The fat, the starving, and global warming


LONDON — Being fat is the new normal, but it won’t last. The global surge in overweight people is concentrated among lower-income city-dwellers, and some may choose to slim down as they climb further up the income scale. (“You can never be too rich or too slim.”) But the real guarantee of a slimmer world, unfortunately, is climate change.

“Obesity is the norm globally, and under-nutrition, while still important in a few countries and in (certain groups) in many others, is no longer the dominant disease,” said Dr. Barry Popkin of the University of North Carolina last week at a conference in Queensland, Australia.

Popkin studies “nutrition transition,” the changes that accompany the shift from a traditional rural diet to a modern urban diet, and he has concluded that thanks to high-speed urbanization, the fat now outnumber the starving.

We have grown accustomed to Americans who look almost perfectly spherical, and we are seeing more and more Europeans who seem to aspire to the same goal. Popkin’s point is that this is not due to some moral failure in the American and European populations, but to the changes that come with urbanization: higher incomes, mass marketing of processed foods, and work patterns involving much less physical labor.

His proof is that the rates of obesity in developing countries undergoing rapid urbanization are rapidly catching up with the levels in the rich countries.

Mexicans of all ages and both sexes are now on average as fat as Americans. In Kuwait, Thailand and Tunisia, 25 to 50 percent of the population are suffering not only developed-world levels of obesity, but also similar plagues of “noncommunicable” obesity-related diseases like diabetes and heart failure. South African and Egyptian women are as fat as American women (although their men lag behind their American counterparts).

In some places, specific local factors play a role as well. In much of Africa, for example, fatness in women was traditionally seen as testimony to the wealth and generosity of their husbands, and recent research in South Africa has revealed a new, additional factor: the fear that being slim will make people think you have AIDS.

Half of all women in South Africa are overweight, compared to only a third of South African men, and the problem is particularly acute among black women, one-third of whom are clinically obese.

“Regretfully,” says Tessa van der Merwe of the International Association for the Study of Obesity, “there is a perception that if a black woman is thin, she might have HIV/AIDS or that her husband can’t afford to feed her well.”

So South Africans, with far lower average incomes than Americans, are only 20 percent less overweight than people in the United States, generally conceded to be the world’s fattest country.

But the shift in dietary patterns and the consequent rise in obesity among the urban population affect the great majority of lower- and middle-income countries in Asia, the Middle East, Africa and Latin America. Moreover, this is happening at a much earlier point in the economic and social development of these countries than was the case in the “old rich” countries.

The typical pattern in 19th-century Europe was that the high-income groups put on weight first. (Think of the stereotypical cartoon plutocrat — he’s always fat.) Only much later, when cheap fats and sweeteners became generally available to the working class, did the urban poor start to bulk up as the rich slimmed down. But this pattern is now kicking in at a point in countries’ development where malnutrition is still widespread.

In urban Brazil, for example, the poor are now on average significantly fatter than the rich, even though the same slum households may also still contain some malnourished people. Urban adults in China and Indonesia are twice as likely to be obese as rural adults. In the Congo, city-dwellers are six times likelier to be fat.

It’s not a pretty picture — a world full of Michelin men and women — but the alternative is worse: a world of very hungry people. And the alternative, alas, is far more likely by the end of this century.

Cheap and plentiful food for the urban masses of a multibillion-population world is an astonishing achievement, but it is probably in its last few decades. Most of the world’s great fisheries are nearing collapse due to overfishing and pollution, and a couple have already died (like the Grand Banks off Newfoundland). More worrisome still is the likely impact of global warming on the great agricultural regions that feed most of those billions of people, like the Chinese river valleys, the American Midwest, and the north Indian plain.

A couple of years ago Dr. Jyoti Parikh, director of IRAD (Integrated Research for Action and Development), a New Delhi-based nongovernment organization, did a detailed study for the World Bank about the probable effects on Indian agriculture of a 2-degree (Celsius) rise in average temperature. The impact was different for different regions of the country, of course, but she concluded that overall Indian food production would be about one-quarter less than at present.

The world is probably going to get considerably hotter than that, and most of the other great breadbaskets of the world will be similarly affected. Obesity is not our long-term problem.