A Big World, After All

Globe and Hourglass

Yes, that title phrase is lifted from Laurie Cunningham, who cleverly adapted it from the Disney song, the one that stays in your head for days after you hear it, the one about how “It’s a small world, after all.” While the world may be small in some ways, “small” is not a word that can be applied to the size of the average human.

The World Health Organization (WHO) compiled the results of national health surveys performed between 2000 and 2008. There is always a time lag as information makes its way from the local level to the district, the state or province, and eventually to the national database, and then from there to the central collecting point for the worldwide statistics.

To begin with, gathering such information is not an exact science because of the different levels of technology enjoyed by different countries, and the varying resources they have available to spend on collecting and documenting statistics. Vital as the childhood obesity epidemic issue is, some countries are fighting other kinds of epidemics, or fighting wars, so it’s not at the top of everybody’s priority list all the time.

Nevertheless, WHO has gathered enough information to pinpoint the nations where runaway obesity was the most obvious, and to project that by 2015, about 2.3 billion adults will be weighing down the Earth with their overweight and obese bodies.

For reasons, Cunningham cites the usual — the ubiquitous availability of highly processed foods, more cars and less walking, less home cooking, and so on. When it comes to highly processed foods, the very serious drawback is that they tend to be made of inferior materials, and then dolled up with additives and transformed into hedonic, highly palatable, “more-ish” concoctions that bear little resemblance to actual food. The calorie content goes up while the nutrition level goes down.

American Samoa is the absolute worst place, with 93.5% of the population overweight or obese. That’s almost everybody! The theory is, many Samoans emigrated to other countries, got good jobs, sent home money, and then came back to visit and introduce their family members to deplorable eating habits. Being an island doesn’t count for much anymore because the isolation factor is gone. Transportation and shipping reach everywhere, and the worldwide distribution mechanism is solidly in place, guaranteeing that everybody gets all the potato chips they want.

The Pacific Island nation of Kiribati is in the same shape, for the same reasons. Apparently, fatty processed meat products are a major import there.

The United State is a mess, as we know, with the overweight total creeping up toward 70%. Cunningham says:

Health experts attribute the rise to an over-production of oil, fat and sugar — the result of government farm subsidies started in the 1970s that made it much cheaper to manufacture products like high fructose corn syrup, a common ingredient in processed foods.

The journalist also quotes Marion Nestle, who gives a reason that doesn’t occur to many people, attributing joint responsibility to the food corporations and the government:

[…] [I]nvestment policies changed in the early 1980s to require corporations to report growth to Wall Street every 90 days. This made food companies seek new ways to market to the public. Obesity was collateral damage.

All the other countries in the “Top 10 Fattest” category also have overweight/obese rates of more than 50% of the population, as follows:

Germany, 66.5 %
Egypt, 66%
Bosnia-Herzegovina, 62.9%
New Zealand, 62.7%
Israel, 61.9%
Croatia, 61.4%
United Kingdom, 61%

You’d think this would only occur in relatively prosperous countries like the United States, Germany, and Israel because, obviously, the people have more money to spend on food. But such countries as Croatia and Bosnia-Herzegovina illustrate the counter-intuitive nature of the obesity problem. Following war and the consequent economic disaster for just about everybody, it’s just like being in a country that was always poor.

Cunningham says:

Those living just above the poverty line in developing countries are gaining weight the fastest, partly because of the tendency to fill up on cheap processed foods high in calories and low on nutritional value.

New Zealand is one of the places where research made it really apparent what a culprit TV-watching is, with a study done at the University of Otago, while British studies have highlighted the inverse relationship between exercise and obesity: More physical activity tends to produce a less weighty population, and vice versa.

Israel is a case study in the influence of education, as the journalist explains:

Like in most developed countries, flab is most prevalent among Israelis with less education, with Jewish women with college degrees having the lowest levels of obesity and Arab women with basic education having the highest.

So, the local reasons vary, with different factors claiming more or less importance, but the bottom line is, the obesity epidemic is definitely a worldwide problem of gargantuan proportions.

Your responses and feedback are welcome!

Source: “Behold: the world’s 10 fattest countries,” GlobalPost.com, 11/22/10
Image by Fidelis, used under its Creative Commons license.

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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