have been raised about negative effects on the kidneys.<ref>{{cite web|last=Wood|first=Shelley|title=Diet Drug Orlistat Linked to Kidney, Pancreas Injuries|url=http://www.medscape.com/viewarticle/740855?src=mp&spon=30|work=Medscape|publisher=Medscape News|accessdate=26 April 2011}}</ref> Aina zingine mbili za dawa pia zinapatikana  [[Lorcaserin]](Belviq) hupelekea upotezaji wa uzito kwa wastani kilogramu 3.1&nbsp; (asilimia 3 ya uzani wa mwili) zaidi ya plasebo kwa muda wa mwaka mmoja.<ref>{{cite journal|last=Bays|first=HE|title=Lorcaserin: drug profile and illustrative model of the regulatory challenges of weight-loss drug development|journal=Expert review of cardiovascular therapy|date=2011 Mar|volume=9|issue=3|pages=265–77|pmid=21438803|doi=10.1586/erc.10.22}}</ref> Mchanganyiko wa [[Phentermine/topiramate|phentermine na topiramate]] (Qsymia) pia ni bora kwa kiwango fulani.<ref>{{cite journal|author=Bays HE, Gadde KM |title=Phentermine/topiramate for weight reduction and treatment of adverse metabolic consequences in obesity |journal=Drugs Today |volume=47 |issue=12 |pages=903–14 |year=2011 |month=December|pmid=22348915 |doi=10.1358/dot.2011.47.12.1718738 |url=}}</ref>

Njia mwafaka zaidi ya kutibu unene wa kupindukia ni [[upasuaji wa kibariatriki]]. Upasuaji kwa mujibu wa unene mkali wa kupindukia unahusiana na upotezaji wa uzito kwa muda mrefu na upunguaji katika vifo kwa ujumla. Utafiti mmoja ulitambua upotezaji wa uzito wa kati wa asilimia 14 na 25 (kulingana na utaratibu uliofuatwa) kwa miaka 10&nbsp; na upunguaji wa asilimia 29 katika vifo vitokanavyo na unene huu ikilinganishwa na hatua za kawaida za upotezaji wa uzito.<ref>{{cite journal |author=Sjöström L |title=Effects of bariatric surgery on mortality in Swedish obese subjects |journal=N. Engl. J. Med. |volume=357 |issue=8 |pages=741–52 |year=2007 |month=August|pmid=17715408 |doi=10.1056/NEJMoa066254 |url= |author-separator=, |author2=Narbro K |author3=Sjöström CD|display-authors=3 |last4=Karason |first4=Kristjan |last5=Larsson |first5=Bo |last6=Wedel |first6=Hans |last7=Lystig|first7=Ted |last8=Sullivan |first8=Marianne |last9=Bouchard |first9=Claude}}</ref> Hata hivyo, kutokana na gharama yake na hatari ya matatizo, watafiti wanatafuta tiba zingine mwafaka ilhali zisizo na madhara.
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==Epidemiolojia==
{{Double image|right|World map of Male Obesity, 2008.svg|200|World map of Female Obesity, 2008.svg|200|World obesity prevalence among males (left) and females (right).<ref name=IOTF2008>{{cite web|url=http://www.iotf.org/database/documents/GlobalPrevalenceofAdultObesity16thDecember08.pdf  |title=Global Prevalence of Adult Obesity |format=PDF |work=[[International Obesity Taskforce]]  |accessdate=January 29, 2008}}</ref>
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{{legend|#ffff65|<5%}}
{{legend|#fff200|5–10%}}
{{legend|#ffdc00|10–15%}}
{{Multicol-break}}
{{legend|#ffc600|15–20%}}
{{legend|#ffb000|20–25%}}
{{legend|#ff9a00|25–30%}}
{{Multicol-break}}
{{legend|#ff8400|30–35%}}
{{legend|#ff6e00|35–40%}}
{{legend|#ff5800|40–45%}}
{{Multicol-break}}
{{legend|#ff4200|45–50%}}
{{legend|#ff2c00|50–55%}}
{{legend|#cb0000|>55%}}
{{Multicol-end}}
|alt=A map of the world with countries colored to reflect the percentage of men who are obese.  Obese males and females have higher prevalence (above 30%) in the U.S. and some Middle Eastern and Oceanian countries, medium prevalence in the rest of North America and Europe, and lower prevalence (<5%) in most of Asia and Africa.||}}

Kabla ya [[karne ya 20]], unene wa kupindukia ulikuwa wa nadra;<ref name=Haslam2007/> in 1997 the WHO formally recognized obesity as a global epidemic.<ref name=Caballero/> As of 2005 the WHO estimates that at least 400&nbsp;million adults (9.8%) are obese, with higher rates among women than men.<ref name=WHO2009a>{{cite web|url=http://www.who.int/mediacentre/factsheets/fs311/en/index.html |title=Obesity and overweight |work=World Health Organization |accessdate=April 8, 2009}}</ref> Kiwango cha unene wa kupindukia pia huongezeka kulingana na umri kwa angalau kufikia umri wa miaka 50 au 60&nbsp; <ref>Seidell 2005 p.5</ref>  na unene mkali wa kupindukia nchini Marekani, Australia, na Canada unaongezeka haraka kuliko kiwango cha jumla cha unene wa kupindukia.<ref name=morbid2007/><ref>{{cite journal |author=Howard, Natasha J.|title=Severe obesity: Investigating the socio-demographics within the extremes of body mass index  |journal=Obesity Research &Clinical Practice |volume=2 |issue=1 |pages=51–59 |year=2008|month=March |pmid=|doi=10.1016/j.orcp.2008.01.001 |url= |first2=A |first3=T |first4=C |last2=Taylor |last3=Gill|last4=Chittleborough}}</ref><ref name=Tjepkema2005>{{cite book | author=Tjepkema M | chapter=Measured Obesity–Adult obesity in Canada: Measured height and weight | title=Nutrition: Findings from the Canadian Community Health Survey |publisher=Statistics Canada | date=2005-07-06 | location=Ottawa, Ontario |url=http://www.statcan.gc.ca/pub/82-620-m/2005001/article/adults-adultes/8060-eng.htm}}</ref>

Ijapokuwa uliwahi kuchukuliwa kama tatizo la nchi zilizo na mapato ya juu pekee,  viwango vya unene wa kupindukia vinaongezeka ulimwenguni kote na kudhuru nchi zilizostaw na aidha zinazostawi<ref name=EuroG2008>{{cite journal |author=Tsigosa Constantine |title=Management of Obesity in Adults: European Clinical Practice Guidelines |journal=The European Journal of Obesity |volume=1 |year=2008 |month=April |pmid=20054170 |doi=10.1159/000126822 |url=http://www.gojaznost.org/gs/dodatak/OMTFManagementofObesityinAdults2008.pdf |first2=Vojtech |issue=2 |first3=Arnaud |first4=Nick |first5=Martin |first6=Elisabeth |first7=Dragan |first8=Maximo |first9=Gabriela |pages=106–16 |last2=Hainer |last3=Basdevant |last4=Finer |last5=Fried |last6=Mathus-Vliegen |last7=Micic |last8=Maislos |last9=Roman |access-date=2013-11-28 |archive-date=2012-04-26 |archive-url=https://web.archive.org/web/20120426034913/http://www.gojaznost.org/gs/dodatak/OMTFManagementofObesityinAdults2008.pdf |dead-url=yes }}</ref>.Ongezeko hili limeonekana sana katika maeneo ya miji.<ref name=WHO2009a/>  Sehemu inayobakia ulimwenguni ambayo unene wa kupindukia sio jambo la kawaida ni[[mataifa ya kusini mwa sahara]].<ref name=HaslamJames/>
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==Historia==
[[File:Charles Mellin zugeschr - Porträt eines Herrn - Gemäldegalerie Berlin.jpg|thumb|wima|alt=Mwanamume mwenye unene zaidi wa kupindukia aliye na kidevu chenye sehemu mbili, masharubu, na kuvalia nguo nyeusi huku akiwa na kitara kwenye upande wake wa kushoto.|Katika[[Enzi za Kati]] na[[kipindi cha mvuvumko]], mara nyingi unene wa kupindukia ulionekana kama ishara ya utajiri na ulikuwa umekithiri kwa tabaka aali: ''The Tuscan General [[Alessandro del Borro]]'', attributed to Charles Mellin, 1645<ref name=Zach2003>{{cite journal |author=Zachary Bloomgarden |title=Prevention of Obesity and Diabetes |journal=Diabetes Care |volume=26 |pages=3172–3178 |year=2003|pmid= 14578257|doi= 10.2337/diacare.26.11.3172|url=http://care.diabetesjournals.org/content/26/11/3172.full|issue=11}}</ref>]]
[[File:Venus von Willendorf 01.jpg|thumb|wima|alt= Kisanamu kilichochongwa kutoka kwa jiwe kilionyesha mwanamke mwenye unene wa kupindukia.|''[[Venus of Willendorf]]'' kilichotengenezwa 24,000–22,000 BC]]
[[Wagiriki]] ndio waliokuwa wa kwanza kutambua unene wa kupindukia kama tatizo la kiafya.<ref name=Haslam2007>{{cite journal|author=Haslam D |title=Obesity: a medical history |journal=Obes Rev |volume=8 Suppl 1 |issue= |pages=31–6 |year=2007|month=March |pmid=17316298 |doi=10.1111/j.1467-789X.2007.00314.x |url=}}</ref> [["Hippocrates]] aliandika kuwa "Unene wa kupindukia si ugonjwa kivyake tu, bali ni dalili  ya magonjwa mengine".<ref name=HaslamJames/> Daktari Mhindi wa upasuaji [[Sushruta]] (karne ya 6 BCE) alihusisha unene wa kupindukia na kisukari na matatizo ya moyo.<ref name=Dwivedi&Dwivedi07/> He recommended physical work to help cure it and its side effects.<ref name=Dwivedi&Dwivedi07>{{cite web |url=http://medind.nic.in/iae/t07/i4/iaet07i4p243.pdf |format=PDF |title=History of Medicine: Sushruta – the Clinician –Teacher par Excellence |accessdate=2008-09-19 |work=Dwivedi, Girish & Dwivedi, Shridhar |publisher= |year=2007 |archivedate=2008-10-10 |archiveurl=https://web.archive.org/web/20081010045900/http://medind.nic.in/iae/t07/i4/iaet07i4p243.pdf |=https://web.archive.org/web/20081010045900/http://medind.nic.in/iae/t07/i4/iaet07i4p243.pdf }}</ref>Katika historia ya watu, wanadamu wamekumbwa sana na ukosefu wa chakula.<ref>{{cite book |author=Theodore Mazzone; Giamila Fantuzzi |title=Adipose Tissue And Adipokines in Health And Disease (Nutrition and Health) |publisher=Humana Press|location=Totowa, NJ |year=2006 |page=222 |isbn=1-58829-721-7 |oclc= |doi= |accessdate=}}</ref>Kwa hivyo, kihistoria, unene wa kupindukia umeonekana kama ishara ya utajiri na ustawi. Ulikuwa umekithiri kwa maafisa wakuu barani Uropa katika [[Enzi za Kati]] na [[Kipindi cha Mvuvumko]]<ref name=Zach2003/> as well as in Ancient East Asian civilizations.<ref>Keller p. 49</ref>

Kwa kuwepo kwa mwanzo wa [[mvuvumko wa viwanda]], iligunduliwa kuwa uwezo wa kijeshi na kiuchumi wa mataifa ulitegemea ukubwa wa mwili na nguvu za wanajeshi na wafanyikazi.<ref name=Caballero/>  Kuongeza wastani wa kielezo cha uzito wa mwili kutoka kile kinachofikiriwa kuwa uzito wa chini hadi kwa kile kilicho anuwai ya kawaida kulichangia pakubwa katika ustawi wa jamii zilizo na viwanda.<ref name=Caballero/>  Kutokana na hayo, kimo na uzito viliongezeka katika karne ya 19&nbsp; katika nchi zilizostawi. Katika karne ya 20, watu walipofikia kikamilifu uwezo wao wa kijenetiki wa kimo, uzito ulianza kuongezeka sana zaidi ya kimo na kupelekea unene wa kupindukia.<ref name=Caballero/>Katika miaka ya 1950, kuongezeka kwa utajiri katika nchi zilizostawi kulipunguza vifo vya watoto. Hata hivyo, uzito ulipoongezeka, ugonjwa wa moyo na figo ulikithiri.<ref name=Caballero/><ref>{{cite journal | doi=10.2105/AJPH.42.9.1116 | author=Breslow L |title=Public Health Aspects of Weight Control | journal=Am J Public Health Nations Health | year=1952 | month=September| volume=42 | issue=9 | pages=1116–20 | pmid=12976585 | pmc=1526346}}</ref>
Katika kipindi hiki, kampuni za bima ziligundua uhusiano kati ya uzito na matarajio ya muda wa kuishi na hivyo basi zikaongeza malipo ya bima kwa walio na unene wa kupindukia.<ref name=HaslamJames/>

Tamaduni nyingi katika historia zimeona unene wa kupindukia kama ambayo inatokana na makosa ya kimienendo. Mwigizaji aliyekuwa na ''obesus'' au mafuta katika[[uigizaji wa Kigriki]] aliwakilisha ulafi na utani. Katika nyakati za Ukristo, chakula kilichukuliwa kama njia inayoelekeza kwenye dhambi za [[uzembe]]na[[tamaa]].<ref name=Woodhouse/> Katika tamaduni za kisasa za Ulaya na Marekani, unene wa kupita kiasi unachukuliwa kama jambo lisilovutia na unene wa kupindukia mara nyingi huhusishwa na mambo kadhaa mabaya yasiyo na uasili. Watu wa umri tofauti wanaweza kufedheheshwa na kulengwa na wadhalimu au kutengwa na wenzao. Unene wa kupindukia kwa mara nyingine ni sababu ya ubaguzi<ref name=Bias2001>{{cite journal |author=Puhl R, Brownell KD |title=Bias, discrimination, and obesity|journal=Obes. Res. |volume=9 |issue=12 |pages=788–805 |year=2001 |month=December |pmid=11743063|doi=10.1038/oby.2001.108 |url=}}</ref>

Fahamu za umma katika jamii ya Ulaya na Marekani kuhusu uzito bora wa mwili  zinatofautiana na zile zinazohusu uzito unaofikiriwa kuwa bora &nbsp;– na zote zimebadilika tangu mwanzo wa karne ya 20. Uzito unaochukuliwa kuwa bora  umekuwa chini tangu miaka ya 1920. Marekani uliongezeka kwa asilimia 2 kutoka mwaka wa 1922 hadi 1999 ilhali wastani wa uzito wao ulipungua kwa asilimia 12.<ref>{{cite journal|author=Rubinstein S, Caballero B |title=Is Miss America an undernourished role model? |journal=JAMA |volume=283|issue=12 |page=1569 |year=2000 |pmid=10735392 |doi= 10.1001/jama.283.12.1569|url=}}</ref> Kwa upande mwingine, mitazamo ya watu kuhusu uzito bora imebadilika na kuchukua mkondo pinzani. Nchini Uingereza, uzito ambapo watu walijiona kuwa na uzito wa kupita kiasi  ulikuwa juu kwa kiasi cha haja katika mwaka wa 2007 kuliko 1999.<ref name=John2008>{{cite journal|author=Johnson F, Cooke L, Croker H, Wardle J |title=Changing perceptions of weight in Great Britain: comparison of two population surveys |journal=BMJ |volume=337 |issue= |pages=a494 |year=2008 |pmid=18617488 |pmc=2500200 |doi= 10.1136/bmj.a494|url=http://www.bmj.com/cgi/content/full/337/jul10_1/a494}}</ref> Mabadiliko haya yanaaminika kusababishwa na viwango vinavyoongezeka vya uadiposi (unene), hali inayopelekekea ukubalifu wa mafuta ya ziada mwilini kama jambo la kawaida.<ref name=John2008/>

Unene wa kupindukia ungali unachukuliwa kuwa ishara ya utajiri na ufanisi katika sehemu nyingi za [[Afrika]]. Hili limekuwa jambo la kawaida hasa tangu kuzuka kwa janga la  [[VVU]]lilianza. <ref name=HaslamJames/>

==Sanaa==
Sanaa ya kwanza ya uchongaji iliyoleta mfano wa mwili wa binadamu kati ya miaka 20,000 - 35,000 &nbsp; iliyopita ilionyesha wanawake walio na unene wa kupindukia. Baadhi ya watu huihusisha [[sanamu ya Zuhura]]na juhudi za kusisitiza uwezo wa kuzaa ilhali wengine huhisi kuwa wao husimamia “unene” kwa watu wa wakati huo.<ref name=Woodhouse/> Hata hivyo, unene wa kupindukia haupo katika sanaa ya Wagiriki na Waroma, yamkini kwa kudumisha ulimbwende wao kwa mujibu wa kiasi. Haya yaliendelea katika sehemu kubwa ya historia ya ukristo barani Uropa ambapo wale tu walio na mapato ya chini wakichukuliwa kuwa wenye unene wa kupindukia.<ref name=Woodhouse/>

Katika [[Kipindi cha Mvuvumko]], baadhi ya watu katika tabaka la juu walianza kuuringia ukubwa wao jinsi inavyoonekana katika picha za Henry wa nane na Alessandro del Borro.<ref name=Woodhouse>{{cite journal |author=Woodhouse R |title=Obesity in art: A brief overview |journal=Front Horm Res |volume=36 |issue= |pages=271–86 |year=2008 |isbn=978-3-8055-8429-6|pmid=18230908 |doi=10.1159/000115370 |url=http://books.google.com/?id=nXRU4Ea1aMkC&pg=PA271&lpg=PA271&dq=Obesity+in+art:+a+brief+overview |series=Frontiers of Hormone Research}}</ref>[[Peter Paul Rubens|Rubens]] (1577–1640) alionyesha wanawake wenye miili mikubwa katika picha zake, ambapo anatoa neno [[Rubenesque]]. Hata hivyo, wanawake hawa bado walilidumisha umbo la shisha na uhusiano wake na uwezo wa kuzaa.<ref name=Fumento>{{cite book |author=Fumento, Michael |title=The Fat of the Land: Our Health Crisis and How Overweight Americans Can Help Themselves |publisher=Penguin (Non-Classics) |year=1997|page=126|isbn=0-14-026144-3}}</ref> Katika karne ya 19 &nbsp; mitazamo kuhusu unene wa kupindukia ilibadilika katika nchi za Ulaya na Amerika. Baada ya karne kadhaa ambapo unene wa kupindukia ulihusiana na mali na hadhi ya kijamii katika jamii, wembamba ulianza kuonekana kama kipimo kifaacho.<ref name=Woodhouse/>

==Jamii na utamaduni==
===Athari za kiuchumi===
Pamoja na athari zake za kiafya, unene wa kupindukia husababisha matatizo mengi yakiwemo ugumu katika ajira <ref name="Puhl R. p.29">Puhl R., Henderson K., and Brownell K. 2005 p.29</ref><ref>{{cite journal |doi=10.1016/j.ehb.2009.01.008|author=Johansson E, Bockerman P, Kiiskinen U, Heliovaara M |title=Obesity and labour market success in Finland: The difference between having a high BMI and being fat |journal=Economics and Human Biology |volume=7 |issue=1 |pages=36–45|year=2009 |pmid=19249259}}</ref> na gharama za juu za biashara.  Athari hizi zinazikumba sekta zote za jamii kutoka kwa watu binafsi, hadi kwa mashirika, na hadi kwa serikali.

Katika mwaka wa 2005, gharama za kimatibabu zinazoweza kuhusishwa na unene wa kupindukia nchini Marekani zilikuwa takribani dola bilioni &nbsp;190.2 &nbsp; au asilimia 20.6 ya gharama zote za kimatibabu,<ref name=medical-costs>{{cite journal|coauthors=John Cawley, Chad Meyerhoefer|title=The medical care costs of obesity: An instrumental variables approach|journal=Journal of Health Economics|year=2012|month=January|volume=31|issue=1|pages=219–230|url=http://www.sciencedirect.com/science/article/pii/S0167629611001366|accessdate=2 August 2012|doi=10.1016/j.jhealeco.2011.10.003|pmid=22094013|last1=Cawley|first1=J}}</ref>  <ref>{{cite journal|author=Finkelstein EA, Fiebelkorn IA, Wang G |title=National medical spending attributable to overweight and obesity: How much, and who's paying |journal= Health Affairs|volume=Online |issue=May |pages=|date=1 January 2003|url=http://content.healthaffairs.org/cgi/content/full/hlthaff.w3.219v1/DC1  }}</ref><ref>{{cite web|url=http://www.cdc.gov/nccdphp/dnpa/obesity/economic_consequences.htm  |title=Obesity and overweight: Economic consequences | publisher=[[Centers for Disease Control and Prevention]] | date=22 May 2007 |accessdate=2007-09-05}}</ref> while the cost of obesity in Canada was estimated at CA$2 billion in 1997 (2.4% of total health costs).<ref name="CADG2006"/> Jumla ya gharama ya unene wa kupindukia nchini Kanada ilikuwa imekadiriwa kuwa dola bilioni 2 za Australia  katika mwaka wa 2005. Waustralia walio na uzito wa kupita kiasi na wanene kupindukia pia walipokea dola za Australia bilioni 35.6 kama ruzuku kutoka kwa serikali.<ref name=MJA2009>{{Cite journal|title=The cost of overweight and obesity in Australia|url=http://www.mja.com.au/public/issues/192_05_010310/col10841_fm.html|year=2009|author=Colagiuri, Stephen|journal=The Medical Journal of Australia|accessdate=2011-06-18|last2=Lee|first2=Crystal M. Y.|last3=Colagiuri|first3=Ruth|display-authors=4|author5=<Please add first missing authors to populate metadata.>}}</ref> Kadiri ya gharama ya bidhaa za lishe imekadiriwa kuwa kati ya dola bilioni 40&nbsp; hadi dola bilioni 100&nbsp&nbsp; nchini Marekani pekee.<ref>{{cite news  | last = Cummings  | first = Laura|title = The diet business: Banking on failure|publisher = BBC News| date = 5 February 2003| url = http://news.bbc.co.uk/2/hi/business/2725943.stm| accessdate = 25 February 2009}}</ref>

Miradi ya kuzuia unene wa kupindukia imezinduliwa ili kupunguza gharama ya kutibu magonjwa yanayohusiana na unene huu. Hata hivyo, jinsi watu wanavyoendelea kuishi ndivyo wanavyogharamika zaidi. Kwa hivyo, watafiti huafiki kuwa kupunguza unene wa kupindukia kunaweza kuidumisha afya ya umma lakini huenda isipunguze gharama ya jumla ya afya..<ref>{{cite journal |author=van Baal PH |title=Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure |journal=PLoS Med. |volume=5 |issue=2 |pages=e29 |year=2008 |month=February |pmid=18254654 |pmc=2225430 |doi=10.1371/journal.pmed.0050029 |url=http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050029 |author-separator=, |author2=Polder JJ |author3=de Wit GA |display-authors=3 |last4=Hoogenveen |first4=Rudolf T. |last5=Feenstra |first5=Talitha L. |last6=Boshuizen |first6=Hendriek C. |last7=Engelfriet |first7=Peter M. |last8=Brouwer |first8=Werner B. F. |access-date=2013-11-28 |archive-date=2015-01-11 |archive-url=https://web.archive.org/web/20150111110729/http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050029 |url-status=dead }}</ref>

[[File:Wide Chair.jpg|thumb|kushoto|alt= Kiti cha ziada kipana kando ya viti kadhaa vyenye ukubwa wa kawaida.|Ni sharti huduma ziwazingatie watu walio na unene wa kupindukia kwa vifaa maalumu kama vile viti vipana.<ref>{{cite journal|author=Bakewell J|title=Bariatric furniture: Considerations for use|journal=Int J Ther Rehabil|issue=7|pages=329–33|year=2007|url=http://www.ijtr.co.uk/cgi-bin/go.pl/library/article.cgi?uid=23858;article=IJTR_14_7_329_333|volume=14|access-date=2013-11-28|archive-date=2011-10-08|archive-url=https://web.archive.org/web/20111008202913/http://www.ijtr.co.uk/cgi-bin/go.pl/library/article.cgi?uid=23858;article=IJTR_14_7_329_333|dead-url=yes}}</ref>]]
Unene wa kupindukia unaweza kusababisha fedheha ya kijamii na ugumu katika ajira.<ref name="Puhl R. p.29"/> Wakilinganishwa na wenzao walio na uzito wa kawaida, wafanyikazi walio na unene wa kupindukia kwa wastani wana viwango vya juu vya kutokuwa kazini kwao na huchukua likizo ya udhaifu mara kwa mara na kupelekea kuongezeka kwa gharama upande wa waajiri na kupunguka kwa tija.<ref>{{cite journal|author=Neovius K, Johansson K, Kark M, Neovius M|title=Obesity status and sick leave: a systematic review |journal=Obes Rev |volume=10|issue=1 |pages=17–27 |year=2009|month=January |pmid=18778315 |doi=10.1111/j.1467-789X.2008.00521.x |url=}}</ref> Utafiti wa kuwachunguza wafanyikazi wa chuo kikuu cha Duke ulionyesha kuwa watu walio na kielezo cha uzito wa mwili zaidi ya 40 walijiandikisha kufidiwa katika [[fidia ya wafanyikazi]] mara mbili zaidi ya wale ambao kielezo chao cha uzito wa mwili kilikuwa 18.5-24.9. Pia siku zao za kutofika kazini kwao zilikuwa zaidi ya mara 12&nbsp; ikilinganishwa na wenzao wasio na kielezo cha juu cha uzito wa mwili. Majeraha ya mara kwa mara katika kikundi hiki yalitokana na kuanguka na kunyanyuka hivyo ikiathiri miguu, vifundo vya mikono au mikono, na migongo.<ref>{{cite journal |author=Ostbye T, Dement JM, Krause KM|title=Obesity and workers' compensation: Results from the Duke Health and Safety Surveillance System |journal=Arch. Intern. Med. |volume=167 |issue=8|pages=766–73|year=2007 |pmid=17452538 |doi=10.1001/archinte.167.8.766}}</ref> Bodi ya Bima ya Wafanyikazi katika Jimbo la Alabama nchini Marekani iliidhinisha mpango tata wa kuwatoza wafanyikazi walio na unene wa kupindukia dola 25 kila mwezi iwapo hawachukui hatua za kuupunguza uzito wao na kudumisha afya yao. Hatua hizi zilianza Januari 2010 na zinalenga wale walio na Kielezo cha Uzito wa Mwili cha zaidi ya kilo 35 &nbsp;kwa kila mita <sup>2</sup> wanaokosa kuboresha afya yao baada ya mwaka mmoja.<ref>{{cite web|url=http://www.webmd.com/diet/news/20080825/alabama-obesity-penalty-stirs-debate |title=Alabama "Obesity Penalty" Stirs Debate |work=Don Fernandez |accessdate=April 5, 2009}}</ref>

Utafiti fulani umeonyesha kuwa watu walio na unene wa kupindukia wana uwezekano mdogo wa kuajiriwa na pia wana uwezekano mdogo wa kupandishwa cheo.<ref name=Bias2001/> Watu hawa pia hulipwa mshahara wa chini kuliko wenzao wasio na unene huu wa kupindukia kwa kazi sawa. Wanawake na wanaume walio na unene wa kupindukia kwa wastani hupata asilimia 6 na 3 chini mtawalia.<ref>Puhl R., Henderson K., and Brownell K. 2005 p.30</ref>

Nyanja mahususi kama vile shirika la ndege, afya na nyanja za vyakula, zina matatizo maalumu. Kutokana na viwango vinavyoongezeka vya unene wa kupindukia, mashirika ya ndege yanakumbwa na gharama ya juu ya mafuta na shinikizo la kuongeza upana wa viti.<ref>{{cite web | author=Lisa DiCarlo| url=http://www.forbes.com/2002/10/24/cx_ld_1024obese.html |title=Why Airlines Can't Cut The Fat|work=Forbes.com|date=2002-10-24 | accessdate=2008-07-23}}</ref> Katika mwaka wa 2000, uzito wa ziada wa abiria wenye unene wa kupindukia uliyagharimu mashirika ya ndege dola za Marekani milioni 275&nbsp;.<ref>{{cite journal|author=Dannenberg AL, Burton DC, Jackson RJ |title=Economic and environmental costs of obesity: The impact on airlines |url=https://archive.org/details/sim_american-journal-of-preventive-medicine_2004-10_27_3/page/264 |journal=American journal of preventive medicine|volume=27 |issue=3 |page=264|year=2004 |pmid=15450642 |doi=10.1016/j.amepre.2004.06.004}}</ref> Ulimwengu wa afya umelazimika kuwekeza katika vifaa maalumu vya kuwashughulikia wagonjwa walio na unene zaidi wa kupindukia vikiwemo vifaa maalumu vya kunyanyua na [[ambyulensi ya kibariatriki]]s.<ref>{{cite web|url=http://abcnews.go.com/Health/Diet/obese-health-care-bariatric-ambulances/story?id=7981746|title=Who Should Pay for Obese Health Care?|author=Lauren Cox|publisher=ABC News|date=July 2, 2009|accessdate=2012-08-06}}</ref>Gharama za hoteli zimeongezwa na mahakama kwa shutma za kusababisha unene wa kupindukia.<ref name=Govtrack>{{cite web | url=http://www.govtrack.us/congress/bill.xpd?bill=h109-554 | title=109th U.S. Congress (2005–2006) H.R. 554: 109th U.S. Congress (2005–2006) H.R. 554: Personal Responsibility in Food Consumption Act of 2005 | publisher=GovTrack.us | accessdate=2008-07-24 | archivedate=2008-11-01 | archiveurl=https://web.archive.org/web/20081101192335/http://www.govtrack.us/congress/bill.xpd?bill=h109-554 }}</ref> Mnamo mwaka wa 2005, bunge la Marekani lilijadili utungaji sheria ya kuzuia kesi za raia dhidi ya sekta ya vyakula kwa mujibu wa unene wa kupindukia; hata hivyo, haikufanikiwa kuwa sheria..<ref name=Govtrack/>

===Ukubalifu wa ukubwa===
[[File:PresidentTaftTelephoneCrop.jpg|thumb|150px|kulia|kulia|Rais wa Marekani [[William Howard Taft]] alidhihakiwa mara nyingi kwa kuwa na uzito wa kupita kiasi]]
Lengo kuu la vuguvugu la ukubalifu wa unene ni kupunguza ubaguzi dhidi ya watu walio na unene na uzito wa kupindukia.<ref>{{cite web |url=http://www.capitalnaafa.org/whatisnaafa.html |title=What is NAAFA |work=[[National Association to Advance Fat Acceptance]] |accessdate=February 17, 2009 |archivedate=2009-03-12 |archiveurl=https://web.archive.org/web/20090312001218/http://www.capitalnaafa.org/whatisnaafa.html }}</ref><ref>{{cite web|url=http://www.size-acceptance.org/mission.html |title=ISAA Mission Statement |work=[[International Size Acceptance Association]] |accessdate=February 17, 2009}}</ref> Hata hivyo, wengine katika vuguvugu hilo pia wanajaribu kupinga uhusiano uliothibitishwa kati ya unene wa kupindukia na athari mbaya za kiafya.<ref name=Pulver2007>{{cite book |author=Pulver, Adam |title=An Imperfect Fit: Obesity, Public Health, and Disability Anti-Discrimination Law |publisher=Social Science Electronic Publishing |location= |year=2007 |pages= |isbn= |oclc= |doi= |url=http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1316106|accessdate=January 13, 2009}}</ref>

Kunayo mashirika kadhaa yanayoendeleza ukubalifu wa unene wa kupindukia. Umaarufu wa mashirika haya umeongezeka katika nusu ya hivi karibuni ya karne ya 20 &nbsp;.<ref>{{cite journal |author=Neumark-Sztainer D |title=The weight dilemma: a range of philosophical perspectives |journal=Int. J. Obes. Relat. Metab. Disord. |volume=23 Suppl 2 |issue= |pages=S31–7|year=1999 |month=March |pmid=10340803 |doi= 10.1038/sj.ijo.0800857|url=}}</ref>Shirika la Kitaifa la Kuendeleza Ukubalifu wa Unene]] nchini Marekani [[lilianzishwa mwaka wa 1969 na hujieleza kama shirika la haki za raia linalolenga kukomesha ubaguzi wa ukubwa.<ref>{{cite | author=National Association to Advance Fat Acceptance |url=http://www.naafaonline.com/dev2/ | title=We come in all sizes | publisher=NAAFA | year=2008 |accessdate=2008-07-29}}</ref>  Hata hivyo, uhamasishaji juu ya unene umebaki harakati za pembeni.<ref>[http://www.bitchmagazine.org/article/big-trouble Big Trouble | Bitch Magazine<!--Bot-generated title-->] {{Wayback|url=http://www.bitchmagazine.org/article/big-trouble |date=20121226160246 }}, bitchmagazine.org</ref>

[[Shirika la Kimataifa la Ukubalifu wa Ukubwa]]ni [[shirika lisilo la kiserikali]] lililoanzishwa mnamo mwaka wa 1997. Shirika hili ni la kimataifa na hueleza lengo lake kama kuendeleza ukubalifu wa ukubwa na kusaidia kukomesha ubaguzi kwa misingi ya uzito.<ref>{{cite web |url=http://www.size-acceptance.org/ |title=International Size Acceptance Association – ISAA |work=International Size Acceptance Association |accessdate=January 13, 2009}}</ref>  Vikundi hivi mara nyingi hupigania kutambulika kwa unene wa kupindukia kama ulemavu chini ya [[Sheria ya Wamarekani Walio na Ulemavu]]  Hata hivyo, mfumo wa kisheria wa Marekani umeamua kuwa gharama zitakazokuwa za afya ya umma zinazidi faida za kueindeleza sheria hii ya dhidi ya ubaguzi kujumlisha unene wa kupindukia.<ref name=Pulver2007/>

==Unene wa utotoni==
Kielezo cha Uzito wa Mwili mwafaka hutofautiana kulingana na umri na jinsia ya mtoto. Unene katika watoto na vijana huelezwa kama Kielezo cha Uzito wa Mwili cha zaidi ya &nbsp;[[asilimia]].<ref name="cdc.gov"/>95. Data ya marejeo yenye ndio mzingi wa asilimia hizi ni kutoka 1963 hadi 1994 na hivyo haijaathiriwa na ongezeko la kiwango cha unene cha hivi karibuni.<ref name="Flegal KM, Ogden CL, Wei R, Kuczmarski RL, Johnson CL 2001 1086–93"/> Unene wa utotoni umefika kiwango cha mlipuko katika karne ya 21 &nbsp;, kukiwa na ongezeko la kiwango katika nchi zimeendelea na zinazoendelea. Kima cha unene kwa wavulana chini Kanada imeongezeka kutoka 11% miaka ya 1980s hadi zaidi ya 30% miaka ya 1990, bali kwa kipindi cha muda huu kiwango kiliongezeka kutoka 4 hadi 14% katika watoto wa Brazili.<ref name=flynn2006/>

Kama ilivyo na unene katika watu wazima, hali nyingi tofauti huchangia kwa viwango vingi ongezeko la unene utotoni. Ubadilishaji wa lishe na upungufu wa mazoezi ya mwili huaminika kuwa ndizo visababishi viwili vya hivi karibu muhimu zaidi vya ongezeko la viwango.<ref>{{cite journal |author=Dollman J, Norton K, Norton L |title=Evidence for secular trends in children's physical activity behaviour |journal=Br J Sports Med |volume=39 |issue=12 |pages=892–7; discussion 897 |year=2005|month=December |pmid=16306494 |pmc=1725088 |doi=10.1136/bjsm.2004.016675 |url=https://archive.org/details/sim_british-journal-of-sports-medicine_2005-12_39_12/page/892}}</ref> Kwa sababu unene wa utotoni huendelea  hadi wakati wa utu uzima na unahusishwa na magonjwa mengi yanayodumu, watoto walio wanene mara nyingi huchunguzwa[[shinikizo la juu la damu]], [[Ugonjwa wa kisukari]], [[hipalipidimia]], na [[ini yenye mafuta]].<ref name=CADG2006/> Matibabu yanayotumika kwa watoto hasa ni hatua ya hali ya maisha na mbinu za mwenendo, hata hivyo bidii za kuongezea mazoezi kwa watoto zimekuwa na mafanikio madogo.<ref>{{cite journal|last=Metcalf|first=B.|coauthors=Henley, W.; Wilkin, T.|title=Effectiveness of intervention on physical activity of children: systematic review and meta-analysis of controlled trials with objectively measured outcomes (EarlyBird 54)|journal=BMJ|date=27 September 2012|volume=345|issue=sep27 1|pages=e5888–e5888|doi=10.1136/bmj.e5888}}</ref>Nchini Marekani, dawa hazikubaliwi na Muungano wa Chakula na Dawa kutumika katika kikundi hiki cha umri.<ref name=flynn2006>{{cite journal |author=Flynn MA |title=Reducing obesity and related chronic disease risk in children and youth: a synthesis of evidence with 'best practice' recommendations|journal=Obes Rev |volume=7 Suppl 1 |issue= |pages=7–66 |year=2006 |month=February |pmid=16371076|doi=10.1111/j.1467-789X.2006.00242.x |url= |author-separator=, |author2=McNeil DA |author3=Maloff B |display-authors=3|last4=Mutasingwa |first4=D. |last5=Wu |first5=M. |last6=Ford |first6=C. |last7=Tough |first7=S. C.}}</ref>

==Katika wanyama==
Unono katika [[mifugo]] ni jambo la kawaida katika nchi nyingi. Kiwango cha unono uliozidi katika mbwa kule Marekani ni kutoka 23% hadi 41%, 5.1% yao wakiwa ni wanono.<ref name=Lund2006>{{cite journal|author=Lund Elizabeth M.|title=Prevalence and Risk Factors for Obesity in Adult Dogs from Private US Veterinary Practices|journal=Intern J Appl Res Vet Med|volume=4|issue=2|pages=177–86|year=2006|pmid= |doi= |url=http://www.jarvm.com/articles/Vol4Iss2/Lund.pdf}}</ref>Rates of obesity in cats was slightly higher at 6.4%.<ref name= Lund2006/>Nchini Australia kiwango cha unene wa kupindukia katika mbwa kwa muktadha wa utabibu wa mifugo imepatikana kuwa 7.6%.<ref>{{cite journal |author=McGreevy PD, Thomson PC, Pride C, Fawcett A, Grassi T, Jones B|title=Prevalence of obesity in dogs examined by Australian veterinary practices and the risk factors involved|journal=Vet. Rec.|volume=156|issue=22|pages=695–702|year=2005|month=May |pmid=15923551|doi= |url=}}</ref> Hatari za unono kwa mbwa inahusiana na unene wa wamiliki; hata hivyo, hakuna uhusiano kama huo baina ya [[paka]] na wamiliki.<ref>{{cite journal |author=Nijland ML, Stam F, Seidell JC|title= Overweight in dogs, but not in cats, is related to overweight in their owners|journal=Public Health Nutr|volume=13|issue= 1|pages= 1–5|year=2009|month=June|pmid=19545467|doi=10.1017/S136898000999022X|url= }}</ref>

==Tazama pia==
*[[Jon Brower Minnoch]]
*[[Manuel Uribe]]
*[[Mayra Rosales]]
*[[Walter Hudson]]

==Tanbihi==
{{Reflist|30em}}

==Marejeo==
{{Refbegin|30em}}
* {{cite journal | doi = 10.1079/BJN2002739 | last1 = Bhargava | first1 = Alok | last2 = Guthrie | first2 = J. | year = 2002 | title = Unhealthy eating habits, physical exercise and macronutrient intakes are predictors of anthropometric indicators in the Women's Health Trial: Feasibility Study in Minority Populations | url = https://archive.org/details/sim_british-journal-of-nutrition_2002-12_88_6/page/719 | journal = British Journal of Nutrition | volume = 88 | issue = 6 | pages = 719–728 | pmid = 12493094 }}
* {{cite journal | last1 = Bhargava | first1 = Alok | year = 2006 | title = Fiber intakes and anthropometric measures are predictors of circulating hormone, triglyceride, and cholesterol concentration in the Women's Health Trial | url = https://archive.org/details/sim_journal-of-nutrition_2006-08_136_8/page/2249 | journal = Journal of Nutrition | volume = 136 | issue = 8 | pages = 2249–2254 | pmid = 16857849 }}
* Jebb S. and Wells J. Measuring body composition in adults and children In:{{cite book|author=Peter G. Kopelman, Ian D. Caterson, Michael J. Stock, William H. Dietz|title=Clinical obesity in adults and children: In Adults and Children|publisher=Blackwell Publishing|location=|year=2005|pages=[https://archive.org/details/clinicalobesityi02edunse/page/12 12]–28|isbn=1-4051-1672-2|url=https://archive.org/details/clinicalobesityi02edunse}}
* Kopelman P., Caterson I. An overview of obesity management In:{{cite book|author=Peter G. Kopelman, Ian D. Caterson, Michael J. Stock, William H. Dietz|title=Clinical obesity in adults and children: In Adults and Children|publisher=Blackwell Publishing|location=|year=2005|pages=[https://archive.org/details/clinicalobesityi02edunse/page/319 319]–326|isbn=1-4051-1672-2|url=https://archive.org/details/clinicalobesityi02edunse}}
* {{cite book |author=[[National Heart, Lung, and Blood Institute]] (NHLBI) |title=Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults |publisher=International Medical Publishing, Inc |location= |year=1998 |pages= |isbn=1-58808-002-1 |oclc= |url=http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf |format=PDF }}
* {{cite web|url=http://www.nice.org.uk/nicemedia/pdf/CG43NICEGuideline.pdf|title=Obesity: guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children|publisher=[[National Health Services]] (NHS)|year=2006|format=PDF|work=[[National Institute for Health and Clinical Excellence]](NICE)|accessdate=April 8, 2009}}
* Puhl R., Henderson K., and Brownell K. Social consequences of obesity In:{{cite book|author=Peter G. Kopelman, Ian D. Caterson, Michael J. Stock, William H. Dietz|title=Clinical obesity in adults and children: In Adults and Children|publisher=Blackwell Publishing|location=|year=2005|pages=[https://archive.org/details/clinicalobesityi02edunse/page/29 29]–45|isbn=1-4051-1672-2|url=https://archive.org/details/clinicalobesityi02edunse}}
* Seidell JC. Epidemiology — definition and classification of obesity In:{{cite book|author=Peter G. Kopelman, Ian D. Caterson, Michael J. Stock, William H. Dietz|title=Clinical obesity in adults and children: In Adults and Children|publisher=Blackwell Publishing|location=|year=2005|pages=[https://archive.org/details/clinicalobesityi02edunse/page/3 3]–11|isbn=1-4051-1672-2|url=https://archive.org/details/clinicalobesityi02edunse}}
* {{cite book | author=[[World Health Organization]] (WHO) | title=Technical report series 894: Obesity: Preventing and managing the global epidemic. | location=Geneva | publisher=World Health Organization | year=2000 | url=http://whqlibdoc.who.int/trs/WHO_TRS_894_(part1).pdf | format=PDF | isbn=92-4-120894-5 | access-date=2013-11-28 | archive-date=2015-05-01 | archive-url=https://web.archive.org/web/20150501075305/http://whqlibdoc.who.int/trs/WHO_TRS_894_(part1).pdf | dead-url=yes }}
{{Refend}}

==Marejeo mengine==
{{Refbegin}}
* {{dmoz|Health/Conditions_and_Diseases/Nutritional_and_Metabolic_Disorders/Obesity/}}
* {{cite book |author=Fumento, Michael | authorlink=Michael Fumento | title=The Fat of the Land: Our Health Crises and How Overweight Americans can Help Themselves |url=https://archive.org/details/fatoflandourheal0000mich |publisher=Penguin Books |location=New York |year=1997|isbn=0-14-026144-3}}
* {{cite book |author=Keller, Kathleen |title=Encyclopedia of Obesity |publisher=Sage Publications, Inc|location=Thousand Oaks, Calif |year=2008 |isbn=1-4129-5238-7 |oclc= |url=http://books.google.com/?id=aRp2rJrEqZsC&dq=IOTF+obesity+map|doi= |accessdate=}}
* {{cite book |author=Kolata, Gina | authorlink=Gina Kolata |title=Rethinking Thin: The new science of weight loss –and the myths and realities of dieting |url=https://archive.org/details/rethinkingthinne0000kola_i1w5 |publisher=Picador |location= |year=2007 |pages= |isbn=0-312-42785-9}}
* {{cite book|author=Kopelman, Peter G.|title=Clinical obesity in adults and children: In Adults and Children|publisher=Blackwell Publishing|location= |year=2005|page=493 |isbn=1-4051-1672-2|url=http://books.google.com/?id=u7RvldSr5M0C&pg=PA87&dq=80+percent+of+the+offspring+of+two+obese+parents+become+obese}}
* {{cite book |author=Levy-Navarro, Elena |title=The Culture of Obesity in Early and Late Modernity |url=https://archive.org/details/cultureofobesity0000levy |publisher=Palgrave Macmillan |location= |year=2008 |pages= |isbn=0-230-60123-5}}
* {{cite book |author=Pool, Robert |title=Fat: Fighting the Obesity Epidemic |url=https://archive.org/details/fatfightingobesi00pool |publisher=[[Oxford University Press]]|location=Oxford, UK |year=2001 |pages= |isbn=0-19-511853-7}}
{{Refend}}

== Viungo vya nje ==
{{commonscat|Obesity}}
{{Sister project links|display=Obesity}}
* [http://www.refugees.org/uploadedfiles/Participate/National_Programs/Healthy_Refugees/Brochures/Swahili-Obesity.pdf Unene ni nini] {{Wayback|url=http://www.refugees.org/uploadedfiles/Participate/National_Programs/Healthy_Refugees/Brochures/Swahili-Obesity.pdf |date=20090331130222 }}
* [http://www.refugees.org/uploadedfiles/Participate/National_Programs/Healthy_Refugees/Brochures/Swahili-ChildhoodObesity.pdf Unene utotoni] {{Wayback|url=http://www.refugees.org/uploadedfiles/Participate/National_Programs/Healthy_Refugees/Brochures/Swahili-ChildhoodObesity.pdf |date=20090331130208 }}
* [https://dmoztools.net/Health/Conditions_and_Diseases/Nutritional_and_Metabolic_Disorders/Obesity/ Unene kwenye tovuti ya DMOZ] {{Wayback|url=https://dmoztools.net/Health/Conditions_and_Diseases/Nutritional_and_Metabolic_Disorders/Obesity/ |date=20171112194539 }}

[[Jamii:Afya]]
[[Jamii:Magonjwa]]
[[Jamii:Chakula]]