1. Obesity A global health issue

2. Obesity: a global health issue Geography of obesity What is obesity? Obesity is abnormal or excessive fat accumulation that can impair health Obesity exists when a person has a body mass index (BMI) of 30 or more It is considered a medical condition in most of the world, but in 2013 the American Medical Association reclassified obesity as a disease BMI is a function of both weight and height

3. Obesity: a global health issue Geography of obesity Impacts on health Obesity is important because it has significant health impacts: It increases the risk of developing non-communicable diseases It reduces life expectancy It has a economic consequences for health provision as the costs of managing obesity rise

4. Obesity: a global health issue Geography of obesity Global patterns Obesity varies between countries, from 3.5% of men overweight/obese in Eritrea in 2010 to 97% on the Pacific island of Nauru. However, in almost every type of country and region it is rising (see table). In some countries, such as China, the increase in overweight/obesity is startling in a short time frame. In others, such as the USA, UK and Mexico prevalence rates are very high. % males overweight/obes e (WHO data)200220052010 Afghanistan11.212.715.6 Argentina70.173.177.7 Australia69.772.175.7 Bangladesh5.96.78.4 China27.533.145 Ethiopia7.47.88.6 UK62.565.767.8 Haiti1315.119 India1516.820.1 Kenya6.56.97.7 Mexico64.668.473.6 USA72.275.680.5

5. Obesity: a global health issue Geography of obesity Global patterns Obesity is highest in North America, North Africa and the Middle East, and many Pacific islands. South Africa and Venezuela are also ‘hotspots’. Levels in Europe and Latin America are similar — despite differences in levels of development. As might be expected, sub- Saharan Africa and Asia have the lowest prevalence, although some of the fastest growth rates.

6. Obesity: a global health issue Geography of obesity Development level and obesity Although there is some evidence of a ‘North–South divide’ in obesity, the pattern is complex. As the scattergraph shows, wealthy countries such as the Netherlands, Canada and the USA have different levels of overweight/obese males. Lower-income countries such as Egypt, Samoa and Mexico have levels equal to or even higher than those in developed countries.

7. Obesity: a global health issue Geography of obesity Explanations Explanations of obesity are complex: On many Pacific islands the abandonment of traditional farming and fishing has given way to a reliance on imported processed meat. Girth is seen as a signof social and economic status. In Europe and North America, a high-fat, processed and fast-food diet has combined with increasingly sedentary office jobs and lifestyles. In much of developing Asia and Latin America the nutrition transition and rural–urban migration have combined to increase fat, sugar and protein in diets at the expense of cereals and vegetable fibre. In cities people labour at desks and workstations rather than in the fields. In the Middle East oil-rich states, wealthy people have domestic servants so do very little in the way of household chores. Increased car use Fast food Larger portions Cultural appreciation of plumpness Sedentary lifestyles TV and video games Urbanisation Decline in farm employment Processed food Poor education Food marketing

8. Obesity: a global health issue Geography of obesity The ‘globesity’ crisis The World Health Organization (WHO) has referred to a ‘global obesity epidemic’ and the world’s media to a‘globesity crisis’ The crisis is worst in middle- income developing countries, like Mexico Obesity levels are high but so are infectious diseases This is a ‘doubleburden’ on the healthcare system. Obesity was recognised as a global epidemic by the WHO in 1997. Over 1.5 billion people worldwide are currently overweight and 500 million are obese. The WHO projects that by 2015, 2.3 billion adults will be overweight and more than 700 million will be obese. About 60% of obese people are women and 40% are men.