International Obesity Epidemic

The International Obesity Epidemic: History, Causes, and Preventions

Jonathan D. Sklaroff New Challenges in Global Politics Professor Cantos November 28th, 2012

1

Introduction When asked to think about the major problem related to food that plagues mankind, we often think of malnutrition as being the most important. However, the current obesity epidemic is now a worldwide problem, and has now been recognized as a public health crisis. Conversely, whereas the problem of malnutrition has been around since the dawn of time, the obesity epidemic is only several decades old. The origins of this epidemic can be traced back to technological advances of the eighteenth century that yielded an abundance of food in industrial advanced countries. Initially, these abundances of food increased life expectancy, nutrition, and quality of life. However, as these abundances grew larger and larger, people began to overindulge, and combined with reduced physical activity from sedentary occupations such as office jobs, humans began to become obese. Furthermore, being “fat,” has not always been an adjective with negative connotations. In the Middle Ages and other time periods, being fat was a status symbol. In other words, if you had enough money to eat more than you needed, you must have been rich. This is the reason why times we often see ancient kings and aristocrats as being obese. In fact, obesity was often reflected in the arts, literature, and medical opinion as being a positive characteristic. According to scholar Dr. Garabed Eknoyan, a medical researcher at Baylor University, “Only in the latter half of the nineteenth century did being fat begin to be stigmatized for aesthetic reasons, and in the twentieth century, its association with increased mortality was recognized.1”

1 Eknoyan, Abstract

2

It is no wonder then, that as the 20th century progressed and with it came an

unprecedented time of growth in human history, that populations from industrialized, developed countries began to gain more weight than height. Furthermore, in his journal article entitled The Global Epidemic of Obesity: An Overview, Dr. Benjamin Caballero notes “by the year 2000, the human race reached a sort of historical landmark, when for the first time in human evolution the number of adults with excess weight surpassed the number of those who were underweight.2” By utilizing several sources, ranging from medical journal articles to New York Times articles, this paper will attempt to clarify several things regarding the global obesity epidemic. First, several statistics will be presented in order to further the reader’s understanding of the magnitude of the issue. The next section will focus on the causes of the global epidemic of obesity, the current state of the epidemic, as well as why obesity is such a problem for countries. Subsequently, a section detailing the epidemic in America will demonstrate that this epidemic is not like other global issues; it is starting right in our backyard. Finally, several theories on how to stop this growing epidemic will lead into a conclusion on the topic. Statistics As I researched statistics relating to the global obesity epidemic, I must say, I

was quite shocked at some of the numbers I found. In my opinion, it’s hard to even picture the numbers some of the statistics put forth, and that so many people could

2 Caballero 1

3

be living in obesity while so many other people live with extreme malnutrition. Before going into the statistics, there are some terms that must be explained. First, overweight and obesity are defined as “abnormal or excessive fat accumulation that may impair health.3” Next, there is in fact a difference between being overweight and being obese. The standard metric of measuring obesity is called the Body Mass Index (BMI). An individual with a BMI greater than or equal to 25 is considered overweight, while a BMI greater than or equal to 30 is considered obese. According to the World Health Organization, obesity has more than doubled since 1980. Additionally, in 2008, more than 1.4 billion adults aged 20 or older were overweight. Of those 1.4 billion, over 200 million men and nearly 300 million were considered obese. Furthermore, 65% of the world’s population lives in countries where overweight and obesity kills more people than malnutrition, and more than 40 million children under the age of five were overweight in 20104. Although these statistics seem overwhelming, obesity is unlike other epidemics, in that it is absolutely preventable. Another interesting statistic is that of the countries with the highest percentage of obesity in their populations. The United States ranks first on this list, with 30.6% of its citizens being classified as obese. Mexico rank second, with 24.2%, and the UK is third with 23%5. Although these numbers prove to be very interesting, the reasons why the U.S. and other rich countries are ranked first on this list will be discussed in depth later on.

3 WHO statistics 4 Ibid 5 Ibid

4

Causes and Effects The concept of being obese and the negative medical results resulting from

the condition is relatively new. As mentioned before, for a long time obesity was somewhat of a status symbol and was linked to wealth and high status. Although the first countries to encounter problems with obesity were in fact rich, developed countries, in recent decades data shows the most of the dramatic increases in obesity are in fact in developing countries such as Mexico, China, and Thailand. Additionally, obesity has shifted from a condition affecting high socioeconomic classes to lower levels6. Because the World Health Organization did not recognize obesity as a global epidemic until 1997, there has not been extensive research conducted on the exact causes of the epidemic. However, many scholars have offered theories attempting to explain this troubling epidemic.

For Dr. Caballero, the two most important causal factors associated with the

rise in obesity in developing countries are urbanization and globalization of food production and marketing. Whereas citizens of these countries used to have occupations that were more labor intensive, such as farming, now they have moved to more sedentary occupations such as desk jobs. In addition, people who used to walk or ride bicycles to work now use public transportation such as trains or buses. Dr. Caballero notes, “The global nature of modern commerce, sustained by the technical advances in food production and transportation, has permitted the introduction of low-­‐cost, energy-­‐dense foods in the domestic food market of many

6 Caballero 3

5

developing countries.7” Additionally, with globalization has come a huge influx of giant multinational fast food corporations such as Burger King and McDonalds, which market their products heavily and incentivize developing countries to buy their products with low-­‐cost items on the menu, when in reality, this food is extremely unhealthy. When these two things happen simultaneously, people being to gain weight.

New York Times writer Jane Brody offers several other theories as to how

this epidemic began. She relates that when she was growing up, if she wanted an ice cream cone or a candy bar, she had to walk many blocks to get it. There were no vending machines making candy readily available at any time of the day, and there were especially no fast-­‐food emporiums or malls with food courts. Furthermore, she notes that as more women entered the work force, food corporations took advantage women spending less time preparing food, and began to produce convenience foods high in sugar, salt, and fat. Finally, she states “he 1970s saw a striking rise in the quantity of refined carbohydrates and fats in the U.S. food supply, which was paralleled by a sharp increase in the available calories and the onset of the obesity epidemic. Energy intake rose because of environmental push factors, i.e., increasingly available, cheap, tasty, highly promoted obesogenic foods.8” It’s really not hard to see why, even looking around in Barcelona it doesn’t take much time to find a “Texas-­‐size breakfast” from McDonalds which comes with three scrambled eggs, two fried potato cakes, a buttered croissant, and four strips of bacon, all for 1.99.

7 Ibid 8 Brody

6

While the causes of the obesity epidemic are somewhat up for debate, the

effects of this epidemic certainly are not. Obesity is linked to a plethora of health diseases, and is linked to more than 60 chronic diseases. Additionally, according to the American Cancer Society, obese adults are at increased risk for all cancers. Furthermore, obesity contributes to two-­‐thirds of all heart disease, and 66% of American adults with arthritis are obese9. Aside from negative medical consequences, obesity also has many negative economic concerns. For example, in 2010, a government report listed obesity as the main cause of the nearly 20% increase in United States health care spending. Furthermore, the yearly health costs linked to obesity in the U.S. are astoundingly high at $168 billion. Moreover, obese full-­‐time workers in the U.S. miss an additional 450 million days of work compared to healthy workers, costing approximately $153 billion in productivity. Finally, according to the USDA, healthier diets could prevent at least $71 billion per year in medical costs and lost productivity.10 How do we stop it? Just as scholars and medical experts somewhat differ on the exact causes of

the global obesity epidemic, many offer different theories and ways in which this epidemic can be controlled and prevented from affecting future generations. For Jane Brody, several coordinated and specific policies must be enacted in order to turn the epidemic around. First, there must be a tax on sugary drinks. A tax on this $24 billion industry could prove to be not only a deterrent for produces and

9 “Campaign to End Obesity” 10 Ibid

7

consumers, but could also help states in need of money such as California, which could “bring in $1.5 billion a year with a 1-­‐cent-­‐per-­‐ounce excise tax on sugar-­‐ sweetened drinks.11”Furthermore, she relates we need more educational programs that teach children healthier eating and exercise habits, combined with reduced advertising of junk foods and beverages to children. 12 The British Medical Journal’s article entitled Unequal weight: equity oriented

policy responses to the global obesity epidemic, put forth a campaign to fight obesity in the UK and offers several other ideas how to address global obesity. It relates that given the complex nature of the causes of obesity, it must require a multi-­‐pronged approach to stop it. According to the journal, “Action must tackle the inequities in this system, aiming to ensure an equitable distribution of ample and nutritious global and national food supplies; built environments that lend themselves to easy access and uptake of healthier options by all; and living and working conditions that produce more equal material and psychosocial resources between and within social groups.13” In my opinion, the best and most efficient way at stopping this epidemic is to

utilize global institutions to help catalyze change at the global level. The World Health Organization, for example, is a critical institution. It’s global strategy to combat global obesity focuses on increasing food and agriculture policies, as well as promoting public health and physical activity14. Furthermore, the United Nations Food and Agriculture Organization has created a joint program with the WHO in

11 Brody 12 Ibid 13 British Medical Journal 14 Global Issues

8

order to assist governments ensure fair trade practices as well as protect consumer health. I believe that the change must come from the top, starting with institutions such as the two mentioned above.

Conclusion Although many will argue about what caused the global obesity epidemic and

how to solve it, one thing is for certain: we must begin to enact policies and programs in order to stop it. We cannot let such a solvable condition continue to ruin lives globally. A large effort must be taken by giant food conglomerates such as Coke-­‐a-­‐Cola and McDonalds to reduce their impact on global health, even if it comes at the cost of some of the companies’ profits. In my opinion, these corporations have a certain corporate social responsibility to the planet to stop propagating unhealthy foods to developing nations and children, two of the biggest problems of the obesity epidemic. Until we figure how to stop this problem, it will only continue to become worse. As listed above, this epidemic produces a litany of negative externalities from diseases to lost productivity. It is of paramount importance that the world finds a way to stop this epidemic before things become worse than they already are.

9

Works Cited Brody, Jane E. "PERSONAL HEALTH; Attacking the Obesity Epidemic by First Figuring Out Its Cause." The New York Times. The New York Times, 13 Sept. 2011. Web. 28 Nov. 2012. . Caballero, B. "The Global Epidemic of Obesity: An Overview." Epidemiologic Reviews29.1 (2007): 1-5. Web. Eknoyan, Garabed. "A History of Obesity, or How What Was Good Became Ugly and Then Bad." Advances in Chronic Kidney Disease 13.4 (2006): 421-27. Web. "Obesity." - Global Issues. N.p., n.d. Web. 28 Nov. 2012. . "Obesity and Overweight." WHO. N.p., n.d. Web. 28 Nov. 2012. . Sharon Friel, Mickey Chopra, David Satcher. Unequal weight: equity oriented policy responses to the global obesity epidemic. British Medical Journal, Volume 335. December 15, 2007, pp 1241-1243. "The Campaign to End Obesity." The Campaign to End Obesity. N.p., n.d. Web. 28 Nov. 2012. .

10

Cited: Brody, Jane E. "PERSONAL HEALTH; Attacking the Obesity Epidemic by First Figuring Out Its Cause." The New York Times. The New York Times, 13 Sept. 2011. Web. 28 Nov. 2012. . Caballero, B. "The Global Epidemic of Obesity: An Overview." Epidemiologic Reviews29.1 (2007): 1-5. Web.   Eknoyan, Garabed. "A History of Obesity, or How What Was Good Became Ugly and Then Bad." Advances in Chronic Kidney Disease 13.4 (2006): 421-27. Web. "Obesity." - Global Issues. N.p., n.d. Web. 28 Nov. 2012. . "Obesity and Overweight." WHO. N.p., n.d. Web. 28 Nov. 2012. . Sharon Friel, Mickey Chopra, David Satcher. Unequal weight: equity oriented policy responses to the global obesity epidemic. British Medical Journal, Volume 335. December 15, 2007, pp 1241-1243. "The Campaign to End Obesity." The Campaign to End Obesity. N.p., n.d. Web. 28 Nov. 2012. .     10