In 2010, humanity passed an important milestone. According to the Global Burden of Disease Study, published in the British medical journal The Lancet, obesity became a bigger public health problem than hunger.
Today, according to the latest edition of the study, more than 2.1 billion people — nearly 30 percent of the global population — are overweight or obese. That is nearly two-and-a-half times the number of adults and children who are undernourished. Obesity is responsible for about 5 percent of deaths worldwide.
This crisis is not just a pressing health concern; it is also a threat to the global economy. The total economic impact of obesity is about US$2 trillion per year, or 2.8 percent of world GDP — roughly equivalent to the economic damage caused by smoking or armed violence, war and terrorism, according to new research by the McKinsey Global Institute (MGI).
The problem is likely to worsen. If the current trend continues, almost half of the world’s adult population will be overweight or obese by 2030.
As WHO Director-General Margaret Chan (陳馮富珍) said: “Not one single country has managed to turn around its obesity epidemic in all age groups.”
According to the Organisation for Economic Co-operation and Development, from 2000 to 2013, the prevalence of obesity increased by at least 0.5 percent per year in 130 of the 196 nations for which data were collected.
This global epidemic is not confined to advanced nations. As emerging economies climb out of poverty, their citizens are becoming fatter. More than 60 percent of the world’s obese people live in developing nations, where rapid industrialization and urbanization are boosting incomes and therefore calorie intake. In India and China, the prevalence of obesity in cities is three to four times the rate in rural areas.
Indeed, the evidence suggests that developing nations are especially vulnerable to the epidemic. Obesity rates tend to explode in nations where food was once scarce and suddenly becomes plentiful. In the mid-20th century, for example, a boom in phosphate mining transformed the Micronesian island state of Nauru from a land of food shortages and starvation to the world’s leader in obesity and type 2 diabetes. In 2005, according to the WHO, 94 percent of men and 93 percent of women in Nauru were overweight, and more than 70 percent of the population was obese.
To make matters worse, in nations with limited public health services, the cost of healthcare falls directly on the afflicted households. As a result, obesity can lock in poverty and perpetuate inequality.
Through a review of 500 intervention trials around the world, MGI has identified 74 potential interventions that could be used to address obesity. These include subsidized school meals, urban design that encourages walking, better nutritional labeling, restrictions on the advertising of high-calorie food and drinks, and fiscal measures.
Education concerning the risks of obesity is important, as is taking personal responsibility for one’s health, fitness and weight. However, all the evidence shows that relying on knowledge about obesity and willpower is not enough to offset the evolutionary instinct to overeat. These effects are compounded by lifestyles that require little or no physical activity.
People need help, and that means changing the environmental forces shaping their decisions — by, say, reducing standard portion sizes, altering marketing practices, and designing cities and educational establishments to make it easier for people to exercise or be active.
MGI was able to collect enough data on 44 of the 74 potential interventions to develop an initial assessment of their impact if they were scaled up to a national level. If the UK, for example, were to deploy all 44 interventions, it could rein in obesity rates and help about 20 percent of its overweight and obese population return to a healthy weight within five to 10 years.
Over the long term, savings from reduced healthcare spending and gains from higher productivity could outweigh the investment needed to deliver interventions. In the UK, reversing obesity trends could save the National Health Service about US$1.2 billion a year.
For many nations, tackling obesity will require a national — if not global — effort. Only a coherent, sustained portfolio of initiatives, implemented on a large scale, will be effective. No single entity — government, retailers, consumer goods companies, restaurants, employers, media organizations, educators, healthcare providers or individuals — can address obesity on its own.
We do not yet have all the answers when it comes to the best way to tackle obesity. However, the rapid rise in obesity rates around the world creates a strong case for experimenting with interventions, to see what works. Today, investment in obesity research worldwide amounts to about US$4 billion a year — just 0.2 percent of the estimated social costs of obesity. We can — and must — do more.
Richard Dobbs is a director of McKinsey & Co and of the McKinsey Global Institute. Boyd Swinburn is professor of population nutrition and global health at the University of Auckland and director of the WHO Collaborating Center for Obesity Prevention at Deakin University in Melbourne, Australia.
Copyright: Project Syndicate
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