How Obesity Can Derail China’s Growth

Obesity in China, particularly in children, has become an important health concern that will not only seriously affect the health of future generations, but also place a heavy economic burden on the country.

While China’s GDP just about doubled between 2005 and 2009, the number of obese people rose from 18 million to 100 million people — a more than fivefold increase — during that same period.

To make the situation even more disconcerting, China, as well as Vietnam, India and many other developing countries, has to shoulder a “double burden.” It has to fight the persistence of undernutrition, particularly among children in rural areas.

And, especially in the cities, it has to contend with a rapid rise in overweight, obesity and related diseases. These include cardiovascular disease, hypertension and stroke, Type 2 diabetes and certain forms of cancer.

Treatment for such diseases is very expensive, not only in a direct sense, but even more so because of the impact of sick people on the labor force.

Obesity and its consequences account for a significant proportion of healthcare costs in most countries, and it can reach up to 7% of the total if obesity-related conditions are included in the calculations.

“What we are seeing in developing countries, which are undergoing rapid economic transition is undernutrition, overnutrition and infectious and chronic diseases coexisting over long periods of time,” said Gina Kennedy, from the Food and Agriculture Organization (FAO).

Although the terms obese and overweight are sometimes used interchangeably, they have different meanings. Overweight is having a weight closer to normal than obese, and the distinction between the terms is made using the body mass index (BMI) , which is a way of determining the amount of body fat based on a person’s weight and height.

Overweight, however, is not only a problem in developing countries, but in industrialized countries as well. In the United States, the number of overweight children has doubled and the number of overweight adolescents has tripled since 1980, according to the U.S. Surgeon General.

In Chinese cities, according to official statistics, 8% of children 10- to 12-years old are considered obese and an additional 15% are overweight. A University of Southern California study carried out in 2006 found that the average body fat of Hong Kong children was 21%, an extremely high number.

The basic cause of obesity in children and adolescents is the energy imbalance between the calories they consume and the calories they expend through activity. But the increasing number of overweight and obese children and adolescents respond to many different causes.

There are several reasons that explain the increase in obesity in China. Traditionally, the Chinese diet included mainly cereals and vegetables, with few animal foods. As a result, the fat and sugar intake of the Chinese population remained low for a long time.

However, as the country experienced explosive economic development, fatty and sugary foods became much more widely available.

Due to the lack of knowledge in the general population of what constitutes proper nutrition and of the harmful effects of fatty and sugary foods, their consumption has increased significantly in the last decades.

And so did, predictably, the problems associated with it. However, because of past famines in the country, different foods — particularly foods high in fat — are now seen as a very attractive option. At the same time, consumption of cereals, fruits and vegetables has decreased.

Eating in fast food restaurants — particularly American chains such as McDonald’s, Pizza Hut and Starbucks, where food is particularly high in fats and sugar — is becoming very attractive and is considered a status symbol.

Although the food items offered in those places are expensive by Chinese standards, they offer an atmosphere of relaxation and luxury that attracts many Chinese, particularly young business people.

And, in a direct replay of a phenomenon that first happened in the United States and then grabbed Europe and Japan, they are too lazy to exercise, while never busy enough not to ingest more fast food.

Whatever one may wish for, the attraction of fast food is not going to disappear. Instead, a new trend is developing regarding these places. It started in Hong Kong, where McDonald’s restaurants provide wedding receptions for young couples — what are being called “McWeddings.”

McDonald’s will open a total of 250 new restaurants this year in China, boosting the nationwide total to 2,000 restaurants by the end of 2013. The Chinese fast-food industry is now the fifth largest in the world.

The inadequate physical activity levels are also a result of the increased use of TV, computers and passive leisure activities, lack of safe and adequate spaces for physical exercise and increased motorized mode of transportation, among other factors. Again, as was first the case in the United States, cars have become not only symbols of wealth, but have led to drastically lower levels of physical activity.

To confront this problem, it is necessary to increase programs in schools aimed at cultivating healthy eating practices and teaching healthy lifestyles in children. It is also important to increase nationwide social and health programs on public nutrition through the mass media and to create or expand community-based nutritional education programs.

Several countries have been experimenting with the use of fiscal measures to limit the consumption of foods high in fat, sugar and salt. Higher taxes on unhealthy foods can help improve health by changing buying and eating habits, while at the same time generating important revenues that can be used for prevention efforts. These measures should be part of an integrated, multisectoral approach to deal with this problem.

The challenge for Chinese policymakers is how to develop effective programs and policies aimed at preventing and controlling what is fast becoming a serious public health problem, while at the same time allowing the population to enjoy the benefits of the country’s remarkable economic growth.