Title: The Shocking Reality of Global Malnutrition: More than 1 Billion People Living with Obesity
The world is facing a startling reality when it comes to malnutrition. According to a recent analysis published in The Lancet, over 1 billion children, adolescents, and adults are living with obesity worldwide [1]. This staggering figure was reached earlier than anticipated, largely due to the rapid transition from underweight to obesity in low-income and middle-income countries.
Previous predictions by the World Obesity Federation suggested that there would be 1 billion people living with obesity by 2030 [2]. However, this number has already been surpassed in the year 2022. “We’ve really been taken aback by how fast things have happened,” said Dr. Majid Ezzati, senior author of the analysis and professor at Imperial College London [1].
The research for this global analysis was conducted by more than 1,500 researchers from the Non-Communicable Diseases Risk Factor Collaboration and the World Health Organization (WHO). The analysis focused on rates of underweight and obesity, two Website contact forms of malnutrition that have detrimental effects on people’s health. The researchers analyzed the height and weight measurements of over 220 million people from more than 190 countries [3].
Adults were classified as obese if their Body Mass Index (BMI) was greater than or equal to 30, and as underweight if their BMI was below 18.5. Children and adolescents were defined as obese or underweight based on age and sex criteria [3].
“Undernutrition and obesity are two faces of the same problem, which is the lack of access to a healthy diet,” said Dr. Francesco Branca, director of the WHO Department of Nutrition and Food Safety [1]. The analysis estimates that nearly 880 million adults and 159 million children lived with obesity in 2022. Obesity rates among children and adolescents increased fourfold from 1990 to 2022, while obesity rates among adults more than doubled [3].
It is concerning that the epidemic of obesity, which was evident among adults in much of the world in 1990, is now mirrored in school-aged children and adolescents,” Ezzati said [3]. While obesity rates increased, the number of people affected by underweight fell in most countries. Obesity rates are now higher than rates of underweight in two-thirds of the world’s countries, according to the analysis [3].
This transition has been most evident in low-income and middle-income countries, particularly in Polynesia and Micronesia, the Caribbean, and the Middle East and North Africa. These countries now have higher obesity rates than those of many wealthy industrialized countries [3].
The island nations of Tonga, American Samoa, and Nauru had the highest prevalence of obesity in 2022, with more than 60% of the adult population living with the condition [3]. “In the past, we’ve been thinking about obesity as a problem of the rich. Obesity is a problem of the world,” Branca said [1].
None of the industrialized wealthy nations except the United States were at the top of the list for countries with the highest prevalence of obesity in 2022 [1]. Ezzati was surprised to find this change, as in 2017, the WHO’s similar global obesity analysis found the US, Canada, Australia, New Zealand, and the United Kingdom in the top category for prevalence of obesity [1].
“What this shows is that this transition is very rapid. We cannot wait to get rid of underweight to deal with obesity,” Ezzati said [1]. The obesity transition is the result of the rapid restructuring of food systems worldwide that has not been governed by public policy, according to Branca [1].
Policy action has not been incisive enough. There has been a reliance on behavior change, but solutions have not touched the structural element, which is the policies around food and environment [1]. To address both Website contact forms of malnutrition, double duty policy interventions are needed. These include promotion and support of breastfeeding, taxation of sweetened beverages, regulation of food marketing that targets children, and the provision of nutritious food in public institutions like schools [1].
Agricultural reform, urban design, and primary health care investment can support these policies [1]. “Getting back on track to meet the global targets for curbing obesity will take the work of governments and communities, supported by evidence-based policies from WHO and national public health agencies,” said Dr. Tedros Adhanom Ghebreyesus, the WHO director-general [1]. Importantly, it requires the cooperation of the private sector, which must be accountable for the health impacts of their products.
Public policy must aim to improve monitoring of food manufacturers and ensure equitable access to healthy, nutritious food for everyone [1]. “One of the roles of policy is to bring good health to people before they are wealthy,” Ezzati said [1].
WHO has partnered with other agencies like the United Nations International Children’s Emergency Fund to release frameworks such as the Global Action Plan on Child Wasting and the Acceleration Plan to Stop Obesity [1]. Encouraging results have been seen through policy changes worldwide, like France’s national plan called Programme National Nutrition Santé and South America’s front-of-package nutritional labelling [1].
Mexico’s taxation of sweetened beverages and Chile’s ban on processed foods marketing to children are other examples of effective policy interventions [1]. “The community interventions which integrate promotion of healthy diet and physical activity have been particularly effective,” Branca said [1].
[1] The Lancet: More than 1 billion people now living with obesity: The Lancet’s coverage of the study.
[2] World Obesity Federation: More than half the world will be overweight or obese by 2035, report predicts.
[3] The Lancet: Global Obesity: Prevalence and Trends from 1975 to 2016: The research article itself.
