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June 13, 2017

The World is Getting Fat

More than 10% of us are obese. That’s not “us” Americans; that’s “us” citizens of the world. According to a study funded by the Gates Foundation and published in The New England Journal of Medicine, the number of obese people has doubled or worse in 75 countries in the last 25 years. It hasn’t gone down in any of the 195 countries studied. Although a greater percentage of adults than children are obese, the obesity rate among children has been going up faster than among adults in many countries. In this study, obesity is defined as a body-mass index (BMI) over 30; people with a BMI between 25 and 29 are classified as “overweight”.

From the study:

“In our systematic evaluation of the health effects of high BMI, we found that excess body weight accounted for about 4 million deaths and 120 million disability-adjusted life-years worldwide in 2015. Nearly 70% of the deaths that were related to high BMI were due to cardiovascular disease, and more than 60% of those deaths occurred among obese persons…

“… Across levels of development, the prevalence of obesity has increased over recent decades, which indicates that the problem is not simply a function of income or wealth. Changes in the food environment and food systems are probably major drivers. Increased availability, accessibility, and affordability of energy-dense foods, along with intense marketing of such foods, could explain excess energy intake and weight gain among different populations. The reduced opportunities for physical activity that have followed urbanization and other changes in the built environment have also been considered as potential drivers; however, these changes generally preceded the global increase in obesity and are less likely to be major contributors.”

Malthus has apparently been turned on his ear by abundance (and foreign aid):

“Many of the countries with the highest increases in the prevalence of obesity are those that have a low or middle SDI [roughly prosperity level - TE] and simultaneously have high rates of other forms of malnutrition. These countries generally have limited financial resources for nutrition programs and mostly rely on external donors whose programs often preferentially target undernutrition; consequently, food security frequently takes precedence over obesity in these countries.”

The word starvation doesn’t appear in the study and malnutrition only once, so I don’t know if death rates from lack of food have gone down as much as death rates from too much food have gone up. In the developed world, death rates from BMI-related causes have not gone up as much as average BMI has; the study speculates that more treatment for these diseases is available in the wealthy world. Probably one cause of rising health care costs.

In a generation, the world’s problem with food has shifted, in many places, from too little to too much. This change is largely due to technology and the increase in productivity both of people and of farm land. We live in a time of abundance, something I’ll write about more. Ironically abundance, like scarcity, can be a problem.

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