Conditions of overweight and obesity are defined by an excess of stored fat
and a body mass index (BMI), a number derived form a height – weight equation, of above 25 or 30 respectively. Morbid and malignant obesity form a subset of obesity where BMI reaches above 40 or
50 respectively. Worldwide obesity has established epidemic status as the new
term “globesity” gains popularity. While hereditary obesity, and
“obesity genes”, has been explored, their legitimacy has been considerably discounted. Analysts cannot deny the evidence that the phenomenon has emerged on the global health radar only in recent
history. This timeline falls short of demonstrating a genetic shift towards obese
individuals. The conclusion is consistent: lifestyle choices are the driving force behind world weight gain. Statistics show
that prevalence in the developed world is setting the trend for many developing countries.
Most Recent Obesity Statistics for the United States
- 58 Million Overweight; 40 Million Obese; 3 Million morbidly Obese
- Eight out of 10 over 25's Overweight
- 78% of American's not meeting basic activity level recommendations
- 25% completely Sedentary
- 76% increase in Type II diabetes in adults 30-40 yrs old since 1990
Obesity and Disease
- 80% of type
II diabetes related to obesity
- 70% of Cardiovascular
disease related to obesity
- 42% breast and
colon cancer diagnosed among obese individuals
- 30% of gall
bladder surgery related to obesity
- 26% of obese
people having high blood pressure
Obesity in Children
- 4% overweight
1982 | 16% overweight 1994
- 25% of all white
children overweight 2001
- 33% African
American and Hispanic children overweight 2001
- Hospital costs
associated with childhood obesity rising from $35 Million (1979) to $127 Million (1999)
- 60% already
have one risk factor for heart disease
SOURCE: Wellness International Network Ltd - web.winltd.com
Moreover, the costs of excess weight and obesity are many fold. The emergence of diabetes as a global epidemic can not considered separately from the decline in Western
nutrition and activity levels.
Ranked fourth or fifth leading cause of death in most developed states, diabetes
is demanding the attention of governments and health care officials around the globe.
With 194 million diabetics world wide - this figure is expected to double in the next twenty years - diabetes is one
of the top ranked non-communicable diseases. While the developed world, North
America in particular, leads the pack in terms of percentage, the greatest relative and absolute increases are projected to
occur in the developing, and newly industrialized world, caused especially by the growing emergence of malnutrition (the new
"type", not the traditional type), sedentary work and leisure activities, overweight and obese individuals, urbanization and
a growing - and aging- population. This prevalence trend is especially problematic
as insulin is considered unaffordable and/or is often unavailable in developing counties.
Furthermore, diabetes is expected to occur in younger age brackets in the developing world (45-65), than in the developed
world (65+). Such a pattern will take a significant toll socially and economically
as diabetic people are forced - either fully or partly - out of the labour pool earlier than anticipated or desired.
|IGT: Impaired Glucose Tolerance
IGT: Impaired Glucose Tolerance
Diabetes occurs in two principal forms.
Type 1, insulin-dependant, primarily affects youth (although recent evidence has shown the contrary), and is caused
by a malfunction in the pancreas where insulin is produced. Genetic patterns
have been identified in relation to type 1 that cause an autoimmune attack on the pancreas' beta cells -the site of insulin
production. Type 2 diabetes, non-insulin-dependent, or adult-onset, accounts
for 90% of today's cases. Traditionally occurring in adults, type 2 has been
increasingly detected in children and adolescents in recent years. A strong familial
correlation exists between type 2 cases, however, the driving forces are obesity, unhealthy diet and low levels, or lack,
of physical activity. In addition, higher numbers in ethnic populations have
According to the International Diabetes Federation (IDF), 45% of adult diabetics
are between the ages of 40 and 59, accounting for 88 million cases. IDF's projection
for 2025 expects 146 million cases in this age group, and 147 million aged 60 or above.
Females tend to comprise an average of 10% more cases than males, this may be due to a higher rates of female obesity
compared to males. Diabetes prevalence in children has brought about especial
alarm as it reaches previously unimaginable levels. For example, in 1990 in the
United States, four percent of child diabetics were type 2; today twenty percent
are type 2. Moreover, 85% of type 2 child diabetics are obese, and one in four
overweight children exhibit signs of type 2 diabetes.
Diabetes prevalence in urbanized societies consistently outpaces prevalence
in rural areas with 78 and 44 million cases respectively. Estimates for 2025
show an over 130% increase in urban populations - 182 million -, and approximately 40% in rural populations -61 million. This connection is likely due to greater frequency of sedentary jobs, convenience
technology and processed, fast food that so pointedly mark "developed city life". The
advent of fast/processed food in developing urban centres may be especially disturbing.
Studies show that indigenous populations that are exposed to processed food for the first time are not physiologically
equipped or genetically capable of coping with its effects. That is to say that
people who have not been incrementally exposed to such foods for generations (as is the case for most Westerners) do not possess
the digestive mechanisms to metabolize the nutrients, thereby causing extreme reactions in their blood sugar levels and digestive
organs. This effect has contributed to soaring rates of obesity and diabetes
prevalence in newly urbanized centres of the developing world. As traditional
diets continue to be swallowed up by the globalization of Golden Arches, Burger Kings and Dairy Queens, this problem does
not appear to be waning despite rising concern analysts and nutrition specialists.
The rise and spread of type 2 diabetes is undeniable. Its connection with obesity and lifestyle choices paints both a foreboding and hopeful picture for the
future. On the one hand, as more societies adopt, or are transformed by, developed
lifestyles, social and environmental factors may create a feedback mechanism that will only further encourage these health
problems. That is to say, if fast food becomes the norm and sedentary jobs and
leisure activities are preferred to physical activities, a potentially less nutritionally healthy and more overweight and
out of shape population will result. Such a population is likely to make less
healthy choices in the future as their norms and lifestyles become rooted in unhealthy practices. Someone that eats fast food every day is increasingly unlikely to choose a walk over a television program
as they become increasingly malnourished and unable to cope with physical demands, especially as the effects of obesity and
diabetes are diverse.
Diabetes has been recognized as a leading catalyst for stroke, neuropathy, blindness,
renal failure, 'diabetic foot' - often leading to amputation, and cardiovascular disease.
Cardiovascular disease, in fact, accounts for 70-80% of diabetic deaths. The
social and economic costs or mortality and morbidity effecting younger and younger populations are also considerable. IDF estimates a 7-13% expenditure of the world's health care funds to be devoted to
diabetes by the year 2025.
Urbanization & Industrialization - A Need to Clear the Air
More development typically means more cars, more factories and more people. As urbanization and industrialization flourish, so do pollution and air particulates. Asthma affects 100 to 150 million people globally, accounting for economics costs
greater than the cumulative Tuberculosis and HIV/AIDS combined. Asthmatics have
doubled in number in Western
Europe in the last decade. Over 180,000 lives are claimed per year
by asthma and this number will continue to rise, as affliction rates increase by 50% per decade.
Scientists have linked urbanization to the increase in asthma prevalence. Cities consolidate emissions from industry, automobiles, and tobacco smoke into areas
of high population density, impregnating the air with irritants, allergens and particulates.
The issuance of smog warnings both more frequently, and in increasing numbers of locations is exemplary of these conditions.
The costs of asthma cannot be overlooked.
Its affects can be socially and economically crippling for both individuals and societies. Absence from, or decreased ability at, the workplace cause governments, employers and asthmatics to pay. Britain
for example, currently spends in the neighbourhood of 1.8 billion USD on asthma health care and due to days absent caused
by illness. The United States
and Australia spend 6 billion USD, and
460 million USD respectively on direct and indirect costs of asthma.
While asthma consistently plagues the developed world, its presence in the developing
world is irregular. This is due in part to variable stages of industrialization
and urbanization. Heavy industry, pollution and highly dense populations set
the stage for asthma and other respiratory problems.
One must only look to Beijing,
China for evidence of these effects. Experiencing the greatest vehicle emmision pollution in the world, and placing one of the two most sulfur
dioxide contaminated environments worldwide, Beijing’s
citizens feel the effects. Dizziness, sore throats and lung/respiratory
problems have been only a handful of the symptoms suffered by residents of the largest centre of vehicle exhaust sediment.
More information is available on this website on the page titled “The
Effects of Industrialization”.
Increased Disposable Income: Money to Burn
Development and economics are inextricably linked.
Many development specialists claim that development is contingent on economic growth within a country. This is corollary with increased per capita GDP creating, once a critical income is surpassed, disposable
income. This ‘surplus’ is used to purchase consumer goods and services
such as property, entertainment or travel. While this consumption can admittedly
bring pleasure, it can also be destructive. Drug and alcohol use and trafficking
- while in some respects timeless – is an area of mounting concern in the world today.
Consumption of alcohol has increased globally, with especial concentration of increase
in the developing world. This phenomenon may be linked to an influence of Western
trends as many countries where alcoholism is increasing have little history of use.
When alcohol is relatively modern development, countries lack the regulatory systems to control distribution or provide
treatment. There are currently 76.3 million cases of alcohol use disorders.
|DALY: Disability Adjusted Life Years
Richer societies able to afford the “luxury” of drug use have created
an irresistible market for drug production in the developing world. When the
market value of growing or selling drugs is higher than that of a minimum wage job, and regulatory and/or punitive mechanisms
are inconsistent or inadequate, the cost-benefit analysis of the drug trade is clear.
Nevertheless, developed societies are not the only drug users. Producer
countries are often heavily populated with users as availability is high and punitive measures are low or easily avoided. Moreover, in many countries where the drug trade is prominent, governments are frequently
corrupt, turn a blind eye, or are overcome by guerilla forces. Colombia
is a famous example where there are very few opportunities with a lucrative equivalent to coca farming, and guerilla forces
dominate the agenda.
The societal costs of drug use are myriad as the effects of production, trafficking
and use permeate many facets of society. With 15.3 million diagnoses of disordered
drug use reported in 2003, the time for treatment and prevention investment is now.
Studies by the World Health Organization show that for every one dollar invested in treatment, seven dollars in social
and health care costs are saved. This is especially pertinent as, of 136 countries
reporting intravenous drug use, 93 of them also reported having cases of HIV/AIDS it citizens.
|DALY: Disability Adjusted Life Years
The number one enemy of health around the world, tobacco stands its ground. The world’s 1.1 thousand million smokers, accounting for about 33% of the over
fifteen population, are continuing to smoke despite global public health alarms. While
number of daily cigarettes and number of smokers is greater in the developed world, the World Health Organization recognizes
an equalization on the horizon as increased take home income in the developing world permits higher cigarette consumption. Also relevant to the developing world, World Bank data highlights a correlation between
low levels of education and greater prevalence of smokers.
Responsible for over 90% of lung cancer in men
and 70% in women in the industrialized world, as well as significantly contributing to chronic respiratory diseases and cardiovascular
disease (56-80%, and 22% respectively), tobacco is estimated to cause almost 9% of global mortality – that’s 4.9
million lives. If today’s trends continue, deaths will double – 10
million – in the next 20-25 years, with the majority – 70%- occurring in the developing world.
The adverse health effects of tobacco use are now highly publicized in developed
countries. This public health campaign has raised awareness and been the menace
to big tobacco companies like Phillip Morris or Malboro. As a result relative
numbers of smokers in high income countries has declined. Corollary to this,
rates of quitting in high income countries are substantially higher. In the early
1990s, approximately 30% of high income male populations were ex-smokers, whereas only 2% of Chinese males and 5% of Indian
males were. Moreover, the original demographic has shifted, a decline in male
smokers has occurred simultaneously along an increase in female smokers and males in low income countries. Despite bad publicity, tobacco companies continue to push their products ever searching for new markets,
most notably targeting the developing world. Marketing cigarettes as developed
status symbols or to children have been dominant strategies. This relocation
has been furthered by free trade agreements opening developing markets to cigarette companies.
The World Bank estimated that, for Japan, Thailand, Taiwan and South Korea, cigarette consumption was ten percent higher
than it would have been had the markets not been opened to American trading partners1. What is more, World Bank estimates calculated 14,000 – 15,000 youth starting smoking per day in the
developed, high-income world, significantly dwarfed by the 68,000 – 84,000 in the developing middle and low income world. In sum, this estimate suggests a staggering 82,000 – 99,000 new youth smokers
around the world per day, exposing themselves to the perils and addictive nature of tobacco and nicotine.
from our Mistakes: Brightening the Shadow of the Future
picture painted for the developing world in this paper is not only sobering, but downright frightening. With such a great population following heavily in the developed world’s footsteps, especially considering
questionable abilities to grapple with such problems and their inherent magnitude, declining economies and climbing morbidity
and mortality seem inevitable. However, all hope is not – and perhaps should
never be – lost. Combating these health problems requires an international
effort. Advances already made, or cures already discovered, in the West must
be shared, breaking down boundaries like medication availability and/or cost barriers.
Equally, if not more importantly, should be universal lessons of prevention.
The safest and most cost effective form of healthcare, preventative measures can steer the world – the developing
world in particular- clear of the shadow of statistical analysis extrapolated for the future.
Moreover, preventative measures for obesity and diabetes for instance, are typically easy and accessible by all socio-economic
classes. The first, safest and most beneficial line of defense is a healthy diet
and moderate exercise. Mass anti-drug, alcohol and tobacco campaigns have demonstrated
positive effects in the developed world, and can be easily adapted to other countries.
Advances in alternative energy technology reducing the necessity of oil and gas for energy should be widely publicized
and marketed. (There is, admittedly, an inherent difficulty in this statement,
as companies will want monopoly rights and prices on such technology.) While
today’s problems are unavoidable, tomorrow’s may be. However, this
process will be by no means automatic. World leaders must take a liberal stance
towards global health, collaborating to achieve absolute, mutual gains.
1. “Global Trends in Tobacco Use”. World Bank Publication. Page 14. http://www1.worldbank.org/tobacco/book/pdf/02-Tobacco-Chap1.pdf
For further information on the global distribution of diabetes and other health problems follow links below to interactive
Current and predicted Diabetes distribution
Global Health Atlas