Obesity is no longer a "first world problem"

 

For most of history, being overweight was a sign of prestige, signalling you were one of the lucky few who could afford to overeat while most people were struggling not to starve. Things have changed a lot since then. Undernourishment remains a major problem, affecting some 820 million people worldwide, but the opposite issue has become even more prevalent, with around 670 million people being obese (body mass index, or BMI, over 30) and another 1.4 billion being overweight (BMI over 25). Industrial- scale agriculture has made food much cheaper (particularly meat), food giants have loaded their products with high-fructose corn syrup and saturated fats, and people in developed countries live an increasingly sedentary lifestyle.

As a result, obesity and all the health complications it brings are no longer a rich people problem. In fact, in the United States and other developed countries, it's actually the working class that's been disproportionately affected by the obesity epidemic, in part because living a healthy lifestyle takes time and money that they often don't have.

This made me curious: how does the correlation look on an international level? In order to visualize the relationship, I decided to create this scatterplot, with GDP per capita (adjusted for cost of living) on the x-axis and obesity rate on the y-axis. 

There is obviously a correlation, seeing as there are still many parts of the world where hunger remains a massive problem. But it's not a perfect correlation--in fact, obesity rates are at their highest for middle income countries, and after that there's actually a slight downward trend, with wealthy Western European countries having somewhat lower obesity rates than poorer countries in Eastern Europe and Latin America. Perhaps in middle income countries, similar to the situation of the American working class, people have enough money to afford plenty of the junk that's so readily avaliable on the grocery store shelves but not enough money (or time) to pursue a healthy lifestyle. 

But to me, what's more interesting than looking at the trends is looking at the outliers. There are three regions that stand out as having higher obesity rates than their incomes would predict: the Arab world, the Anglosphere, and above all the Pacific Islands.

The nine highest obesity rates in the world can all be found in the Pacific Islands, where the average BMI falls into the obese category. Such countries have been flooded with cheap American products loaded with high-frustose corn syrup. Americans also developed a tradition of sending loads of cholesterol-rich turkey butts--the only part of the bird we eschew on Thanksgiving--to impoverished Pacific Islands, where it became a dirt-cheap source of calories. However, part of me can't help but think that there's a genetic component to this, and Polynesians tend to have bigger frames regardless of their health--after all, look how many of them play in the NFL.

The Arab world also has remarkably rotund waistlines. Filthy-rich oil states like Saudi Arabia, Bahrain, Qatar, Kuwait, and the UAE have some of the highest obesity rates in the world, while poorer countries like Egypt, Lebanon, Jordan, and even war-torn Syria and Libya are not far behind. In this case, there is indeed evidence of genetic factors. Arab foods tend to be fatty, and the climate in many countries is hardly conducive to an active and outdoorsy lifestyle. Cultural factors are also part of the equation, as traditionally obesity is seen as desirable in women in Arab culture.

And of course, I bet no one is surprised that America is near the top of the list. The US is the birthplace of fast food. We consume notoriously big potion sizes, and eating red meat every day is consider the norm. In addition, most US cities are designed in a way that makes it nigh impossible to get around without a car, meaning Americans walk far less than other countries. Unsurprisingly, the same factors contribute to high obesity rates in our close cultural cousins such as Canada, Australia, New Zealand, and to a lesser extent, the UK. Either that, or English is simply a high-calorie language.

Before I go, I should note that BMI is by no means a perfect predictor of someone's health. Other factors, such as cholesterol levels, body fat percentage, blood pressure, and heart rate, are more directly consequential. Indeed, most professional athletes are technically considered overweight because muscle weighs more than fat. But on the whole, BMI is the best rough approximation we have, and the idea that one can be "fat butt fit" is simply a myth.