England confronts 'globesity'

Levels of obesity in England have tripled in the past 20 years, with 1 in 5 adults here now seriously overweight, according to a study released last week by the National Audit Office.

England is just one example, experts here say, of how the conveniences of modern technology, coupled with increasingly sedentary lifestyles, have tipped the scales toward a society where overweight people are in the majority.

One-third of the people living in the wealthy European Union are overweight, and experts have warned that half of adult Europeans could be obese within a generation. By comparison, one-quarter of the US population is obese.

"Never in the history of humanity have we had so much food to eat," says Neville Rigby of the International Obesity Taskforce in London. "A cornucopia around the clock: This kind of environment of plenty was unheard of several generations ago in most parts of world."

Experts agree that any strategy to combat obesity will need to be as varied as the causes, but will need to focus on nutrition education, increased physical activity, and improving medical understanding of obesity causes and treatments. The experts urge launching awareness campaigns - not unlike the movement that began 30 years ago to sound alarm bells about the dangers of smoking.

Costly consequences

The report estimated that obesity cost England $4 billion in treating related health problems, which the study said include diabetes, high blood pressure, and heart disease.

In the US, the prevalence of diabetes has increased by more than 32 percent between 1990 and 1998, according to a report published last year by the Centers for Disease Control and Prevention.

Experts have been warning about the "silent epidemic" of obesity and the health risks it poses for some time.

In many regions, people still struggle to fill their plates, but the problem of obesity is by no means limited to rich developed countries. According to the World Health Organization (WHO), the number of obese adults worldwide has increased by 50 percent since 1995, to 300 million last year. One-third of these people are believed to live in the developing world.

In 1996, WHO set up a global database on obesity and body mass index, the common measure of fatness. WHO calls obesity "one of today's most blatantly visible - yet most neglected - public health problems," and has dubbed the global epidemic "globesity."

Together with the University of Auckland in New Zealand, WHO is studying the impact of globalization on nutrition, as well as the varied factors that lead to obesity.

Experts agree that obesity results from a number of causes, many of which are related to advances in technology.

"The increase in sedentary lifestyles comes before eating patterns," says Rob Prideaux, principal author of the England study.

Fifty years ago people were much more physically active both at the workplace and at home; labor-saving devices, individualized transport, and hours before TVs have had their price in extra inches on the waistline.

And going back beyond that, to America's Colonial period, when there were almost no conveniences, Americans were even more active. But they burned it off. Revolutionary war participants, for example, required 5,000 calories per day to support their physical activity.

The study of obesity in England warns that obesity levels could reach those of the US within a decade. Given the global appeal of the American lifestyle, which puts a premium on convenience, an increasing number of people are eating out - often choosing high-fat fast foods - or microwaving ready-to-eat meals. Mr. Rigby of the International Obesity Taskforce says that they also may be consuming more.

"Anybody going from Europe to America is shocked by the scale of servings and of people's appetites," Rigby says. "The supersize culture is being exported."

Childhood obesity

Studies in several countries have shown a dramatic rise in obesity among children, leading to an early risk of diabetes and other health problems. Last week, The Lancet medical journal published the results of a US study, showing that an extra soft drink a day makes children 60 percent more likely to become obese, independent of what they eat or how much they exercise.

Obesity, roughly defined as being 30 pounds overweight, is the second highest preventable cause of death after smoking in countries such as the US.

The England report calls for urgent government action to promote physical activity, improve nutrition education, and raise awareness among doctors to treat obesity. In Scotland, a "fat czar" is expected to be appointed to address questions of nutrition.

In Rio de Janeiro, where a pan-American declaration on obesity was signed last summer, the issue is being tackled on a local basis. Certain neighborhoods routinely close roads so that children can play freely and adults are able to take walks.

Carnaval on a diet

Brazilian concern over avoirdupois has resulted in slightly less excess at Rio's famed annual pre-Lenten carnaval, which begins Sunday. In a traditional carnaval ceremony, the keys to the city are handed over to the Rei Momo - the king of overindulgence. Amid new concern about overweight, and after the death of a previous Rei Momo from complications related to obesity, the current king of indulgence has slimmed down from 450 to 300 pounds.

In the US a number of organizations have appeared that preach "fatness acceptance" in defiance of overweight's societal stigma and of ubiquitous images of the idealized - usually unattainable - thin body. In Britain the movement is not well organized, though it was here that the first "No Diet Day" was held eight years ago.

The goals of groups like the International Obesity Taskforce need not be contradictory.

"Most medical experts would agree that dieting is part of the problem, not the solution," says Rigby. "The only thing that's going to change things is to take a long-term view."

Andrew Downie contributed to this report from Rio de Janeiro, Brazil.

(c) Copyright 2001. The Christian Science Publishing Society