Fat’s Heavy Burden

ROME – Today, about 2.1 billion people, or almost 30% of the world’s population, are regarded as overweight (defined as a body mass index, or BMI, of 25 or higher) – double the number in 1980, and more than 2.5 times the number of people who are chronically hungry. In fact, according to a recent report by the McKinsey Global Institute, being overweight or obese is now linked to 2.8 million deaths annually – more than those associated with being underweight – via non-communicable diseases like type-2 diabetes, cancer, and cardiovascular disease. Clearly, this is a serious problem, and addressing it will require a commitment to sustained and well-coordinated action.

The data are unambiguous. In the United Kingdom, for example, 37% of the population is now deemed overweight, with a quarter of that group qualifying as obese (a BMI of 30 or higher). Though being overweight or obese is often perceived as accompanying wealth, the problem has disproportionately affected lower-income communities.

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Moreover, in recent decades, the scourge has been spreading rapidly in many developing countries, especially the more prosperous among them. In the emerging economies, the rate of increase in the number of overweight and obese children has been more than 30% higher than that of developed countries in recent years.

In fact, the trend is accelerating everywhere, with the number of overweight people worldwide having increased by some 40% in the last decade alone. At this rate, half of the world’s adult population will be overweight in about 15 years.

The economic burden that this imposes is massive. Accounting for diminished economic productivity, direct costs to health-care systems, and the investment required to mitigate the impact of obesity, the McKinsey report places the annual losses at $2 trillion, or 2.8% of world GDP. That is almost as big as the burdens of smoking and armed conflict, war, and terrorism, each of which amount to an estimated $2.1 trillion.

This grim situation has led the World Health Organization – and the United Nations more generally – to recognize obesity as an epidemic that must be addressed urgently. To kick-start its efforts, early last year the WHO halved its recommendation for sugar consumption from 10% of adult daily caloric intake to 5%, despite considerable resistance from corporate vested interests and the governments that support them.

But, as the McKinsey report notes, no single intervention will have a sufficient impact; a comprehensive strategy is needed. Based on an assessment of 74 potential measures, the report offers several recommendations. These include reducing fast-food portions, restricting food and beverage advertising, providing consumers (especially parents) with better nutrition information, reformulating processed foods, requiring more exercise at school, and ensuring balanced, varied, and healthy meals at school and workplaces.

There is good reason to believe that such initiatives can work. Last year, US official statistics reported a 43% decrease in childhood obesity since 2004, mainly during the second half of the decade – a shift that may have been driven, at least partly, by targeted interventions.

But significant challenges are likely to arise, the most daunting of which is the need for various seemingly disparate initiatives to be undertaken simultaneously, in a concerted and sustainable manner. Compounding this challenge is the need to adjust measures to suit various circumstances. And, with no designated body in international organizations or most countries to coordinate these efforts, this will not be easy to achieve.

The key to progress will be strong political will. First and foremost, policymakers and the public must recognize the scale of the problem. Following the Second International Conference on Nutrition, organized by the UN Food and Agricultural Organization and the WHO in Rome last November, some worried that the extent of nutrition issues (including undernutrition, micronutrient deficiencies, and excessive weight), as well as their human and economic burden, were overestimated. But recent numbers suggest the opposite: the conference underestimated these figures – not least with regard to obesity.

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Likewise, public and private investors should be made aware of the very high returns associated with tackling nutrition issues. As it stands, only about 1% of total aid is allocated for this purpose, as investors prefer to focus on projects that pay off quickly, rather than on those that require a longer-term commitment. If they understood the longer-term benefits of investment in tackling nutrition-related challenges, they might be willing to reconsider this approach.

With coordinated and concerted policy action – underpinned by strong political commitment – we can make great strides toward eliminating malnutrition in all its forms, including hunger, micronutrient deficiencies (or “hidden hunger”), and the diet-related non-communicable diseases associated with obesity. With obesity rising fast, there is no time to waste.