Globalizing Fatness

Some progress we can do without.

Posted Jan 30, 2014

Societal Obesity


Life has improved for lots of people. Economic development and globalization has brought many out of poverty. Kenyan farmers shop and bank with cell phones. Hundreds of millions of Chinese have moved from the impoverishment of the Cultural Revolution to high levels of education and ambition-filled lives. 

As civilization “progresses” much is also lost. Environmental degradation vies with climate change as a future threat to our food supply. We may sooner than suspected lose the ability to live in some great cities. But with such losses arrive ungainly gains:

Humans weigh a lot more. And the increases are particularly stark outside the US.

What’s Happening

According to recent data published in Population Health Metrics, the number of overweight and obese adults in the developing world has quadrupled in less than 30 years, from 1980 -2008. Huge jumps were seen in the Middle East, Latin America, and Southeast Asia.

How Bad is It?

According to the research from UK’s Overseas Development Institute, one in three people are now overweight or obese; an increase in 30 years of 50 percent.

The future increase in heart attacks, strokes, cancer, and particularly diabetes will prove dramatic. Health across nations will deteriorate. Health care costs may skyrocket.

This is no surprise to many health companies. Big Pharma has been targeting diabetes and cancer for a long time. They know the demographic trends. The steady increase in antibiotic resistance—as antibiotics get used more and more—has not occasioned similar research largesse.

Curing bacterial infections is generally a one shot deal. Even when you price your drug sky high, the profit margins are slimmer than with chronic disease pharmaceuticals. New antibiotics are badly needed. They don't yet exist.  So when major bacterial epidemics do hit, the economic and civilizational costs may prove immense. The same thing may occur with increasing obesity.

How Bad is Bad?

Worse than it looks. The global data is based on the widely used but 18th century measure of body mass index—body mass index, or BMI. Arbitrarily, 25 and above is considered overweight.

This is a misleading measure for many populations.

Mexicans weigh less than Americans. In Mexico, the diabetes rate is 16 percent, versus less than 10 percent in the U.S.

Different populations possess different genes. In Mexico and Asia, people develop diabetes at much lower weights than is commonly seen in North America. Multiple genes, including some inherited from Neanderthals are blamed for the high diabetic rates. 

One other unfortunate result is TOFI—thin outside, fat inside. In the U.S. you can witness the effect in retired fashion models, whose diets of tobacco/coffee/sugar set them up for lots of unhealthy results—including early diabetes. In the rest of the world TOFI is a pretty routine occurrence. As this abdominal fat—hidden from sight—also acts as a huge endocrine gland, this is truly bad news for all.

At this stage, 70 percent of North Americans are said to be overweight. In Latin America it’s 63 percent.

Why Is the Population Getting So Big?

Lack of exercise, plus sugary, fatty foods are routinely blamed. Yet this puts most of the onus on the individual.

That’s not fair.

With globalization arrive major cultural and social changes. Coca-Cola may be junk food to some Americans. Yet in much of the developing world, it is aspirational—just as Prada bags are to Miami teenagers. The food companies that have spent tens of billions figuring out how a Dorito can provide eating pleasure just short of feeling full are selling their wares to working people everywhere—as quickly as rising wages permit. Often times the new foods arrive in tiny packages which still showcase their glamour.

When you get your first television set you don’t have to walk so far for entertainment. Cell phones let you know how your neighbors and friends are doing without visiting them—or moving at all.

What Can Be Done To Reverse Global Diabesity?

Stress is said to make people eat more. New York City is arguably one of the more stressful environments in the developed world. Yet New Yorkers are living about 2.5 years longer than other Americans.

Much of the difference is civilizational—culture, economics, and urban design.

To get to most places in NY you can drive. But you may not be able to park. If you do find a parking space, it may cost you your daily wage. 

But there are subways and buses. They move fast. They are cheap.

People have to walk to them to use them. So they walk. And the social conviviality of cities appears to have other healthy results.

Recent data argue two things: 1. If people walk after meals they can really cut their risks of obesity and diabetes 2. Intense exercise for surprisingly short periods—even just four minutes—seem to change gene expression and increase insulin sensitivity.

Some governments are paying attention. They don’t want to spend what the U.S. does—18 percent of GDP—on health care. It’s cheaper—and far better for economic productivity—to keep people healthy.

Change is difficult. People will not and should not give up their cell phones. They will continue to adore—and describe as semi-orgasmic experiences—restaurant meals providing extraordinary quantities of salt, sugar, and fat.

But you can train people to love their traditional diets. You can set up parks and make it safe and easy for people to use them. You can get people to walk around their neighborhoods and cook their own meals—including vegetables they’ve grown themselves.

And then have them walk after each meal.

Simple things work. They work pretty much everywhere.

They also save lives.