The Reality of a Global Obesity Epidemic

Thomas Robert Malthus, English cleric, scholar, and revered economist, published a novel in 1798 entitled Essay on the Principle of Population. In this work, Malthus predicted that in a certain number of years – because population growth occurs exponentially while the food supply would grow linearly – humans would eventually become too numerous for the world’s resources and run out of food. Keep in mind, the population of the world was around 800 million in the year 1798.

Today there are more than 7.5 billion humans on Earth.

And most of us, are NOT starving.

I don’t want to say that Malthus was wrong, but he did not predict – really, who could have expected? – the earth-shaking advancements to be able to produce genetically modified organisms (GMOs), efficient farming, mass production, and innovation of agriculture. Now, there is enough food on the planet to feed everyone, and then some. The human race has been smart enough to keep itself alive through mass quantities of food and (although there are still undernourished humans) many people have more than enough to eat.

On the contrary, this innovation has almost been too good. Malthus would not have ever guessed, but now we are in the midst of an epidemic spanning nations because of the excess supply of available food: obesity.

Yes, it IS an Epidemic

When we think of an epidemic, immediately we recall Zika, Ebola, AIDS, and so forth. However, epidemics are not only communicable diseases that we see people “catching” and “transmitting”. According to the CDC (a respected government agency dedicated to epidemiology and research of communicable and noncommunicable diseases), epidemics are defined as an increase, often sudden, in the number of cases of a disease above what is normally expected in the population in a certain area.

This definition of epidemic is accurate, however, in order to apply this to problems concerning obesity, one must decide what a disease is. Can we apply this definition to obesity?

Diseases are conditions of a living animal or plant that impairs normal functioning and is typically manifested by distinguishing signs and symptoms. Obesity is just that. It can impair day-to-day life, is distinguished by painful symptoms, – joint pain, heart disease, etc. – and signs of being overweight. Also, we are seeing a higher than expected amount of obese people in the world, thus classifying obesity as an epidemic.

No, obesity is not something you “catch” if you don’t wash your hands, but diseases aren’t necessarily spread through pathogens. We must begin to think about obesity as a disease and an epidemic if we want to be able to work towards fixing the problem.

What’s the BIG deal?

Obesity is a serious health issue because of the burden that excess weight will place on the body. Having too high of a fat content is linked to problems such as high cholesterol, higher risk for heart disease and heart attack, and potential emergence of type 2 diabetes. The National Institute of Health (another reputable government agency dedicated to funding public health endeavors and further research in the field of public health) explains the prevalence and morbidity concerning obesity, especially among children in the US. Although the United States has been a prominent player in the obesity epidemic, the US is not the only nation being affected.

Some public health officials have classified the obesity epidemic as a pandemic – meaning that it affects numerous nations and regions across the globe – because of its prevalence across the world. Worldwide obesity has tripled since 1975, adding a slew of problems among nations that are already burdened with economic problems and corrupt government as it is. Since malnutrition and obesity are not mutually exclusive, public health observers are seeing a rise in nations today – predominately located in Sub-Saharan Africa – that are burdened by both obesity and malnutrition.

In 2016, more than 1.9 billion adults, 18 years and older, were overweight. Of these, 650 million were obese. BMI ChartThe difference between being overweight and being obese is most widely classified by Body Mass Index (BMI). Although encompassing every aspect of the health of a whole person is impossible to do in one number, in the medical field, BMI is one of the most well-regarded, broad ways to determine the healthy weight of an individual. To calculate BMI, one takes their weight (in kilograms) and divides it by their height (in meters) squared. A BMI over 25 is considered overweight while a BMI over 30 is considered obese. (Use the chart on the left to find your BMI!)

 America First…?

The world is getting bigger and bigger everyday – both in population and in weight. As the epidemic has largely stemmed from American culture and the globalization of western diets, it is understandable why many experts focus on the obesity epidemic as it relates to the United States. But Americans are not the only ones in the world having to loosen their belts.

The epidemic has reached global proportions – potentially a pandemic – and time seems to exacerbate the problem. Regardless of location, size, or population, every nation – to some extent – has been impacted by the global reach of obesity.

This fact is often neglected in our media as it fails to mention the rise in obesity rates in foreign nations. Books have been published, articles have been written, and well-respected associations have built arguments centered around obesity only as it pertains to Americans. Although the epidemic is a pressing issue in the US, these reports fail to understand the problem as a whole – they are ignoring a hefty proportion of the issue. They do not lie and claim that the obesity epidemic is only an issue in the US, but they omit the rest of the world in their claims. Articles declaring America as the fattest nation in the world blatantly ignore lesser developed nations that are burdened by a higher average BMI.

World Obesity Epidemic
The US may be fat, but some other nations are just as, if not more, obese. Also, the rate of increase of the rate of obesity is a major determinant in observing how pressing of an issue obesity is in a specific nation.

The US is fat, but many other nations are worse. In general, island nations in the South Pacific and the Caribbean have generally poor, unbalanced diets and consistently have the highest rates of obesity. Also, many nations larger than islands – Mexico, Italy, Australia, Brazil, South Africa, etc. – have obesity rates comparable, if not greater, than the US.

Japan is a nation of high interest that has a low BMI compared to other nations of similar economic standing. Due to a very healthy diet and culture of well-being, Japan is one of very few nations who seem to be less affected by the almost inevitable global weight gain.

 

In the above charts, one can understand the proportion of populations in different nations of various economic statuses of different BMIs. Look to this (extensive yet informative) report by The Lancet for more population data and charts by nation and region.

Money Talks

Even in more developed nations, it is expensive to maintain a healthy diet and poorer nations have an even harder time trying to maintain a healthy diet. Convenient inventions like fast food have been beneficial for minimizing the global rate of starvation, yet it is not sufficient in providing the correct nutrition to maintain a healthy body. Some nations with a lower GDP are plagued with both malnutrition and obesity simultaneously because people have access to food but only from unhealthy, high fat, nutrient-lacking sources. However, interesting trends due to globalization can be observed below:

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(Age Standardized BMI includes all ages and standardizes weight and mass to a certain standard based on age. This becomes a different value than obesity rate of adults in a nation. 47 nations spanning various regions, economic status, cultures, and languages were picked for all three charts.)

In the past, the prevalence of obesity was much more limited by the wealth of a nation (here measured by GDP per capita) because richer people had more access to food. As globalization has impacted more nations and the world has become more economically and socially connected, a high GDP is not necessary anymore to have a significant proportion of obese citizens. As observed in the above diagrams, the growth of agricultural innovation and globalization of food supplies have allowed for obesity to be prevalent in nations that do not have a high GDP per capita. Lesser developed nations are still experiencing this epidemic. Today, obesity is not as much of a problem of wealth disparity, but a problem of lack of access to nutrition.

Today, originally western fast food restaurants have franchises in most of the nations of the world. These restaurants are convenient because they are cheap, filling, and fast; yet, they are nutritionally insufficient. With high portion sizes, greasy fatty meat, little to no vegetables, high sodium and sugar content, it is nearly impossible to maintain a healthy weight while consistently relying on fast food as the primary means of sustenance.

How do we fix this?

There is a paramount need to address this epidemic from multiple perspectives in order to truly conquer it and take control of global health again. There are numerous negative consequences of obesity that cannot be fully controlled unless we change the way we view the epidemic.

Similar to any illness or disorder that is not well understood, – mental health, for example – stigma surrounds the way people address it. Our first effort to treat obesity should be to destigmatize it. Today, society views overweight people as lazy, gluttonous, or disgusting; there is a lack of respect for and representation of overweight individuals in media and in American society. In order to allow for overweight individuals to feel more comfortable in seeking treatment, we need to make them feel accepted and eliminate fear or discomfort they would feel in seeking help. If we treated this epidemic like other epidemics – Ebola, maybe? – we would view overweight individuals as people who need help, not people who are making all the wrong decisions. Although life decisions are just as important in treating obesity, let us start to understand genetics, economics, and situation are all aditional factors in the rising obesity rate.

As we try to understand the global obesity epidemic better, we must see it as more than just a problem in one nation; obesity is a global problem. Every report and article addressing the obesity epidemic should include global context because Americans are not the only ones who are being affected by it. The US is simply not the fattest nation in the world, although many experts seem to address it as such. If we begin to recognize that obesity is affecting more nations than our own, more funds could be allocated, more attention could be given to, and more efforts to help could be extended to treat this epidemic domestically and internationally.

Although the pandemic is global, some nations are being affected more compared to others. For example, island nations, deveoped nations, and poorer nations alike have been greatly affected by an increased average BMI, yet, in comparrison, Japan has not. One way to hopefully limit the obesity rate in each country is to promote nutrition education, access to healthy food, and exercise rate of children and adults. An increased education and awareness of the dangers of obesity can hopefully lead to a more conscious public. Nations who have the means to – perhaps the United States – should take after healthier nations like Japan and model diets after an Eastern Asian diet. Potentially the US could then extend that help to other nations and a greater focus on the public health of society could be achieved.

Understanding and addressing the obesity epidemic should be a paramount priority. The below map illustrates the liklihood of each nation to make its way out of the obesity rate crisis if post 2000 trends of diet and exercise continue. Doesn’t look too promising does it?

Fate of Obesity Epidemic
Found in a research report by The Lancet, this map illustrates that if post 2000 trends of diet and exercise continue, it is unlikely for any nation in the world to successfully improve their obesity rate.

 

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