UN goals on diet-related disease will fail to be met because of the soaring numbers of people becoming obese or overweight, with almost 1 billion of the world’s adults projected to be obese by 2025, analysis shows.
Experts warn that targets will not be met because of the spread of the westernised diet around the globe as a result of heavy marketing by the food industry.
Concern over the rise in diabetes, heart disease, cancer and other conditions fuelled by obesity led to a UN summit in 2011, where the World Health Organisation (WHO) was commissioned to set targets to bring down the alarming rate of weight gain across the planet. It set a goal for 2025 of no increase in obesity or diabetes beyond the levels of 2010.
But the latest statistics suggest the world will spectacularly fail to meet the target, says the World Obesity Federation (WOF). In 2010, 11.5% of adults, or 565 million people, were obese. By 2014, that had already risen to 13% (670 million).
The charity, analysing the data before the firstWorld Obesity Day on Sunday, says that if the trajectory does not change, 17% of adults will be obese by 2025. There will be 170 million adults with a BMI above 35, which is the threshold for urgent medical treatment, such as gastric surgery, to reduce the amount people can eat. But even in affluent countries, there is insufficient capacity for those who already need help.
Adding in those who are overweight as well as obese, by 2025 there will be about 2.7 billion with excess weight, up from 2 billion in 2010.
“What we have seen is, on the WHO’s own estimates, a pretty dramatic increase from 2010 to 2014,” says Dr Tim Lobstein, WOF’s director of policy. “On their own figures, they are shooting upwards and if we were to carry on without doing anything, things can only get dramatically worse.”
Behind the world’s weight gain is the rapid transition from traditional foods, often grown in the community, to modern urban diets – and especially the take-up of sugary soft drinks and snacks. Increased sedentary behaviour is also a major issue.
The WOF blames the multinationals, known as Big Food. “Their marketing strategies are to reach further and further into developing countries, to find ways they can increase their market share amongst even the lowest income populations,” says Lobstein.
He cites the efforts of some of the multinationals, including Nestlé and Coca-Cola, to encourage women in poor communities to start small-scale businesses selling processed food products to their neighbours.
Obesity rates look to be levelling off in the wealthier countries of North America and Europe, although there is no sign of a downturn and the statistics disguise alarming differences between the rich and the poor within those nations. But developing countries have shown an escalation in obesity rates never seen before. The United States no longer leads the world in obesity, having been overtaken by some 18 states, from the Caribbean to the Middle East and the Pacific islands.
Child obesity figures are also rising in many developing countries, particularly in the Middle East, Latin America, China and parts of south-east Asia, which means there will eventually be further worsening of the adult figures.
A big problem is the assumption that children in developing countries are under-nourished and need more calories. Even where that has been true, says Lobstein, giving children highly calorific sugary drinks and snacks is not the answer. In Mexico, which has some of the highest levels of child obesity in the world, in 2012 the two largest contributors to children’s energy intake were milk – much of it sweetened milk drinks – and sugar-sweetened soft drinks.
Many children in the Middle East do not eat breakfast, surveys show, which leads to unhealthy snacking during the day. “A survey among pre-school children in Jordan found more than 50% consumed carbonated sugary beverages, and 71% regularly consumed biscuits and cakes, and 76% confectionery,” says Lobstein. “These children also consumed other sugar-sweetened soft drinks, a high quantity of desserts, and tea with sugar.
“While concerns about child nutrition remain dominated by the language of under-nutrition and the adequacy of food supplies, these problems will only get worse.”
We know how to tackle obesity, he adds. “Preventing obesity means tough government action to limit the promotion of junk food, especially to children, to ensure healthier food is offered at work, in schools and institutions, and to encourage physical activity through better urban design and transport systems.
“Like climate change, we know the answers to the obesity crisis. We know that tough policies will need to be implemented, and we know that such policies are challenged by powerful commercial interests. But we have no choice if we hope to meet those 2025 targets.”
Asked about the prospect of missing its target, a spokesperson for the WHO says: “Indeed the rates of overweight and obesity are increasing globally. WHO has not made predictions on what the prevalence of overweight and/or obesity may be in 2020 (the next reporting period) or at the final reporting period of 2025 as we can’t assume the rate of increase will continue and we must take into account the changing of global population structures.
“We do not see at this time that the current global target of “no increase in obesity” will be met in adults or adolescents unless urgent focused action to reduce overweight and obesity is taken by countries and other stakeholders.”
Australia – a miss-match between reputation and reality
In 2011 the rural Australian town of Ararat was named the fattest town in the state of Victoria by a national health survey. Twelve months later the unwelcome title prompted a visit from weight-loss reality TV show, The Biggest Loser, and the community came together to turn the numbers around.
Regional and remote-living Australians are already about 15% more likely to be obese than metropolitan residents, but almost 60% of the Grampians town’s population was obese, the data revealed.
The same year Ararat hit the headlines, a study predicted Australia was on track for almost 80% of its population to be overweight or obese by 2025. It is currently at more than 63%.
Despite a reputation for sport and outdoor living, Australia has one of the fattest populations on the planet. Its rate of obesity is the second-fastest growing in the world, and the fastest among women, according to the Australian Institute of Health and Welfare. The figures from the World Obesity Federation show Australia now has 62 severely obese people per 1,000 adults, up from 55 in 2010.
“We’ve engineered exercise out of our lives,” said Jane Martin, executive manager of the Obesity Policy Coalition (OPC). There’s a real problem with diet, and highly processed foods are very cheap, highly promoted and easily available.”
Martin, whose background is in public health and tobacco policy, said that of particular concern was the fact that more people were moving from the “overweight category to the obese category”.
Diseases associated with obesity and being overweight have financial impacts as well as health ones. An Australian Diabetes, Obesity and Lifestyle study in 2005 estimated an annual indirect cost of AU$21bn (£12bn) and a direct cost of $35.6bn to the economy.
In Ararat, the appearance on The Biggest Loser gave the town of 8,000 people the financial means to launch their own health kick.
The Activ8 programme runs for three months a year with eight participants receiving a mentor, a trainer and a gym membership free of charge. But the knock-on effects go much further as family and friends are included, says Ararat council’s Angela Hunt.
“Health and wellbeing is now front of mind for people when it wasn’t before. As soon as this stuff started to happen we saw a lot more people out walking and moving and trying to make changes.”
The council has set up more walking tracks and outdoor exercise equipment, and Hunt jokes that Ararat has the healthiest pets in the country. A big part of the town’s success is the gentle and non-judgmental support residents give each other, she says.
“Some are just starting out now, and some have been going for two years. By having waves of new people … it kind of re-motivates those who have been at it for a couple of years, and there’s something really powerful about people helping other people.”
The data which put Ararat in the national spotlight is gathered every three years and takes three years to analyse. This means the town will not have comparable statistics until six years after those 2011 headlines. But in the meantime its residents keep going, and are happy to share their success.
“There’s still lots of things others can do without the national spotlight,” says Hunt.
The OPC is lobbying for government intervention in the form of a tax on sugary drinks, restrictions on marketing of junk food when kids can see it, and labelling on food in supermarkets and in fast-food outlets.
“This problem is driven by availability, price, and promotion. That’s why it’s important to address those elements,” says Martin.