The number of obese people worldwide has now surpassed 1 billion, a new study has found, with global food systems and technology influencing what and how much people eat.
Obesity is a manifestation of malnutrition that can lead to a range of non-communicable diseases.
At the World Economic Forum’s Annual Meeting in 2024, experts have discussed how governments and the public sector can tackle obesity.
“Undernourished” is most often associated with starving people who are underweight, but the term can also apply to obese people.
Underweight and overweight obesity are called the “double burden” of malnutrition. The number of obese people in the world now exceeds the number of underweight people.
In fact, according to new research published in The Lancet, the number of obese people worldwide has exceeded 1 billion, or about one in eight of the world’s population.
The study collected data from 197 countries, covering more than 99% of the world’s population, to explore changes in the number of underweight and overweight obese people worldwide between 1990 and 2022. “This is a time of tremendous change in food and nutrition.”
Over the past three decades, obesity rates have more than doubled among adults and quadrupled among adolescents ages 5 to 19, the study found.
Southeast Asia is the only region where more people are underweight than obese, while Pacific and Caribbean island nations and countries in the Middle East and North Africa have the highest combined rates of underweight and obesity in 2022.
The study also found that women had higher rates of obesity than men. At the same time, independent research has pointed to a wage gap between obese and non-obese people, and a gender wage gap within obese people, with obese women earning lower wages.
Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO), said the study “highlights the importance of preventing and managing obesity through diet, physical activity and appropriate care services from early life through adulthood.”
Definition and impact of obesity
Zero Hunger is Target 2 of the 17 United Nations Sustainable Development Goals (SDGS), which mandate an “end to all forms of malnutrition” by 2030, including obesity.
The WHO defines obesity and overweight as “abnormal or excessive fat accumulation that poses a risk to health.” Overweight and obesity are complex and multifaceted problems caused by biological, genetic, social, psychological and environmental factors. People often think that obesity is just a result of diet and exercise, but this is actually a misconception.
An estimated 5 million non-communicable disease (NCD) deaths in 2019 were due to excessive body mass index (BMI). BMI is an indicator of whether a person is at a healthy weight based on height and weight.
NCDS, which include metabolic cardiovascular diseases (such as high blood pressure and diabetes) and cancer, account for about three-quarters of all deaths each year.
According to the American Medical Association, obesity can cause more than 200 comorbidities (a person suffering from multiple diseases at the same time), including heart disease and many types of cancer.
The health effects of obesity. Image: WHO
Obese people are more deficient in essential nutrients than those of a healthy weight, according to a study that looks at obesity as the “paradoxical manifestation of malnutrition.”
Malnutrition is a problem that occurs when the body does not receive enough nutrients or is unable to absorb them, and can negatively affect physical performance, cognitive function, and well-being.
Causes of rising obesity rates
Obesity rates are rising because of changes in global food systems and consumption patterns, driven by both economic and technological influences.
Global incomes rose in the decades before the coronavirus pandemic and people spent more on food, the Lancet study found. At the same time, the food system shifted from self-sufficiency and local agriculture to commercial products with an emphasis on transportation.
In short, what people consume has changed. Most people in low – and middle-income countries are able to consume more calories, animal products and sugar.
At the same time, the development of food processing technology and “food industrialization” means that we are eating more ultra-processed foods (UPF). Compared with fiber-rich foods such as whole grains and fruits, UPF causes the body to “consume higher calories and gain weight.”
According to the British Medical Journal, UPF makes up 58% of the diet of American adults.
These foods contain a lot of salt, sugar, additives and preservatives, and are cheap and easy to eat.
“Since the COVID-19 pandemic and the war in Ukraine, poverty rates have risen and food costs have increased, particularly for nutrient-rich foods,” the Lancet study said.
“Climate change will adversely affect food production and supply. These factors may contribute to underconsumption in some countries and households and a shift to more unhealthy foods in others, exacerbating underweight and obesity.”
In addition, decreased energy expenditure among adults due to changes in work and transportation modes may also contribute to rising obesity rates.
Measures to be taken
“There is an urgent global need to prevent obesity, support weight loss, and reduce the risk of disease in obese people,” the authors of the Lancet study note.
“Prevention and management are particularly important because the age of onset of obesity has decreased, increasing the duration of exposure.”
Dr. Tedros Adhanom Ghebreyesus of the WHO commented on the study. To achieve global targets for controlling obesity, “governments and communities need to work vigorously to implement evidence-based policies identified by the WHO and national public health agencies,” he said.
“Private sector cooperation is also important. The private sector must be held accountable for the health effects of its products.”
At the World Economic Forum’s annual meeting in Davos in January 2024, experts discussed tackling obesity.
American Heart Association CEO Nancy Brown, Transcarent founder and CEO Glen Tullman, Burjeel Holdings Plc founder and Chairman Shamsheer Vayalil and Novo Mads Krogsgaard Thomsen, CEO of the Nordisk Foundation, discussed how societies and health systems can be better prepared to meet this challenge.
Echoing Dr Tedros’s comments, the experts noted that obesity is a whole-of-society and system-level problem that requires multi-stakeholder action.
They stressed that we must immediately intervene early, working with parents and families to develop education and awareness efforts, starting with the youngest groups in society.
Solutions include leveraging the impact of food labels, engaging in physical activity, and creating access to healthy foods.
“Most sodium is consumed through bread, but most consumers don’t understand that.” Brown explains.
She noted that incorporating healthy foods into the health care system could significantly improve health in the United States.
But the authors of the study noted that “people with low income and low autonomy do not have access to or afford” healthy foods and active lifestyles.
“Lack of access to and affordability of healthy foods and lack of opportunities to participate in games and sports contribute to inequities in obesity rates and can weaken the impact of policies that address unhealthy foods.”
The study concludes that the world “urgently needs to develop programmes that promote healthy nutrition, such as targeted cash transfers, food aid such as healthy food subsidies or coupons, free healthy school meals, and primary care-based nutrition interventions.”
It is clear to me that in tackling obesity we need to look at the wider healthcare picture and prioritise three key areas:
Strengthen health systems to integrate obesity care and management into routine primary care.
Strengthen the training of healthcare professionals, as few are adequately trained on obesity or nutrition.
Increase investment in research and ensure that people have equitable access to care, as obesity can have a particularly severe impact on certain groups, often low-income people
Businesses also have a role to play. The World Economic Forum’s Healthy Workforce initiative calls for multi-stakeholder collaboration to use the workplace to improve the overall well-being of employees, families and society as a whole.
An important part of the initiative is work on healthy weight and metabolism, which focuses on raising awareness, sharing best practices and supporting a whole-of-society approach to tackling obesity.