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Wide world

Obesity is no longer a North American issue

If you have any money stuffed under your mattress you’re afraid to invest in the high tech economy, you might want to think about investing in commodities – i.e. sugar and cotton. The world is gaining weight on high calorie, high fat diets, and hundreds of millions of people are going to need bigger pants.

According the International Obesity Task Force (IOTF), the proactive wing of the International Association for the Study of Obesity, there are over 300 million obese people on this planet, and that number is expected to continue to climb through the first part of the 21 st century. Obesity rates have more than doubled in some countries since obesity was first recognized as a disease a half century ago. And, according the World Health Organization, there are now more obese people (8.2 per cent) on the planet than underweight people (5.8 per cent).

In 1999, the University of Laval in Quebec compiled regional statistics on obesity from around the world, compiling data on what the IOTF is calling the "Millennium Disease," and a "Global Epidemic."

The prevalence of obesity has increased between 10 and 50 per cent in European countries in the last 10 years alone. The most dramatic increase has been in the United Kingdom, where obesity rates have more than doubled since 1980. As a whole, the reported prevalence of obesity in Europe is 15 and 22 per cent for men and women respectively.

In Western Samoa, an estimated 77 per cent of all males are obese.

In the Republic of South Africa, approximately 44 per cent of all black women have caught the disease.

Between 1989 and 1992 – pre and post Berlin Wall – East German obesity rates for men and women between 25 and 74 have nearly doubled – from 13 and 21 per cent for men and women respectively, to 21 and 27 per cent.

In the U.S., 19.9 per cent of men and 24.9 per cent of women are obese.

In Canada the average is 13.5 per cent for men and women, but the number of overweight children has increased from 15 per cent in 1981 to 35.4 per cent in 1996. The prevalence of obese children has tripled over the same period, from 5 per cent in 1981 to 16.6 per cent for boys in 1996, and 5 per cent to 14.6 for girls in the same period – if the trend continues, we will have a higher per capita rate for obesity than the U.S. in the next 10 years.

Recent estimates suggest that between two and eight per cent of the total sick care costs in Western countries are attributable to obesity.

In general, obesity has been linked to respiratory difficulties, musculo-skeletal problems, skin problems, and infertility.

In more serious cases it has been linked to diabetes, gallbladder disease, cardiovascular problems (stroke, hypertension, coronary heart disease), and cancers which are home related and associated with the large bowel. Hypertension, diabetes and raised serum cholesterol are between two and six times more prevalent among heavier women, and mortality rates are 12 times higher for severely obese men and women.

Psychologically, obesity has been tied to lowered self-esteem and clinical depression. Rates of anxiety and depression are three to four times higher among the obese.

The Canadian Medical Association estimates that the direct cost of obesity in 1997 alone was $1.7 billion, accounting for nearly 2.4 per cent of all health expenditures – and that’s just in cases where a direct correlation between weight and illness can be proved. When you factor in our low general fitness levels and the fact that a third of Canadians are overweight, the cost of our indolent lifestyles is much higher.

While these statistics certainly warrant our immediate attention, and suggest the need for more physical education for the young and more programs and education for Canadians of all ages, it’s clearly a global problem – and a global problem needs a global solution.

Consider China – 1.3 billion people who until recently subsisted largely on rice, fruit, vegetables, and the occasional serving of meat or fish. Dishes were simple, the use of sauces was minimal, and people were active.

As that nation rapidly becomes more Westernized, however, the obesity problem is surfacing just as rapidly.

At the 11 th European Congress on Obesity last May, Professor Chunming Chen of the Chinese Academy of Preventative Medicine said obesity is already reaching epidemic proportions – "It has been going up in the last decade. If you compare 1982 to 1992, it is almost double. You can see that in the future it will be growing very, very quickly."

Although it was estimated by the IOTF that five per cent of Chinese – approximately 65 million people – are obese and that 30 per cent – 390 million people – are overweight, Chen said that the numbers were probably much higher because the figures are based on Western body weight standards.

Professor Philip James, chairman of the International Obesity Task Force, said that million across Asia and elsewhere are already "doomed in the womb" to be especially vulnerable to abdominal obesity with a higher risk of developing diabetes, hypertension and heart disease.

"We have seen the warning signs of this already with an explosion in the levels of overweight and obesity in China and Asia. The problem is growing rapidly in India too. The developing world is not only catching up, but is set to overtake the West. It faces a huge epidemic which no one is really prepared for."

That’s not to suggest that we’ve wiped out World Hunger – famine continues to haunt the poorer nations of this planet. But as prosperity and development spreads (and it’s taking its sweet time because we haven’t wiped out poverty either), so does obesity.

Unlike most diseases, you don’t contract obesity by drinking the wrong water or through bad genes – although some people are genetically disposed to weight gain – it comes from eating too much of the wrong things and not exercising. For that reason, obesity gets little sympathy and even less attention.

Packing on pounds is viewed as a personal choice, whatever the underlying causes are, and governments are loathe to interfere because their efforts can be misconstrued as an attack on personal liberty – the cornerstone of any democracy – and bigotry at its worst.

At the same time, groups of overweight people have accepted the stigma of being overweight and even take a certain pride in being true to themselves – challenging anyone to judge them based on their appearances. It’s not about looks, however, it’s about health.

In the developed world, there are no hard and fast rules over who gets fat. Poor people are generally more disposed to obesity for a combination of factors, such as a lack of education, the perceived cost of fitness, and the fact that high calorie and high fat foods are by and large cheaper, easier and more appealing than healthy alternatives. To a certain degree, it has also become socially acceptable to be overweight.

More and more careers involve sitting at desks, and long hours on the job means less recreational time to exercise and eat healthy. Habits have also changed, with people spending more time in front of televisions and computer screens in their recreational time. Family structures have changed, and busy parents often have to rely on fast food to feed the family rather than a home-cooked meal.

There is also a shortage of green space in urban areas, poor city planning that practically makes it impossible to shop unless you have a car, and far less emphasis on playing sports from a young age.

Those are just a few of the reasons given for the Western weight-gain phenomenon, and by emulating the Western consumer ideal, other countries are falling into the same trap.

To combat the problem on a global scale, the IOTF knows it has its hands full in convincing global leaders that something can be done to address the problem. Working with the World Health Organization, they have created five groups to look at different aspects of the problem.

Prevention — Halting the drift from overweight to obesity through education and fitness, and by convincing health care systems to assume more responsibility, funding programs and treatments for the overweight.

Childhood Obesity — It starts when you’re young. The IOTF believes that by combating obesity at an early age, starting programs to make kids more active and teaching parents how to feed their families better, the problem can be headed off later in life.

Management — Weight management is a lifelong goal, and the IOTF believes that the state could help at every stage by guiding patients in the right direction at the right time, as our bodies go through changes.

Health Training — Improving professional understanding of obesity, its causes and effects, will result in better treatments and better advice from personal physicians.

Economic Costs — Because obesity impacts on health care costs, it affects everyone at some level. By assessing the true financial burden of obesity, it will be easier to convince governments to invest in the programs and policies that could solve the obesity problem.

While Whistler doesn’t have a real problem with obesity (and while B.C. is the fittest province in the nation, according to a recent Statistics Canada study) a good chunk of our tax money is still going towards the treatment of the obese and overweight.

More than $1.7 billion a year, to be precise – a good start towards solving our collective hospital staffing and striking problems.