Staggering Cost of Global Obesity May be Underestimated

July 13th, 2016 No comments »

According to an analysis by the McKinsey Global Initiative, obesity ranks third, behind smoking and armed violence, war and terrorism, in its global social burden, or about $2 trillion or 2.8% of global gross domestic product (GDP) approximately equal to the GDP of Russia or Italy. Lost productivity may be responsible for 70% of total costs. “In the United States, armed conflict (and especially spending on the military) has the highest social and economic impact, and obesity is second; obesity generated an impact in the United States of $664 billion a year in 2012, or 4.1% of GDP.” As jaw-dropping as that analysis, the situation may be worse. A new paper by Hruschka and Hadley posits that worldwide variation in human body weights are far more widespread that previously thought. The use of standard cut-offs might lead to underestimating global obesity levels by 400-500 million while also incorrectly prioritizing high-risk areas for undernutrition in children.

Insight into the African Obesity Crisis

December 15th, 2015 No comments »

For those who have looked at it, the disparities between men and women rates for obesity are striking. Now comes a report from South Africa commenting on the economic and cultural aspects of the spreading, global, obesity epidemic.

Global Obesity Targets Will Not be Achieved

October 10th, 2015 No comments »

The World Obesity Federation [formerly the International Obesity Task Force (IOTF)] has published new data on global obesity prevalence prediction through 2025. The data indicate that the global targets, set by the World Health Organization to hold obesity rates to the 2010 level will not be met. See article from The Guardian.


World Health Organization’s Credibility Problem

January 29th, 2015 No comments »

The World Health Organization (WHO) plays a vital role in fighting everything from ebola to avian flu and a hundred other communicable and non-communicable diseases. In recent years, non-communicable diseases (NCDs) have assumed greater importance as major communicable diseases have declined and the impact of NCDs has increased.

So, it was of some interest when the WHO recently issued its 2014 Global Status Report on NCDs. WHO’s Global Target #7 is “Halt the Rise in Diabetes and Obesity.”  (Ok, it isn’t exactly “Remember the Alamo!” but it is their target.)

The report, directed to senior health ministers around the world, states in its Executive Summary:

Obesity increases the likelihood of diabetes, hypertension, coronary heart disease, stroke and certain types of cancer. Worldwide, the prevalence of obesity has nearly doubled since 1980. In 2014, 11% of men and 15% of women aged 18 years and older were obese. More than 42 million children under the age of 5 years were overweight in 2013. The global prevalence of diabetes in 2014 was estimated to be 9%. Obesity and diabetes can be prevented through multisectoral action that simultaneously addresses different sectors that contribute to the production, distribution and marketing of food, while concurrently shaping an environment that facilitates and promotes adequate levels of physical activity. Diabetes risk can be reduced by moderate weight loss and moderate daily physical activity in persons at high risk. This intervention has been scaled up to the whole population in a small number of high-income countries. However, it is difficult to implement this intervention at scale in low- and middle-income countries, partly because current methods for identifying people at high risk are cumbersome and rather costly. Further research is urgently needed to evaluate the effectiveness of interventions to prevent obesity and diabetes.

The main body of the report asks, “What are the cost-effective policies and interventions for reducing the prevalence of obesity and diabetes?” Good Question. Unfortunately, WHO offers a bad answer:

Although evidence on what works as a package of interventions for obesity prevention is limited, much is known about the promotion of healthy diets and physical activity, which are key to attaining the obesity and diabetes targets. Evidence of population-wide policies and settings-based and individual-based interventions that have worked are described below.

Population-wide policies

Evidence suggests that changes in agricultural subsidies to encourage fruit and vegetable production could be beneficial in increasing the consumption of fruits and vegetables and improving dietary patterns. (Ed: citation is discussed below.) Evidence strongly supports (Ed: same citation) the use of such subsidies and related policies to facilitate sustained long-term production, transportation and marketing of healthier foods.

Let’s look at what the WHO considers to be “evidence”. One paper is cited for “evidence”. Written by David Wallinga, director of the Food and Health Program, Institute for Agriculture and Trade Policy in Minneapolis, MN, titled, “Agricultural Policy and Childhood Obesity: A Food Systems and Public Health Commentary” (Health Affairs, 2010;29(3):405-10), it is an expansive, creative foray in possible changes in agricultural policy in the United States in anticipation of the reauthorization of the Farm Bill.

Let me draw your attention to the word “Commentary” in the title because that is exactly what it is. The paper, which is quite good and worth reading reviewing the history of US agricultural policy which has evolved to favor “cheap calories”. The author reflects that perhaps it is time to shift to an agricultural policy which favors the production of fruits and vegetables. He makes a very nuanced observation that, “Diets rich in fruits and vegetables can help manage weight and can lower risks for cancer and other chronic diseases, especially when they replace calorie-dense, nutrient poor foods.” In addition to using the qualifying verb “can”, Wallinga offers no citations for this assertion but that is not the point. Maybe it is my legal education but I think “evidence” means something more than philosophical on what might be the effects of future policy changes at all levels of government and affecting many vital economic sectors. I doubt Mr. Wallinga would consider his paper to be “evidence” of anything. For WHO to call it “evidence” to the intended audience of health ministers is simply misleading. Worse, it assumes that the only intervention they might make are enormous changes in their countries agricultural programs. Since agriculture is a major economic sector in most countries, such an approach is likely to be, well, fruitless.

Unstoppable Rise in Global Obesity?

May 29th, 2014 No comments »

The Lancet has published an analysis of the global, regional, and national prevalence of overweight and obesity in children and adults between 1980-2013. The bottom line: overweight and obesity is increasing in children and adults, among men and women in developed and developing countries, albeit at different rates. No national success story in preventing or controlling obesity has been reported in the past 33 years. The abstract reads, in part, “Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m2 or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4—29·3) to 36·9% (36·3—37·4) in men, and from 29·8% (29·3—30·2) to 38·0% (37·5—38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9—24·7) of boys and 22·6% (21·7—23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7—8·6) to 12·9% (12·3—13·5) in 2013 for boys and from 8·4% (8·1—8·8) to 13·4% (13·0—13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene.”


Recession Increased Odds of Becoming Obese

May 28th, 2014 No comments »

The widely-respected OECD reports that obesity continues to increase rates of obesity. The interesting finding is that the economic recession has increased the prevalence of obesity. Their research indicates that people worried about their economic condition reduced their food budget and moved from healthier, more costly foods to cheaper, more calorically dense foods.




Global Obesity Tops 900 million in Poor Countries

January 3rd, 2014 No comments »

A UK think tank, the Overseas Development Institute (ODI), has issued a sobering report on the global epidemic of obesity. Over one third of all adults across the world – 1.46 billion people – are obese or overweight. Between 1980 and 2008, the numbers of people affected in the developing world more than tripled, from 250 million to 904 million. In high-income countries the numbers increased by 1.7 times over the same period.

• Diets are changing wherever incomes are rising in the developing world, with a marked shift from cereals and tubers to meat, fats and sugar, as well as fruit and vegetables.

• While the forces of globalisation have led to a creeping homogenisation in diets, their continued variation suggests that there is still scope for policies that can influence the food choices that people make.

• Future diets that are rich in animal products, especially meat, will push up prices for meat, but surprisingly, not for grains. This suggests that future diets may matter more for public health than for agriculture.

• There seems to be little will among public and leaders to take the determined action that is needed to influence future diets, but that may change in the face of the serious health implications. Combinations of moderate measures in education, prices and regulation may achieve far more than drastic action of any one type.

For the report, click here. For more on the global obesity epidemic, see “global obesity.”

Another think tank has projected substantial increases in leading industrial countries.

Global Obesity Rates Expected to Rise

December 16th, 2013 No comments »

Global Data, a research and consulting firm, has issued a report predicting obesity will affect 480 million people worldwide by 2011. The nine major markets (United States, France, Germany, Italy, Spain, UK, Japan, Brazil and Canada) will see increase from 167 million in 2012 to 213 million in 2022.