{{infobox disease |name

Obesity |Image Obesity-waist circumference.PNG |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 |ICD9 |MedlinePlus 003101 |OMIM 601665 |eMedicineSubj med |eMedicineTopic 1653 |MeshName Obesity |MeshNumber C23.888.144.699.500 | }}

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems. Body mass index (BMI), a measurement which compares weight and height, defines people as overweight (pre-obese) if their BMI is between 25 and 30 kg/m², and obese when it is greater than 30 kg/m².

Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis. Obesity is most commonly caused by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility, although a few cases are caused primarily by genes, endocrine disorders, medications or psychiatric illness. Evidence to support the view that some obese people eat little yet gain weight due to a slow metabolism is limited; on average obese people have a greater energy expenditure than their thin counterparts due to the energy required to maintain an increased body mass.

Dieting and physical exercise are the mainstays of treatment for obesity. Moreover, it is important to improve diet quality by reducing the consumption of energy-dense foods such as those high in fat and sugars, and by increasing the intake of dietary fiber. To supplement this, or in case of failure, anti-obesity drugs may be taken to reduce appetite or inhibit fat absorption. In severe cases, surgery is performed or an intragastric balloon is placed to reduce stomach volume and/or bowel length, leading to earlier satiation and reduced ability to absorb nutrients from food.

Obesity is a leading preventable cause of death worldwide, with increasing prevalence in adults and children, and authorities view it as one of the most serious public health problems of the 21st century. Obesity is stigmatized in much of the modern world (particularly in the Western world), though it was widely perceived as a symbol of wealth and fertility at other times in history, and still is in some parts of the world.

Classification

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health. It is defined by body mass index (BMI) and further evaluated in terms of fat distribution via the waist–hip ratio and total cardiovascular risk factors. BMI is closely related to both percentage body fat and total body fat.

In children, a healthy weight varies with age and sex. Obesity in children and adolescents is defined not as an absolute number, but in relation to a historical normal group, such that obesity is a BMI greater than the 95th percentile. The reference data on which these percentiles are based are from 1963 to 1994, and thus have not been affected by the recent increases in weight.

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	class III obesity

BMI is calculated by dividing the subject's mass by the square of his or her height, typically expressed either in metric or US "customary" units:

:Metric: $BMI=kilograms/meters^2$

:US customary and imperial: $BMI=lb*703/in^2$

where $lb$ is the subject's weight in pounds and $in$ is the subject's height in inches.

The most commonly used definitions, established by the World Health Organization (WHO) in 1997 and published in 2000, provide the values listed in the table at right.

Some modifications to the WHO definitions have been made by particular bodies. The surgical literature breaks down "class III" obesity into further categories whose exact values are still disputed.

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''

As Asian populations develop negative health consequences at a lower BMI than Caucasians, some nations have redefined obesity; the Japanese have defined obesity as any BMI greater than 25 while China uses a BMI of greater than 28.

Effects on health

Excessive body weight is associated with various diseases, particularly cardiovascular diseases, diabetes mellitus type 2, obstructive sleep apnea, certain types of cancer, and osteoarthritis. As a result, obesity has been found to reduce life expectancy.

Mortality

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Obesity is one of the leading preventable causes of death worldwide. Large-scale American and European studies have found that mortality risk is lowest at a BMI of 20–25 kg/m² in non-smokers and at 24–27 kg/m² in current smokers, with risk increasing along with changes in either direction. A BMI above 32 has been associated with a doubled mortality rate among women over a 16-year period. In the United States obesity is estimated to cause an excess 111,909 to 365,000 deaths per year, while 1 million (7.7%) of deaths in the European Union are attributed to excess weight. On average, obesity reduces life expectancy by six to seven years: a BMI of 30–35 reduces life expectancy by two to four years, while severe obesity (BMI > 40) reduces life expectancy by 10 years.

Morbidity

Obesity increases the risk of many physical and mental conditions. These comorbidities are most commonly shown in metabolic syndrome, a combination of medical disorders which includes: diabetes mellitus type 2, high blood pressure, high blood cholesterol, and high triglyceride levels.

Complications are either directly caused by obesity or indirectly related through mechanisms sharing a common cause such as a poor diet or a sedentary lifestyle. The strength of the link between obesity and specific conditions varies. One of the strongest is the link with type 2 diabetes. Excess body fat underlies 64% of cases of diabetes in men and 77% of cases in women.

Health consequences fall into two broad categories: those attributable to the effects of increased fat mass (such as osteoarthritis, obstructive sleep apnea, social stigmatization) and those due to the increased number of fat cells (diabetes, cancer, cardiovascular disease, non-alcoholic fatty liver disease). Increases in body fat alter the body's response to insulin, potentially leading to insulin resistance. Increased fat also creates a proinflammatory state, and a prothrombotic state.

! Medical field

! Condition

! Medical field

! Condition

ischemic heart disease: angina pectoris>angina and myocardial infarction

*congestive heart failure

*high blood pressure

Dyslipidemia>abnormal cholesterol levels

*deep vein thrombosis and pulmonary embolism

Dermatology

*stretch marks

*acanthosis nigricans

*lymphedema

*cellulitis

*hirsutism

*intertrigo

Endocrinology and Reproductive medicine

*diabetes mellitus

*polycystic ovarian syndrome

menstruation>menstrual disorders

*infertility

Maternal obesity>complications during pregnancy

* birth defects

Stillbirth>intrauterine fetal death

Gastrointestinal

*gastroesophageal reflux disease

non-alcoholic fatty liver disease>fatty liver disease

*cholelithiasis (gallstones)

Neurology

*stroke

*meralgia paresthetica

*migraines

*carpal tunnel syndrome

*dementia

*idiopathic intracranial hypertension

*multiple sclerosis

Oncology

*breast cancer

*[[esophageal cancer

*[[hepatocellular carcinoma

*[[Gallbladder cancer

*[[Endometrial cancer

*[[prostate cancer

*[[non-Hodgkin's lymphoma, multiple myeloma

Major depressive disorder>depression in women

*social stigmatization

Respirology

sleep apnea>obstructive sleep apnea

*obesity hypoventilation syndrome

*asthma

*increased complications during general anaesthesia

Rheumatology and Orthopedics

*gout

*poor mobility

*osteoarthritis

*low back pain

Urology and Nephrology

*erectile dysfunction

*urinary incontinence

*chronic renal failure

*hypogonadism

Survival paradox

Although the negative health consequences of obesity in the general population are well supported by the available evidence, health outcomes in certain subgroups seem to be improved at an increased BMI, a phenomenon known as the obesity survival paradox. The paradox was first described in 1999 in overweight and obese people undergoing hemodialysis, and has subsequently been found in those with heart failure and peripheral artery disease (PAD).

In people with heart failure, those with a BMI between 30.0 and 34.9 had lower mortality than those with a normal weight. This has been attributed to the fact that people often lose weight as they become progressively more ill. Similar findings have been made in other types of heart disease. People with class I obesity and heart disease do not have greater rates of further heart problems than people of normal weight who also have heart disease. In people with greater degrees of obesity, however, risk of further events is increased. Even after cardiac bypass surgery, no increase in mortality is seen in the overweight and obese. One study found that the improved survival could be explained by the more aggressive treatment obese people receive after a cardiac event. Another found that if one takes into account chronic obstructive pulmonary disease (COPD) in those with PAD the benefit of obesity no longer exists.

Causes

At an individual level, a combination of excessive food energy intake and a lack of physical activity is thought to explain most cases of obesity. A limited number of cases are due primarily to genetics, medical reasons, or psychiatric illness. In contrast, increasing rates of obesity at a societal level are felt to be due to an easily accessible and palatable diet, increased reliance on cars, and mechanized manufacturing.

A 2006 review identified ten other possible contributors to the recent increase of obesity: (1) insufficient sleep, (2) endocrine disruptors (environmental pollutants that interfere with lipid metabolism), (3) decreased variability in ambient temperature, (4) decreased rates of smoking, because smoking suppresses appetite, (5) increased use of medications that can cause weight gain (e.g., atypical antipsychotics), (6) proportional increases in ethnic and age groups that tend to be heavier, (7) pregnancy at a later age (which may cause susceptibility to obesity in children), (8) epigenetic risk factors passed on generationally, (9) natural selection for higher BMI, and (10) assortative mating leading to increased concentration of obesity risk factors (this would not necessarily increase the number of obese people, but would increase the average population weight). While there is substantial evidence supporting the influence of these mechanisms on the increased prevalence of obesity, the evidence is still inconclusive, and the authors state that these are probably less influential than the ones discussed in the previous paragraph.

Diet

The per capita dietary energy supply varies markedly between different regions and countries. It has also changed significantly over time. From the early 1970s to the late 1990s the average calories available per person per day (the amount of food bought) increased in all parts of the world except Eastern Europe. The United States had the highest availability with 3,654 calories per person in 1996. This increased further in 2003 to 3,754. During the late 1990s Europeans had 3,394 calories per person, in the developing areas of Asia there were 2,648 calories per person, and in sub-Saharan Africa people had 2,176 calories per person. Total calorie consumption has been found to be related to obesity.

The widespread availability of nutritional guidelines has done little to address the problems of overeating and poor dietary choice. From 1971 to 2000, obesity rates in the United States increased from 14.5% to 30.9%. During the same period, an increase occurred in the average amount of food energy consumed. For women, the average increase was 335 calories per day (1,542 calories in 1971 and 1,877 calories in 2004), while for men the average increase was 168 calories per day (2,450 calories in 1971 and 2,618 calories in 2004). Most of this extra food energy came from an increase in carbohydrate consumption rather than fat consumption. The primary sources of these extra carbohydrates are sweetened beverages, which now account for almost 25 percent of daily food energy in young adults in America, and potato chips. Consumption of sweetened drinks is believed to be contributing to the rising rates of obesity.

As societies become increasingly reliant on energy-dense, big-portions, and fast-food meals, the association between fast-food consumption and obesity becomes more concerning. In the United States consumption of fast-food meals tripled and food energy intake from these meals quadrupled between 1977 and 1995.

Agricultural policy and techniques in the United States and Europe have led to lower food prices. In the United States, subsidization of corn, soy, wheat, and rice through the U.S. farm bill has made the main sources of processed food cheap compared to fruits and vegetables.

Obese people consistently under-report their food consumption as compared to people of normal weight. This is supported both by tests of people carried out in a calorimeter room and by direct observation.

Sedentary lifestyle

A sedentary lifestyle plays a significant role in obesity. Worldwide there has been a large shift towards less physically demanding work, and currently at least 60% of the world's population gets insufficient exercise. This is primarily due to increasing use of mechanized transportation and a greater prevalence of labor-saving technology in the home. In children, there appear to be declines in levels of physical activity due to less walking and physical education. World trends in active leisure time physical activity are less clear. The World Health Organization indicates people worldwide are taking up less active recreational pursuits, while a study from Finland found an increase and a study from the United States found leisure-time physical activity has not changed significantly.

In both children and adults, there is an association between television viewing time and the risk of obesity. A 2008 meta-analysis found 63 of 73 studies (86%) showed an increased rate of childhood obesity with increased media exposure, with rates increasing proportionally to time spent watching television.

Genetics

Like many other medical conditions, obesity is the result of an interplay between genetic and environmental factors. Polymorphisms in various genes controlling appetite and metabolism predispose to obesity when sufficient food energy present. As of 2006 more than 41 of these sites have been linked to the development of obesity when a favorable environment is present. People with two copies of the FTO gene (fat mass and obesity associated gene) has been found on average to weigh 3–4 kg more and have a 1.67-fold greater risk of obesity compared to those without the risk allele. The percentage of obesity that can be attributed to genetics varies, depending on the population examined, from 6% to 85%.

Obesity is a major feature in several syndromes, such as Prader-Willi syndrome, Bardet-Biedl syndrome, Cohen syndrome, and MOMO syndrome. (The term "non-syndromic obesity" is sometimes used to exclude these conditions.) In people with early-onset severe obesity (defined by an onset before 10 years of age and body mass index over three standard deviations above normal), 7% harbor a single point DNA mutation.

Studies that have focused upon inheritance patterns rather than upon specific genes have found that 80% of the offspring of two obese parents were obese, in contrast to less than 10% of the offspring of two parents who were of normal weight.

The thrifty gene hypothesis postulates that certain ethnic groups may be more prone to obesity in an equivalent environment. Their ability to take advantage of rare periods of abundance by storing energy as fat would be advantageous during times of varying food availability, and individuals with greater adipose reserves would be more likely survive famine. This tendency to store fat, however, would be maladaptive in societies with stable food supplies. This is the presumed reason that Pima Indians, who evolved in a desert ecosystem, developed some of the highest rates of obesity when exposed to a Western lifestyle.

Medical and psychiatric illness

Certain physical and mental illnesses and the pharmaceutical substances used to treat them can increase risk of obesity. Medical illnesses that increase obesity risk include several rare genetic syndromes (listed above) as well as some congenital or acquired conditions: hypothyroidism, Cushing's syndrome, growth hormone deficiency, and the eating disorders: binge eating disorder and night eating syndrome. However, obesity is not regarded as a psychiatric disorder, and therefore is not listed in the DSM-IVR as a psychiatric illness. The risk of overweight and obesity is higher in patients with psychiatric disorders than in persons without psychiatric disorders.

Certain medications may cause weight gain or changes in body composition; these include insulin, sulfonylureas, thiazolidinediones, atypical antipsychotics, antidepressants, steroids, certain anticonvulsants (phenytoin and valproate), pizotifen, and some forms of hormonal contraception.

Social determinants

While genetic influences are important to understanding obesity, they cannot explain the current dramatic increase seen within specific countries or globally. Though it is accepted that energy consumption in excess of energy expenditure leads to obesity on an individual basis, the cause of the shifts in these two factors on the societal scale is much debated. There are a number of theories as to the cause but most believe it is a combination of various factors.

The correlation between social class and BMI varies globally. A review in 1989 found that in developed countries women of a high social class were less likely to be obese. No significant differences were seen among men of different social classes. In the developing world, women, men, and children from high social classes had greater rates of obesity. An update of this review carried out in 2007 found the same relationships, but they were weaker. The decrease in strength of correlation was felt to be due to the effects of globalization. Among developed countries, levels of adult obesity, and percentage of teenage children who are overweight, are correlated with income inequality. A similar relationship is seen among US states: more adults, even in higher social classes, are obese in more unequal states.

Many explanations have been put forth for associations between BMI and social class. It is thought that in developed countries, the wealthy are able to afford more nutritious food, they are under greater social pressure to remain slim, and have more opportunities along with greater expectations for physical fitness. In undeveloped countries the ability to afford food, high energy expenditure with physical labor, and cultural values favoring a larger body size are believed to contribute to the observed patterns. Attitudes toward body mass held by people in one's life may also play a role in obesity. A correlation in BMI changes over time has been found among friends, siblings, and spouses. Stress and perceived low social status appear to increase risk of obesity.

Smoking has a significant effect on an individual's weight. Those who quit smoking gain an average of 4.4 kilograms (9.7 lb) for men and 5.0 kilograms (11.0 lb) for women over ten years. However, changing rates of smoking have had little effect on the overall rates of obesity.

In the United States the number of children a person has is related to their risk of obesity. A woman's risk increases by 7% per child, while a man's risk increases by 4% per child. This could be partly explained by the fact that having dependent children decreases physical activity in Western parents.

In the developing world urbanization is playing a role in increasing rate of obesity. In China overall rates of obesity are below 5%; however, in some cities rates of obesity are greater than 20%.

Malnutrition in early life is believed to play a role in the rising rates of obesity in the developing world. Endocrine changes that occur during periods of malnutrition may promote the storage of fat once more food energy becomes available.

Infectious agents

The study of the effect of infectious agents on metabolism is still in its early stages. Gut flora has been shown to differ between lean and obese humans. There is an indication that gut flora in obese and lean individuals can affect the metabolic potential. This apparent alteration of the metabolic potential is believed to confer a greater capacity to harvest energy contributing to obesity. Whether these differences are the direct cause or the result of obesity has yet to be determined unequivocally.

An association between viruses and obesity has been found in humans and several different animal species. The amount that these associations may have contributed to the rising rate of obesity is yet to be determined.

Pathophysiology

Flier summarizes the many possible pathophysiological mechanisms involved in the development and maintenance of obesity. This field of research had been almost unapproached until leptin was discovered in 1994. Since this discovery, many other hormonal mechanisms have been elucidated that participate in the regulation of appetite and food intake, storage patterns of adipose tissue, and development of insulin resistance. Since leptin's discovery, ghrelin, insulin, orexin, PYY 3-36, cholecystokinin, adiponectin, as well as many other mediators have been studied. The adipokines are mediators produced by adipose tissue; their action is thought to modify many obesity-related diseases.

Leptin and ghrelin are considered to be complementary in their influence on appetite, with ghrelin produced by the stomach modulating short-term appetitive control (i.e. to eat when the stomach is empty and to stop when the stomach is stretched). Leptin is produced by adipose tissue to signal fat storage reserves in the body, and mediates long-term appetitive controls (i.e. to eat more when fat storages are low and less when fat storages are high). Although administration of leptin may be effective in a small subset of obese individuals who are leptin deficient, most obese individuals are thought to be leptin resistant and have been found to have high levels of leptin. This resistance is thought to explain in part why administration of leptin has not been shown to be effective in suppressing appetite in most obese people.

While leptin and ghrelin are produced peripherally, they control appetite through their actions on the central nervous system. In particular, they and other appetite-related hormones act on the hypothalamus, a region of the brain central to the regulation of food intake and energy expenditure. There are several circuits within the hypothalamus that contribute to its role in integrating appetite, the melanocortin pathway being the most well understood. The circuit begins with an area of the hypothalamus, the arcuate nucleus, that has outputs to the lateral hypothalamus (LH) and ventromedial hypothalamus (VMH), the brain's feeding and satiety centers, respectively.

The arcuate nucleus contains two distinct groups of neurons. The first group coexpresses neuropeptide Y (NPY) and agouti-related peptide (AgRP) and has stimulatory inputs to the LH and inhibitory inputs to the VMH. The second group coexpresses pro-opiomelanocortin (POMC) and cocaine- and amphetamine-regulated transcript (CART) and has stimulatory inputs to the VMH and inhibitory inputs to the LH. Consequently, NPY/AgRP neurons stimulate feeding and inhibit satiety, while POMC/CART neurons stimulate satiety and inhibit feeding. Both groups of arcuate nucleus neurons are regulated in part by leptin. Leptin inhibits the NPY/AgRP group while stimulating the POMC/CART group. Thus a deficiency in leptin signaling, either via leptin deficiency or leptin resistance, leads to overfeeding and may account for some genetic and acquired forms of obesity.

Public health

The World Health Organization (WHO) predicts that overweight and obesity may soon replace more traditional public health concerns such as undernutrition and infectious diseases as the most significant cause of poor health. Obesity is a public health and policy problem because of its prevalence, costs, and health effects. Public health efforts seek to understand and correct the environmental factors responsible for the increasing prevalence of obesity in the population. Solutions look at changing the factors that cause excess food energy consumption and inhibit physical activity. Efforts include federally reimbursed meal programs in schools, limiting direct junk food marketing to children, and decreasing access to sugar-sweetened beverages in schools. When constructing urban environments, efforts have been made to increase access to parks and to develop pedestrian routes.

Many countries and groups have published reports pertaining to obesity. In 1998 the first US Federal guidelines were published, titled "Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report". In 2006 the Canadian Obesity Network published the "Canadian Clinical Practice Guidelines (CPG) on the Management and Prevention of Obesity in Adults and Children". This is a comprehensive evidence-based guideline to address the management and prevention of overweight and obesity in adults and children.

In 2004, the United Kingdom Royal College of Physicians, the Faculty of Public Health and the Royal College of Paediatrics and Child Health released the report "Storing up Problems", which highlighted the growing problem of obesity in the UK. The same year, the House of Commons Health Select Committee published its "most comprehensive inquiry [...] ever undertaken" into the impact of obesity on health and society in the UK and possible approaches to the problem. In 2006, the National Institute for Health and Clinical Excellence (NICE) issued a guideline on the diagnosis and management of obesity, as well as policy implications for non-healthcare organizations such as local councils.

A 2007 report produced by Sir Derek Wanless for the King's Fund warned that unless further action was taken, obesity had the capacity to cripple the National Health Service financially. In the United States organizations such as the Bill Clinton Foundation's Alliance for a Healthier Generation and Action for Healthy Kids are working to combat childhood obesity. Additionally, the Centers for Disease Control and Prevention co-hosted the first-ever Weight of the Nation Conference in 2009 with the goal of focusing national attention on the obesity epidemic.

Comprehensive approaches are being looked at to address the rising rates of obesity. The Obesity Policy Action (OPA) framework divides measure into 'upstream' policies, 'midstream' policies, 'downstream' policies. 'Upstream' policies look at changing society, 'midstream' policies try to alter individuals' behavior to prevent obesity, and 'downstream' policies try to treat currently afflicted people.

Management

The main treatment for obesity consists of dieting and physical exercise. Diet programs may produce weight loss over the short term, but maintaining this weight loss is frequently difficult and often requires making exercise and a lower food energy diet a permanent part of a person's lifestyle. Success rates of long-term weight loss maintenance with lifestyle changes are low ranging from 2–20%.

One medication, orlistat (Xenical), is current widely available and approved for long term use. Weight loss however is modest with an average of 2.9 kg (6.4 lb) at 1 to 4 years and there is little information on how these drugs affect longer-term complications of obesity. It use is associated with high rates of gastrointestinal side effects and concerns have been raised about negative effects on the kidneys.

The most effective treatment for obesity is bariatric surgery. Surgery for severe obesity is associated with long-term weight loss and decreased overall mortality. One study found a weight loss of between 14% and 25% (depending on the type of procedure performed) at 10 years, and a 29% reduction in all cause mortality when compared to standard weight loss measures. However, due to its cost and the risk of complications, researchers are searching for other effective yet less invasive treatments.

Epidemiology

|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.||}}

Before the 20th century, obesity was rare; in 1997 the WHO formally recognized obesity as a global epidemic. As of 2005 the WHO estimates that at least 400 million adults (9.8%) are obese, with higher rates among women than men. The rate of obesity also increases with age at least up to 50 or 60 years old and severe obesity in the United States, Australia, and Canada is increasing faster than the overall rate of obesity.

Once considered a problem only of high-income countries, obesity rates are rising worldwide and affecting both the developed and developing world. These increases have been felt most dramatically in urban settings. The only remaining region of the world where obesity is not common is sub-Saharan Africa.

History

Etymology

''Obesity'' is from the Latin ''obesitas'', which means "stout, fat, or plump." ''Ēsus'' is the past participle of ''edere'' (to eat), with ''ob'' (over) added to it. ''The Oxford English Dictionary'' documents its first usage in 1611 by Randle Cotgrave.

Historical trends

The Greeks were the first to recognize obesity as a medical disorder. Hippocrates wrote that "Corpulence is not only a disease itself, but the harbinger of others". The Indian surgeon Sushruta (6th century BCE) related obesity to diabetes and heart disorders. For most of human history mankind struggled with food scarcity. Obesity has thus historically been viewed as a sign of wealth and prosperity. It was common among high officials in Europe in the Middle Ages and the Renaissance as well as in Ancient East Asian civilizations.

With the onset of the industrial revolution it was realized that the military and economic might of nations were dependent on both the body size and strength of their soldiers and workers. Increasing the average body mass index from what is now considered underweight to what is now the normal range played a significant role in the development of industrialized societies. Height and weight thus both increased through the 19th century in the developed world. During the 20th century, as populations reached their genetic potential for height, weight began increasing much more than height, resulting in obesity. In the 1950s increasing wealth in the developed world decreased child mortality, but as body weight increased heart and kidney disease became more common. During this time period insurance companies realized the connection between weight and life expectancy and increased premiums for the obese.

Many cultures throughout history have viewed obesity as the result of a character flaw. The ''obesus'' or fat character in Greek comedy was a glutton and figure of mockery. During Christian times food was viewed as a gateway to the sins of sloth and lust. In modern Western culture, excess weight is often regarded as unattractive, and obesity is commonly associated with various negative stereotypes. People of all ages can face social stigmatization, and may be targeted by bullies or shunned by their peers. Obesity is once again a reason for discrimination.

Public perceptions in Western society regarding healthy body weight differ from those regarding the weight that is considered ideal  – and both have changed since the beginning of the 20th century. The weight that is viewed as an ideal has become lower since the 1920s. This is illustrated by the fact that the average height of Miss America pageant winners increased by 2% from 1922 to 1999, while their average weight decreased by 12%. On the other hand, people's views concerning healthy weight have changed in the opposite direction. In Britain the weight at which people considered themselves to be overweight was significantly higher in 2007 than in 1999. These changes are believed to be due to increasing rates of adiposity leading to increased acceptance of extra body fat as being normal.

Obesity is still seen as a sign of wealth and well-being in many parts of Africa. This has become particularly common since the HIV epidemic began.

The arts

The first sculptural representations of the human body 20,000–35,000 years ago depict obese females. Some attribute the Venus figurines to the tendency to emphasize fertility while others feel they represent "fatness" in the people of the time. Corpulence is, however, absent in both Greek and Roman art, probably in keeping with their ideals regarding moderation. This continued through much of Christian European history, with only those of low socioeconomic status being depicted as obese.

During the Renaissance some of the upper class began flaunting their large size, as can be seen in portraits of Henry the VIII and Alessandro del Borro. Rubens (1577–1640) regularly depicted full-bodied women in his pictures, from which derives the term Rubenesque. These women, however, still maintained the "hourglass" shape with its relationship to fertility. During the 19th century, views on obesity changed in the Western world. After centuries of obesity being synonymous with wealth and social status, slimness began to be seen as the desirable standard.

Society and culture

Economic impact

In addition to its health impacts, obesity leads to many problems including disadvantages in employment and increased business costs. These effects are felt by all levels of society from individuals, to corporations, to governments.

The estimate range for annual expenditures on diet products is $40 billion to $100 billion in the US alone. In 1998, the medical costs attributable to obesity in the US were $78.5 billion or 9.1% of all medical expenditures, while the cost of obesity in Canada was estimated at CA$2 billion in 1997 (2.4% of total health costs).The total annual direct cost of overweight and obesity in Australia in 2005 was AUD $21 billion. Overweight and obese Australians also received AUD $35.6 billion in government subsidies.

Obesity prevention programs have been found to reduce the cost of treating obesity-related disease. However, the longer people live, the more medical costs they incur. Researchers therefore conclude that reducing obesity may improve the public's health, but it is unlikely to reduce overall health spending.

Obesity can lead to social stigmatization and disadvantages in employment. When compared to their normal weight counterparts, obese workers on average have higher rates of absenteeism from work and take more disability leave, thus increasing costs for employers and decreasing productivity. A study examining Duke University employees found that people with a BMI over 40 filed twice as many workers' compensation claims as those whose BMI was 18.5–24.9. They also had more than 12 times as many lost work days. The most common injuries in this group were due to falls and lifting, thus affecting the lower extremities, wrists or hands, and backs. The US state of Alabama Employees' Insurance Board approved a controversial plan to charge obese workers $25 per month if they do not take measures to reduce their weight and improve their health. These measures started in January 2010 and apply to those with a BMI of greater than 35 kg/m² who fail to make improvements in their health after one year.

Some research shows that obese people are less likely to be hired for a job and are less likely to be promoted. Obese people are also paid less than their non-obese counterparts for an equivalent job. Obese women on average make 6% less and obese men make 3% less.

Specific industries, such as the airline and food industries, have special concerns. Due to rising rates of obesity, airlines face higher fuel costs and pressures to increase seating width. In 2000, the extra weight of obese passengers cost airlines US$275 million. Costs for restaurants are increased by litigation accusing them of causing obesity. In 2005 the US Congress discussed legislation to prevent civil law suits against the food industry in relation to obesity; however, it did not become law.

Size acceptance

The principal goal of the fat acceptance movement is to decrease discrimination against people who are overweight and obese. However, some in the movement are also attempting to challenge the established relationship between obesity and negative health outcomes.

A number of organizations exist that promote the acceptance of obesity. They have increased in prominence in the latter half of the 20th century. The US-based National Association to Advance Fat Acceptance (NAAFA) was formed in 1969 and describes itself as a civil rights organization dedicated to ending size discrimination. However, fat activism remains a marginal movement.

The International Size Acceptance Association (ISAA) is a non-governmental organization (NGO) which was founded in 1997. It has more of a global orientation and describes its mission as promoting size acceptance and helping to end weight-based discrimination. These groups often argue for the recognition of obesity as a disability under the US Americans With Disabilities Act (ADA). The American legal system, however, has decided that the potential public health costs exceed the benefits of extending this anti-discrimination law to cover obesity.

Childhood obesity

The healthy BMI range varies with the age and sex of the child. Obesity in children and adolescents is defined as a BMI greater than the 95th percentile. The reference data that these percentiles are based on is from 1963 to 1994 and thus has not been affected by the recent increases in rates of obesity. Because childhood obesity often persists into adulthood and is associated with numerous chronic illnesses, children who are obese are often tested for hypertension, diabetes, hyperlipidemia, and fatty liver. Treatments used in children are primarily lifestyle interventions and behavioral techniques. In the United States, medications are not FDA approved for use in this age group.

In other animals

Obesity in pets is common in many countries. Rates of overweight and obesity in dogs in the United States range from 23% to 41% with about 5.1% obese. Rates of obesity in cats was slightly higher at 6.4%. In Australia the rate of obesity among dogs in a veterinary setting has been found to be 7.6%. The risk of obesity in dogs is related to whether or not their owners are obese; however, there is no similar correlation between cats and their owners.

See also

Maternal obesity

Notes

References

Jebb S. and Wells J. Measuring body composition in adults and children In: Kopelman P., Caterson I. An overview of obesity management In: Puhl R., Henderson K., and Brownell K. Social consequences of obesity In: Seidell JC. Epidemiology — definition and classification of obesity In:

Further reading

External links

World Health Organization – Obesity pages

Diet, Nutrition and the prevention of chronic diseases (including obesity) by a Joint WHO/FAO Expert consultation (2003).

Obesity at Endotext.org

International Task Force on Obesity

Obesity at the Centers for Disease Control (USA)

The Obesity Society (USA)

National Obesity Forum (UK)

Australasian Society for the Study of Obesity

Category:Nutrition Category:Bariatrics Category:Body shape

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Demetri Martin (born May 25, 1973) is an American comedian, actor, artist, musician, writer and humorist. Martin is best known for his work as a stand-up comedian, contributor on ''The Daily Show'' and for his Comedy Central show ''Important Things with Demetri Martin''.

Early life

Demetri Martin was born to a Greek American family in New York City, New York, and grew up in Toms River, New Jersey. He is the son of Lillian, a nutritionist, and Dean C. Martin, now deceased, a Greek Orthodox priest. Martin graduated from Yale University in 1995. Although he was accepted into Harvard Law School, he went to New York University School of Law after he received a full scholarship.

Career

In 2001, Martin caught his first big break in stand-up comedy when he appeared on Comedy Central's stand-up showcase ''Premium Blend''. At the 2003 Edinburgh Festival Fringe he won the Perrier award with his show ''If I...''. The show was turned into a British television special in 2004. From 2003 to 2004, Martin wrote for ''Late Night with Conan O'Brien''. In 2004, Martin had his own ''Comedy Central Presents'' stand-up special. His special was divided into three parts. In the first, he performed in traditional stand-up comedy fashion. In the second segment, he used humorous drawings as visual aids, which would serve either as the punchline or a background. During the third segment, he played a guitar and put on a pseudo-play where he would strum his guitar while alternating between playing harmonica and talking; some of his comedian friends dressed as fairies and dragons acted according to the story he was telling, detailing the magical land where his jokes came from. Martin's mother and grandmother also appeared.

Since late 2005, he has been credited as a contributor on ''The Daily Show'', on which he has appeared as the named "Senior Youth Correspondent" and on which he hosts a segment called "Trendspotting". He has used this segment to talk about so-called hip trends among youth such as hookahs, wine, guerilla marketing and Xbox 360. A piece about social networking featured his profile on MySpace. On March 22, 2007, Demetri made another appearance on ''The Daily Show'', talking about the Viacom lawsuit against Google and YouTube.

He has recorded a comedy CD/DVD titled ''These Are Jokes'', which was released on September 26, 2006. This album also features ''Saturday Night Live'' member Will Forte and stand-up comedian Leo Allen.

Martin returned to ''The Daily Show'' on March 22, 2006, as the new Youth Correspondent, calling his segment "Professional Important News with Demetri Martin". In 2007, he starred in a Fountains of Wayne music video for "Someone to Love" as Seth Shapiro, a character in the song. He also starred in the video for the new Travis single "Selfish Jean", in which he wears multiple t-shirts with lyrics written on them.

On September 2, 2007, Martin appeared on the season finale of the HBO series ''Flight of the Conchords''. He appeared as a keytar player named Demetri.

He also had a part in the movie ''The Rocker'' (2008) starring Rainn Wilson. Martin played the part of the videographer when the band in the movie was making their first music video.

In 2009, he hosted and starred in his own television show called Important Things With Demetri Martin on Comedy Central. Later in June, it was announced his show had been renewed for a second season. The second season premiered, again on Comedy Central, on February 4, 2010. Martin has stated that ''Important Things'' will not return for a third season.

Prior to completing work on his second season, Martin starred in the comedy-drama film ''Taking Woodstock'' (2009), directed by Ang Lee, which premiered at the 2009 Cannes Film Festival. In the film Martin plays Elliot Tiber, a closeted gay artist who has given up his ambitions in the city to move upstate and help his old-world Jewish family run their Catskill Mountains motel. The film is based on the book written by Tiber.

On April 25, 2011, Martin released his first book, titled ''This Is a Book by Demetri Martin''.

Martin was slated to portray Paul DePodesta as Oakland Athletics assistant GM to Billy Beane in the 2011 movie Moneyball (film), however was dropped and Jonah Hill took his place in the movie.

Future plans

Martin sold his movie concept ''Will'' to DreamWorks; he is expected to play a key supporting role. He will play the lead in the film ''Moon People'', a pitch that he sold to Columbia Pictures.

Martin also signed a blind script deal with CBS in October 2010 to produce, write, and star in his own television series.

After CBS was shown the pilot for the series, they decided not to air it.

On August 11, 2011, Fox ordered a presentation of a new animated show they might air.

''If I''

''If I'' is a Perrier Comedy Award-winning comedy one-man show written and performed by Demetri Martin at the 2003 Edinburgh Festival Fringe. It was also aired on British television as a special. The show is an autobiographical examination of Martin's life, as seen through various definitions of the word "if."

The title of the special comes from a lengthy palindromic poem that Martin wrote; the words "if I" are at the center of the poem.

Comedic style

Martin is known for being an unconventional stand-up comic. He uses one-liners and drawings on a "large pad", as well as accompanying his jokes with music on either guitar, harmonica, piano, keyboard, glockenspiel, toy bells, ukulele, or tambourine, sometimes all at once. He has cited comedian Steven Wright as an important influence (both use deadpan one-liners in their acts) and he is also a fan of Bill Cosby.

Personal life

According to a July 2011 interview on the WTF with Marc Maron podcast, Demetri had a short-lived marriage to a girl he knew from high school. They began dating after high school and got married when he was in NYU Law School and she was attending NYU Medical School. He was aged 25 and in the end of his marriage when his stand-up career began.

He is extremely allergic to nuts and peanuts.

Martin moved to Santa Monica, California in 2009.

Discography

''Invite Them Up'' (2005)

''These Are Jokes'' (2006)

''Demetri Martin. Person.'' (2007)

Filmography and television work

''If I'' ''12:21'' ''Late Night with Conan O'Brien'' "''Someone to Love (Fountains of Wayne song) ''Flight of the Conchords (TV series) ''The Rocker (film) ''Paper Heart'' ''Post Grad'' ''Taking Woodstock'' ''Important Things with Demetri Martin'' ''Take Me Home Tonight (film) ''Contagion (film) ''Conan_(TV_series)

Year	! Title	! Role	Notes
2002	''Analyze That''	Personal Assistant
2003	|	Himself	British television special, also writer
2004	|	Himself	short film, also writer
2004	|	Himself	1 episode, series writer
2007	Someone to Love''" ||	Seth Shapiro	''Fountains of Wayne'' music video
2007	Flight of the Conchords'' ||	Demetri	Season 1, Episode 12
2008	The Rocker'' ||	Kip (a music video producer)
2009	|	Himself
2009	|	Ad Exec
2009	|	Elliot Tiber
2009–2010	|	Himself / Various	writer, series creator, executive producer, and composer
2011	Take Me Home Tonight'' ||	Carlos
2011	Contagion'' ||	Dr. David Eisenberg
2011	Conan'' ||	Himself	guest

Written works

''This Is a Book'', April 2011, .

Awards and nominations

AwardPerrier Comedy AwardEmmy Awards Shared with Mike Sweeney (writer)Writers Guild of America Award Shared with Mike Sweeney (writer)Barry Award (for comedy)

Year	|	For	Category	Result	Other notes
2003	|	''If I''		Won	At the Edinburgh Festival Fringe
2004	|	''Late Night with Conan O'Brien''	Outstanding Writing for a Variety, Music, or Comedy Program	Nominated	Mike Sweeney (head writer), Chris Albers, Jose Arroyo, Andy Blitz, Kevin Dorff, Daniel J. Goor, Michael Gordon, Brian Kiley, Michael Koman, Brian McCann, Guy Nicolucci, Conan O'Brien, Allison Silverman, Robert Smigel, Brian Stack, Andrew Weinberg
2005	|	''Late Night with Conan O'Brien''	Comedy/Variety (Including Talk) - Series	Won	Mike Sweeney (head writer), Chris Albers, Jose Arroyo, Andy Blitz, Kevin Dorff, Daniel J. Goor, Michael Gordon, Brian Kiley, Michael Koman, Brian McCann, Guy Nicolucci, Conan O'Brien, Allison Silverman, Robert Smigel, Brian Stack, Andrew Weinberg
2006	Barry Award ||	''Dr. Earnest Parrot Presents Demetri Martin''		Won	Award for best show at the Melbourne International Comedy Festival

References

External links

Interview from November, 2006, in Onion AV Club

Interview from October 2006, in The DePaulia

Article, in ''The Scotsman''

Article, in ''Gelf Magazine''

Interview by Brian M. Palmer

MP3 Audio Interview on ''The Sound of Young America'' public radio show and podcast

Interview Believer Mag

New Jersey Monthly Magazine

Fresh Air, NPR.org

Category:1973 births Category:Actors from New Jersey Category:Actors from New York City Category:American comedians Category:American comedy musicians Category:American comedy writers Category:American film actors Category:American humorists Category:American people of Greek descent Category:American stand-up comedians Category:American television actors Category:American television writers Category:Living people Category:New York University alumni Category:Writers from New Jersey Category:Writers from New York City Category:Writers Guild of America Award winners Category:Yale University alumni Category:The Daily Show correspondents and contributors

cs:Demetri Martin da:Demetri Martin de:Demetri Martin fr:Demetri Martin gl:Demetri Martin it:Demetri Martin ru:Мартин, Деметри simple:Demitri Martin fi:Demetri Martin sv:Demetri Martin

name	The Cure
background	group_or_band
origin	Crawley, England
genre	Alternative rock, gothic rock, New Wave, post-punk
years active	1976–present
label	Fiction, Suretone, Geffen, Polydor, Elektra, Asylum, Sire|, Warner
associated acts	Malice, Easy Cure, The Glove, Siouxsie and the Banshees
website
current members	Robert SmithSimon Gallup Porl Thompson Jason Cooper
past members	Michael DempseyMatthieu HartleyPhil ThornalleyAndy AndersonBoris WilliamsPerry Bamonte Lol Tolhurst Roger O'Donnell }}

The Cure are an English rock band formed in Crawley, West Sussex in 1976. The band has experienced several line-up changes, with frontman, vocalist, guitarist and principal songwriter Robert Smith being the only constant member. The Cure first began releasing music in the late 1970s with its debut album ''Three Imaginary Boys'' (1979); this, along with several early singles, placed the band as part of the post-punk and New Wave movements that had sprung up in the wake of the punk rock revolution in the United Kingdom. During the early 1980s, the band's increasingly dark and tormented music helped form the gothic rock genre.

After the release of ''Pornography'' (1982), the band's future was uncertain and Smith was keen to move past the gloomy reputation his band had acquired. With the 1982 single "Let's Go to Bed" Smith began to place a pop sensibility into the band's music (as well as a unique stage look). The Cure's popularity increased as the decade wore on, especially in the United States where the songs "Just Like Heaven", "Lovesong" and "Friday I'm in Love" entered the ''Billboard'' Hot 100 chart. By the start of the 1990s, The Cure were one of the most popular alternative rock bands in the world. The band is estimated to have sold 27 million albums as of 2004. The Cure have released thirteen studio albums and over thirty singles during the course of their career.

History

Formation and early years (1973–1979)

The first incarnation of what became The Cure was The Obelisk, a band formed by students at Notre Dame Middle School in Crawley, Sussex. The band made their public debut in a one-off performance in April 1973, and featured Robert Smith (piano), Michael "Mick" Dempsey (guitar), Laurence "Lol" Tolhurst (percussion), Marc Ceccagno (lead guitar) and Alan Hill (bass guitar). The first real incarnation though came in January 1976 when Ceccagno formed Malice with Smith and Dempsey along with two other classmates from St. Wilfrid's Catholic Comprehensive School, with Ceccagno on lead, Smith on guitar, and Dempsey switching to bass. Ceccagno soon left, however, to form a jazz-rock fusion band called Amulet. Increasingly influenced by the emergence of punk rock, Malice's remaining members became known as Easy Cure in January 1977. By this time, Smith and Dempsey had been joined by Lol Tolhurst from The Obelisk on drums, and new lead guitarist Porl Thompson. Both Malice and Easy Cure also trialled several unsuccessful vocalists before Smith finally assumed the role of Easy Cure's frontman in September 1977.

That year, Easy Cure won a talent competition with German label Hansa Records, and received a recording contract. Although the band recorded tracks for the company, none were ever released. Following disagreements in March 1978 over the direction the band should take, the contract with Hansa was dissolved. Smith later recalled, "We were very young. They just thought they could turn us into a teen group. They actually wanted us to do cover versions and we always refused." Thompson was dropped from the band in May, and the remaining trio (Smith/Tolhurst/Dempsey) were soon renamed The Cure by Smith. Later that month the band recorded their first sessions as a trio at Chestnut Studios in Sussex, which were distributed as a demo tape to a dozen major record labels. The demo found its way to Polydor Records scout Chris Parry, who signed The Cure to his newly formed Fiction label—distributed by Polydor—in September 1978. However, as a stopgap while Fiction finalised distribution arrangements with Polydor, in December 1978 The Cure released their debut single "Killing an Arab" on the Small Wonder label. "Killing an Arab" garnered both acclaim and controversy: while the single's provocative title led to accusations of racism, the song is actually based on French existentialist Albert Camus' novel ''The Stranger''. The band placed a sticker label that denied the racist connotations on the single's 1979 reissue on Fiction. An early ''NME'' article on the band wrote that The Cure "are like a breath of fresh suburban air on the capital's smog-ridden pub and club circuit" and noted "With a John Peel session and more extensive London gigging on their immediate agenda, it remains to be seen whether or not The Cure can retain their refreshing ''joie de vivre''."

The Cure released their debut album ''Three Imaginary Boys'' in May 1979. Due to the band's inexperience in the studio, Parry and engineer Mike Hedges took control of the recording. The band, particularly Smith, were unhappy with their debut; in a 1987 interview, he admitted, "a lot of it was very superficial – I didn't even like it at the time. There were criticisms made that it was very lightweight, and I thought they were justified. Even when we'd made it, I wanted to do something that I thought had more substance to it". The band's second single "Boys Don't Cry" was released in June. The Cure then embarked as the support band for Siouxsie & The Banshees' ''Join Hands'' promotional tour of England, Northern Ireland, and Wales between August and October. The tour saw Smith and Tolhurst pull double duty each night by performing with The Cure and as the guitarist / drummer with The Banshees when their guitarist John McKay and drummer Kenny Morris both walked out on the group just two days into the tour. That musical experience had a strong impact on him: "On stage that first night with the Banshees, I was blown away by how powerful I felt playing that kind of music. It was so different to what we were doing with The Cure. Before that, I'd wanted us to be like The Buzzcocks or Elvis Costello, the punk Beatles. Being a Banshee really changed my attitude to what I was doing."

The Cure's third single "Jumping Someone Else's Train" was released in early October 1979. Soon afterwards, Dempsey was dropped from the band due to his cold reception to material Smith had written for the upcoming album. Dempsey joined the Associates, while Simon Gallup (bass) and Matthieu Hartley (keyboards) from The Magspies joined The Cure. The Associates toured as support band for The Cure and The Passions on the ''Future Pastimes Tour'' of England between November and December—all three bands were on the Fiction Records roster—with the new Cure line-up already performing a number of new songs for the projected second album. Meanwhile, a spin-off band comprising Smith, Tolhurst, Dempsey, Gallup, Hartley and Thompson, with backing vocals from assorted family and friends, and lead vocals provided by their local postman Frankie Bell released a 7-inch single in December under the assumed name of Cult Hero.

Gothic phase (1980–1982)

Wary, due to the band's lack of creative control on the first album, Smith exerted a greater influence on the recording of The Cure's second album ''Seventeen Seconds'', which he co-produced with Mike Hedges. The album was released in 1980 and reached number 20 on the UK charts. A single from the album, "A Forest", became the band's first UK hit single, reaching number 31 on the singles chart. The album was a departure from The Cure's sound up to that point, with Hedges describing it as "morose, atmospheric, very different to ''Three Imaginary Boys''." In its review of ''Seventeen Seconds'' the ''NME'' said, "For a group as young as The Cure, it seems amazing that they have covered so much territory in such a brief time." At the same time, Smith was pressed concerning the concept of an alleged "anti-image". Smith told the press he was fed up with the anti-image association that some considered to be "elaborately disguising their plainness", stating, "We had to get away from that anti-image thing, which we didn't even create in the first place. And it seemed like we were trying to be more obscure. We just didn't like the standard rock thing. The whole thing really got out of hand." That same year ''Three Imaginary Boys'' was repackaged for the American market as ''Boys Don't Cry'', with new artwork and a modified tracklist. The Cure set out on their first world tour to promote both releases. At the end of the tour, Matthieu Hartley left the band. Hartley said, "I realised that the group was heading towards suicidal, sombre music—the sort of thing that didn't interest me at all."

The band reconvened with Hedges to produce their third album ''Faith'' (1981), which furthered the mood of misery present on ''Seventeen Seconds''. The album peaked at number 14 on the UK charts. Included with cassette copies of ''Faith'' was an instrumental soundtrack for ''Carnage Visors'', an animated film shown in place of an opening act for the band's 1981 Picture Tour. In late 1981, The Cure released the non-album single "Charlotte Sometimes". By this point, the sombre mood of the music had a profound effect on the attitude of the band. The band would refuse requests for older songs in concert, and sometimes Smith would be so absorbed by the persona he projected onstage he would leave at the end in tears.

In 1982, The Cure recorded and released ''Pornography'', the third and final album of an "oppressively dispirited" trio that cemented the Cure's stature as purveyors of the emerging gothic rock genre. Smith has said that during the recording of ''Pornography'' he was "undergoing a lot of mental stress. But it had nothing to do with the group, it just had to do with what I was like, my age and things. I think I got to my worst round about ''Pornography''. Looking back and getting other people's opinions of what went on, I was a pretty monstrous sort of person at that time". Gallup described the album by saying, "Nihilism took over [. . .] We sang 'It doesn't matter if we all die' and that is exactly what we thought at the time." Parry was concerned that the album did not have a hit song for radio play and instructed Smith and producer Phil Thornalley to polish the track "The Hanging Garden" for release as a single. Despite the concerns about the album's uncommercial sound, ''Pornography'' became the band's first UK Top 10 album, charting at number eight. The release of ''Pornography'' was followed by the Fourteen Explicit Moments tour, where the band finally dropped the anti-image angle and first adopted their signature look of big, towering hair and smeared lipstick on their faces. The tour also saw a series of incidents that prompted Simon Gallup to leave The Cure at the tour's conclusion. Gallup and Smith did not talk to each other for eighteen months following his departure.

Increasing commercial success (1983–1986)

With Gallup's departure from The Cure and with Smith's work with Siouxsie & the Banshees, rumours spread that The Cure had broken up. In December 1982, Smith remarked to ''Melody Maker'', "Do The Cure really exist any more? I've been pondering that question myself [. . .] it has got to a point where I don't fancy working in that format again." He added, "Whatever happens, it won't be me, Laurence, and Simon together any more. I know that."

Parry was concerned at the state of his label's top band, and became convinced that the solution was for The Cure to reinvent its musical style. Parry managed to convince Smith and Tolhurst of the idea; Parry said, "It appealed to Robert because he wanted to destroy The Cure anyway." With Tolhurst now playing keyboards instead of drums, the duo released the single "Let's Go to Bed" in late 1982. While Smith wrote the single off as a throwaway, "stupid" pop song to the press, it became a minor hit in the UK, reaching number 44 on the singles chart. It was followed in 1983 by two more successful songs: the synthesiser-based "The Walk" (number 12), and the jazz-influenced "The Lovecats", which became the band's first British Top 10 hit, reaching number seven. The group released these studio singles and their B-sides as the compilation album ''Japanese Whispers'', designed by Smith for the Japanese market only, but released worldwide on the decision of the record company. The same year, Smith also recorded and toured with Siouxsie & the Banshees, contributing as guitarist on their ''Nocturne'' live video and their ''Hyaena'' studio album. Meanwhile, he recorded the ''Blue Sunshine'' album with Banshees bassist Steven Severin as The Glove, while Lol Tolhurst produced the first two singles and debut album of the English band And Also The Trees.

In 1984, The Cure released ''The Top'', a generally psychedelic album on which Smith played all the instruments except the drums—played by Andy Anderson—and the saxophone—played by returnee Porl Thompson. The album was a Top 10 hit in the UK, and was their first studio album to break the ''Billboard'' 200 in the U.S., reaching number 180. ''Melody Maker'' praised the album as "psychedelia that can't be dated", while pondering, "I've yet to meet anyone who can tell me why The Cure are having hits now of all times." The Cure then embarked on their worldwide "Top Tour" with Thompson, Anderson, and producer-turned-bassist Phil Thornalley on board. Released in late 1984, The Cure's first live album, ''Concert'' consisted of performances from this tour. Near the tour's end, Anderson was fired for destroying a hotel room and was replaced by Boris Williams. Thornalley also left due to the rigors of the road. However, the bassist slot was not vacant long, for a Cure roadie named Gary Biddles had brokered a reunion between Smith and former bassist Simon Gallup, who had been playing in the band Fools Dance. Soon after reconciling, Smith asked Gallup to rejoin the band. Smith was ecstatic about Gallup's return and declared to ''Melody Maker'', "It's a group again."

In 1985, the new line-up of Smith, Tolhurst, Gallup, Thompson, and Williams released ''The Head on the Door'', an album which managed to bind together the optimistic and pessimistic aspects of the band's music that they had previously shifted between. ''The Head on the Door'' reached number seven in the UK and was the band's first entry into American Top 75 at number 59, a success partly due to the international impact of the LP's two singles, "In Between Days" and "Close to Me". Following the album and world tour, the band released the singles compilation ''Standing on a Beach'' in three formats (each with a different track listing and a specific name) in 1986. This compilation made the US Top 50, and saw the re-issue of three previous singles: "Boys Don't Cry" (in a new form), "Let's Go To Bed" and later "Charlotte Sometimes". This release was accompanied by a VHS or LaserDisc called ''Staring at the Sea'', which featured videos for each track on the compilation. The Cure toured to support the compilation and released a live concert VHS of the show, filmed in the south of France called ''The Cure in Orange''. During this time, The Cure became a very popular band in Europe (particularly in France, Germany and the Benelux countries) and increasingly popular in the U.S.

''Kiss Me, Kiss Me, Kiss Me'' and worldwide success (1987–1993)

In 1987, The Cure released the double LP ''Kiss Me, Kiss Me, Kiss Me'', which reached number six in the UK, the Top 10 in several countries and was the band's first entry into the U.S. Top 40 at number 35 (where it was certified platinum), due to the combination of the band's rising popularity and the success of lead single, "Why Can't I Be You?". The album's third single, "Just Like Heaven" was the band's most successful single to date in the US, being their first to enter the ''Billboard'' Top 40. After the album's release, the band embarked on the successful Kissing Tour. During the European leg of the tour, Lol Tolhurst's alcohol consumption was interfering with his ability to perform so The Psychedelic Furs keyboardist Roger O'Donnell was frequently called upon to stand in for him. In 1989, The Cure released the album ''Disintegration'', which saw a return to the gothic atmospheres of earlier releases like ''Faith'' and ''Pornography''. It became their highest charting album in the UK to date, entering at number three and featuring three Top 30 singles in the UK and Germany ("Lullaby", "Lovesong" and "Pictures of You"). ''Disintegration'' also reached number twelve on the US charts. The first single stateside, "Fascination Street", reached number one on the American Modern Rock chart, but was quickly overshadowed when its third US single, "Lovesong", reached number two on the American pop charts (the only Cure single to reach the US Top 10). By 1992, ''Disintegration'' had sold over three million copies worldwide.

During the ''Disintegration'' sessions, the band gave Smith an ultimatum that either Tolhurst would have to leave the band or they would. In February 1989, Tolhurst's exit was made official and announced to the press; this resulted in Roger O'Donnell becoming a full-fledged member of the band and left Smith as The Cure's only remaining founder member. Smith attributed Tolhurst's dismissal to an inability to exert himself and issues with alcohol, concluding, "He was out of step with everything. It had just become detrimental to everything we'd do." Because Tolhurst was still on the payroll during the recording of ''Disintegration'', he was credited in the album's liner notes as playing "other instruments", however it has since been revealed that he contributed nothing to the album in either performance or song writing. The Cure then embarked on the Prayer Tour, which saw the band playing stadiums in America.

In May 1990, Roger O'Donnell quit and was replaced with the band's guitar technician Perry Bamonte. That November, The Cure released a collection of remixes called ''Mixed Up''. The album was not well received and quickly slid down the charts. The one new song on the collection, "Never Enough", was released as a single. In 1991 The Cure were awarded the BRIT Award for Best British Band. That same year Tolhurst filed a lawsuit against Smith and Fiction Records in 1991 over royalties payments, and claimed joint ownership of the name "The Cure" with Smith; the verdict was handed out in September 1994 in favour of Smith. In respite from the lawsuit, the band returned to the studio to record their next album. ''Wish'' reached number one in the UK and number two in the US and yielded the international hits "High" and "Friday I'm in Love". The Cure also embarked on the "Wish Tour" with Cranes, and released the live albums ''Show'' (September 1993) and ''Paris'' (October 1993). As a promotional exercise with the Our Price music chain in the UK, a limited edition EP was released consisting of instrumental outtakes from the ''Wish'' sessions. Entitled ''Lost Wishes'', the proceeds from the four-track cassette tape went to charity.

In the years between the release of ''Wish'' and the start of sessions for The Cure's next album, the band's line-up shifted again. Thompson left the band once more during 1993 to play with Robert Plant and Jimmy Page of Led Zeppelin, and Bamonte took over as lead guitarist. Boris Williams also left the band, and was replaced by Jason Cooper (formerly of My Life Story).

Period of transition (1994–1999)

The album sessions began in 1994 with only Smith and Bamonte present; the pair were later joined by Gallup (who was recovering from physical problems), and Roger O'Donnell, who had been asked to rejoin the band at the end of 1994. The Cure performed "Burn" in the movie The Crow and "Dredd Song," the theme song of the 1995 movie ''Judge Dredd'' starring Sylvester Stallone. It was not released on a Cure album until 2004 on ''Join the Dots: B-Sides & Rarities 1978–2001 (The Fiction Years)''.''Wild Mood Swings'', finally released in 1996, was poorly received compared with previous albums and marked the end of the band's commercial peak. Early in 1996, the Cure played festivals in South America, followed by a world tour in support of the album ''Galore''. ''Galore'' contained all of the Cure's singles released between 1987 and 1997, as well as the new single "Wrong Number", which featured longtime David Bowie guitarist Reeves Gabrels. Gabrels also accompanied the Cure on a brief American radio festival tour as an onstage guest guitarist for "Wrong Number". In 1998 The Cure contributed to the soundtrack album for ''The X-Files'' feature film as well as the Depeche Mode tribute album ''For the Masses'', with their cover of "World in My Eyes".

Recent years (2000–present)

With only one album left in their record contract and with commercial response to ''Wild Mood Swings'' and the ''Galore'' compilation lacklustre, Smith once again considered that the end of The Cure might be near and thus wanted to make an album that reflected the more serious side of the band. The Grammy-nominated album ''Bloodflowers'' was released in 2000 after being delayed since 1998. According to Smith, The album was the third of a trilogy along with ''Pornography'' and ''Disintegration''. The band also embarked on the nine-month Dream Tour, attended by over one million people worldwide. In 2001, The Cure left Fiction and released their ''Greatest Hits'' album and DVD, which featured the music videos for a number of classic Cure songs. In 2002, the band headlined twelve major summer music festivals, and played three extended concerts (one in Brussels, two in Berlin) in which they performed the albums ''Pornography'', ''Disintegration'' and ''Bloodflowers'' in their respective entireties each night. The Berlin performances were released on DVD as ''The Cure: Trilogy'' in 2003.

In 2003, The Cure signed with Geffen Records. In 2004, they released a new four-disc boxed set on Fiction Records titled ''Join the Dots: B-Sides and Rarities, 1978-2001 (The Fiction Years)''. The compilation includes seventy Cure songs, some previously unreleased, and a 76-page full-colour book of photographs, history and quotes, packaged in a hard cover. The album peaked at number 106 on the ''Billboard'' 200 album charts. The band released their twelfth album ''The Cure'' on Geffen in 2004, which was produced by Ross Robinson. It made a top ten debut on both sides of the Atlantic in July 2004. To promote the album, the band headlined the Coachella Valley Music and Arts Festival that May. From 24 July to 29 August, The Cure headlined the Curiosa concert tour of North America. While attendances were lower than expected, Curiosa was still one of the more successful American summer festivals of 2004. The same year the band was honoured with an MTV Icon television special.

In May 2005, Roger O'Donnell and Perry Bamonte were fired from the band. O'Donnell claims Smith informed him he was reducing the band to a three-piece. Previously O'Donnell said he had only found out about the band's upcoming tour dates via a fan site and added, "It was sad to find out after nearly 20 years the way I did but then I should have expected no less or more." The remaining members of the band—Smith, Gallup and Cooper—made several appearances as a trio before it was announced in June that Porl Thompson would be returning for the band's 2005 Festival summer shows, as well as their set at Live 8 in Paris on 2 July. Later that year, the band recorded a cover of John Lennon's "Love" for Amnesty International's charity album ''Make Some Noise''. It is available for download on the Amnesty website, while the album was released on CD in 2006. On 1 April 2006, The Cure appeared at the Royal Albert Hall on behalf of the Teenage Cancer Trust. It was their only show through to the end the year. In December a live DVD, entitled ''The Cure: Festival 2005'' including 30 songs of their 2005 Festival tour was released.

The Cure began writing and recording material for their thirteenth album in 2006. Smith initially stated it would be a double album. The Cure announced a last-minute postponement of their autumn 2007 North American 4Tour in August in order to continue working on the album, rescheduling the dates for spring 2008. Titled ''4:13 Dream'', the album was released in October 2008. The group released four singles and an EP—"The Only One", "Freakshow", "Sleep When I'm Dead", "The Perfect Boy" and ''Hypnagogic States'' respectively—on or near to the 13th of each month, in the months leading up to the album's release. In February 2009, The Cure received the 2009 Shockwaves NME Award for Godlike Genius.

In 2011, the band played their first 3 studio albums in their entirety during two shows in Sydney, Australia. These "Reflections" shows notably featured Roger O'Donnell and Laurence Tolhurst, both in a keyboard and percussion role. The shows are due to be released on DVD in 2011.

Musical style

The Cure are often identified with the gothic rock subgenre of alternative rock, and are viewed as one of the form's definitive bands. However, the band has routinely rejected classification, particularly as a gothic rock band. Robert Smith said in 2006, "It's so pitiful when 'goth' is still tagged onto the name The Cure", and added, "We're not categorisable. I suppose we were post-punk when we came out, but in total it's impossible [...] I just play Cure music, whatever that is." Smith has also expressed his distaste for gothic rock, describing it as "incredibly dull and monotonous. A dirge really." While typically viewed as producers of dark and gloomy music, The Cure have also yielded a number of upbeat songs. ''Spin'' has said "The Cure have always been an either/or sort of band: either [...] Robert Smith is wallowing in gothic sadness or he's licking sticky-sweet cotton-candy pop off his lipstick-stained fingers."

The Cure's primary musical traits have been listed as "dominant, melodic bass lines; whiny, strangulated vocals; and a lyric obsession with existential, almost literary despair." Most Cure songs start with Smith and Gallup writing the drum parts and bass lines. Both record demos at home and then bring them into the studio for fine-tuning. Smith said in 1992, "I think when people talk about the 'Cure sound,' they mean songs based on 6-string bass, acoustic guitar, and my voice, plus the string sound from the Solina." On top of this foundation is laid "towering layers of guitars and synthesisers". Keyboards have been a component of the band's sound since ''Seventeen Seconds'', and their importance increased with the instrument's extensive use on ''Disintegration''. With the Departure of Roger O'Donnell in 2005, keyboards have not been as prominent in the band's album 4:13 Dream and their live shows.

Music videos

The band's early music videos have been described as "dreadful affairs" and have been maligned for their poor quality, particularly by the band itself. Lol Tolhurst said, "Those videos were unmitigated disasters; we weren't actors and our personalities weren't coming across." It was with the video for "Let's Go to Bed", their first collaboration with director Tim Pope, that The Cure would become noted for their videos. Pope added a playful element to the band's videos; the director insisted in a 1987 ''Spin'' interview, "I think that side of them was always there, but was never brought out." Pope would go on to direct the majority of The Cure's videos, and his videos, which became synonymous with the band, helped expand The Cure's audience during the 1980s. Pope explained the appeal of working with The Cure by saying, "The Cure is the ultimate band for a filmmaker to work with because Robert Smith really understands the camera. His songs are so cinematic. I mean on one level there's this stupidity and humour, right, but beneath that there are all [Smith's] psychological obsessions and claustrophobia."

Legacy

The Cure were one of the first alternative bands to have chart and commercial success in an era before alternative rock had broken into the mainstream. In 1992 the ''NME'' declared The Cure had during the 1980s become "a goth hit machine (19 to date), an international phenomenon and, yep, the most successful alternative band that ever shuffled disconsolately about the earth". Smith has noted he looks at Cure-influenced bands like Interpol and My Chemical Romance with affection, adding, "I also think [Interpol bassist] Carlos D.'s obsession with Simon Gallup is sweet." Interpol lead singer, Paul Banks was quoted as saying ""The Cure is the band that all of us in Interpol can say influenced us. When I was younger I listened to them a lot. Carlos as well. Actually, he took a straight influence from this band on the way he played the bass and the keys. To me, Robert Smith is also one of these examples: you can't be Robert Smith if you're not Robert Smith. It's one of the bands with the deepest influence on Interpol, because we all like them. They're legendary."

Several references to The Cure and their music have been made in popular culture. A number of films have used the title of a Cure song as the film's title, including ''Boys Don't Cry'' (1999) and ''Just Like Heaven'' (2005). The Cure's gloomy image has been the subject of parody at times. In series two of ''The Mighty Boosh'', The Moon sings 'The Lovecats' over the credits. In the same episode, a powerful gothic hairspray, Goth Juice, is said to be "The most powerful hairspray known to man. Made from the tears of Robert Smith." ''The Mary Whitehouse Experience'' often featured brief clips of the stars of the show performing comical songs and nursery rhymes as The Cure in a morose style. Robert Smith appeared in the final episode of the first series of ''The Mary Whitehouse Experience'' singing "The Sun has got his hat on" before punching the character Ray (played by Robert Newman) whilst uttering Ray's catch phrase "Oh no what a personal disaster". Robert Smith was also portrayed on an episode of ''South Park'' (Season 1, Episode 12) where he transforms into the form of Mothra and battles Mecha-Streisand to save the day and Kyle shouts "''Disintegration'' is the best album ever!" In Craig Thompson's graphic novel ''Blankets'' the chapter seven is called "Just Like Heaven". The same chapter shows Raina singing some lyrics from this song to Craig.

Discography

''Three Imaginary Boys'' (1979)

''Seventeen Seconds'' (1980)

''Faith'' (1981)

''Pornography'' (1982)

''The Top'' (1984)

''The Head on the Door'' (1985)

''Kiss Me, Kiss Me, Kiss Me'' (1987)

''Disintegration'' (1989)

''Wish'' (1992)

''Wild Mood Swings'' (1996)

''Bloodflowers'' (2000)

''The Cure'' (2004)

''4:13 Dream'' (2008)

Members

;Current line-up

Robert Smith – lead vocals, guitars, keyboards (1976–present)

Porl Thompson – guitars, keyboards (1976–1978, 1983–1993, 2005–present)

Simon Gallup – bass guitar, keyboards (1979–1982, 1985–present)

Jason Cooper – drums, percussion (1995–present)

References

Sources

Apter, Jeff. (2006). ''Never Enough: The Story of the Cure''. Omnibus Press. ISBN 1-84449-827-1

Further reading

''Ten Imaginary Years'', by L. Barbarian, Steve Sutherland and Robert Smith (1988) Zomba Books ISBN 0-946391-87-4

''The Cure: A Visual Documentary'', by Dave Thompson and Jo-Ann Greene(1988) Omnibus Press ISBN 0-7119-1387-0

''The Cure: Songwords 1978–1989'' S. Hopkins, Robert Smith and T. Foo (1989) Omnibus Press ISBN 0-7119-1951-8

''In Between Days: An Armchair Guide To The Cure'' by Dave Thompson, Helter Skelter Publishing (October 2005) ISBN 1-905139-00-4

''The Cure – Greatest Hits'' (songbook containing 20 of their best, transcribed note-for-note with tab, chord symbols and complete lyrics), Hal Leonard Corporation (May 2002) ISBN 0-634-04667-5

''Robert Smith: "The Cure" and Wishful Thinking'' by Richard Carman (2005) Independent Music Press (UK) ISBN 9-78095-497041-3

''Jeremy Wulc : My dream comes true : Carnet de route avec The Cure. (2009) Editions : Camion Blanc

External links

'Chain of Flowers' – News about The Cure

Category:BRIT Award winners Category:English alternative rock groups Category:British New Wave musical groups Category:Gothic rock groups Category:Musical groups established in 1976 Category:British post-punk music groups Category:People from Crawley

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