What, No Party? No Cake?

A billion of anything is quite a landmark. A person might think it would warrant some kind of celebration. But no. The Lancet just went with a sober headline: “More than one billion people in the world are now living with obesity, global analysis suggests.” Here’s more:

In total, an estimated nearly 880 million adults were living with obesity in 2022 (504 million women and 374 million men)… Combined with the 159 million children living with obesity in 2022, this is a total of over one billion people affected by obesity in 2022.

The article talks about a study funded by a trio of venerable institutions and conducted by the NCD (Non-Communicable Disease) Risk Factor Collaboration, described as “a worldwide network of over 1,500 researchers and practitioners.” Ever since 1990, when global health authorities apparently started seriously keeping track, children and adolescents have become more and more obese. At the same time…

[…] rates of underweight fell among children, adolescents and adults, leading to obesity becoming the most common form of malnutrition in many countries.

Doesn’t that sound crazy? Even more confounding is a quotation from one of the study’s senior authors, Professor Majid Ezzati of Imperial College London, identifying the answer to both problems as the same: namely, to “significantly improve the availability and affordability of healthy, nutritious foods.” He also makes a point of mentioning the huge demographic shift. In the 1990s, obesity was a condition that mainly affected adults. Now, children and adolescents are experiencing obesity on a scale that would have been impossible to imagine back then.

From the report, here are just a few examples of the statistics:

USA obesity rate among girls in 1990 —   11.6% In 2022 — 19.4%
USA obesity rate among boys in 1990 —   11.5% In 2022 — 21.7%
UK obesity rate among girls in 1990 —     4.7% In 2022 — 10.1%
UK obesity rate among boys in 1990 —     4.3% In 2022 — 12.4%
China obesity rate among girls in 1990 —      0.6% In 2022 —   7.7%
China obesity rate among boys in 1990 —      1.3% In 2022 — 15.2%

Despite the most rigorous controls and conscientious procedures, it is doubtful that any study can ever guarantee total accuracy. Here is an example of why. Although more than 1,500 researchers took part in this effort, all the measurements on which it was based were of BMI (body mass index). While by no means totally discredited, BMI has been recognized as an imperfect standard, and many experts would much rather see everyone in the field switch over to the waist-to-height ratio.

Even with enthusiastic endorsement and total cooperation from the majority of professionals in the field, it is unlikely that such a drastic change could take hold completely within a short time span. But even more discouraging is the plain fact that, if BMI is a misleading criterion, when 1,500 researchers report conclusions based on it, that essentially translates into “misleading multiplied by 1,500.”

The authors of course acknowledge the inevitable shortcomings faced by any endeavor of this massive scale:

While BMI is an imperfect measure of the extent and distribution of body fat, it is widely recorded in population-based surveys, making analyses such as these possible. Some countries had little data and three had no studies, meaning their estimates are more uncertain. There were also differences in data availability by age group, with fewer data available for those aged five to nine years, and people aged over 65 years, increasing the uncertainty of estimates for these age groups.

“This new study highlights the importance of preventing and managing obesity from early life to adulthood, through diet, physical activity, and adequate care, as needed,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General.

If human nature as it relates to food and eating were the only drawback, the prognosis would not be good. But several other factors are involved, mostly based on human nature as it impinges on everything else concerned with life on earth. These pessimistic words are from study co-author Dr. Guha Pradeepa of the Madras Diabetes Research Foundation:

The impact of issues such as climate change, disruptions caused by the COVID-19 pandemic, and the war in Ukraine risk worsening both rates of obesity and underweight, by increasing poverty and the cost of nutrient-rich foods. The knock-on effects of this are insufficient food in some countries and households and shifts to less healthy foods in others.

Your responses and feedback are welcome!

Source: “The Lancet: More than one billion people in the world are now living with obesity, global analysis suggests,” EurekAlert.org, 02/29/24
Image by Simeon W/CC BY 2.0 DEED

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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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