Alarm blaring on obesity, the single greatest public health threat

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We’ve all heard the alarm. How can we miss it? It’s blaring out, warning us about the greatest health threat of this age.

The alarm has sounded loudly for many on a personal level. Maybe our blood pressure or blood sugars are too high or we have excess fat around the middle, all strong signals of metabolic disease, that cluster of conditions that the esteemed Mayo Clinic tells us increases our risk of heart disease, stroke and Type 2 diabetes.

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We’re all in danger of being hammered by metabolic disease, which makes this problem far bigger than any individual woe. How will our health care system handle a population that is getting serious diseases at an ever younger age? How will our provincial and federal budgets be able to handle such cost?

These issues were thankfully brought into focus by a new study published in The Lancet medical journal on rising levels of obesity around the world.

The Lancet, led by senior researcher Majid Ezzati of Imperial College London, reported that more than one billion people worldwide are now obese. The number of obese adults was 878 million in 2022, up by 684 million from 1990.

The study also reported 159.3 million obese kids in 2022, up by 127.9 million since 1990. “Global adult obesity rates increased more than twofold from 1990 to 2022, while obesity rates among adolescents and children jumped fourfold,” said Dr. Michael Nova, summarizing the Lancet results.

The rise in obesity has grave health implications. “Underweight and obesity are associated with adverse health outcomes throughout the life course,” the Lancet study reported, calling both being underweight and obese a form of malnourishment.

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The study’s report card on Canada contained this nugget, that since 1970 the percentage of obese Canadians has tripled, from eight per cent to 24 per cent.

The number of obese or overweight Canadians combined has gone from 47 per cent in 1970 to 66 per cent in 2019.

The percentage of adult Canadians who don’t get enough physical activity was crudely estimated at just under 30 per cent in 2016, but closer to 76 per cent for teenagers. We’re second only to the United States in the Western Hemisphere when it comes to eating processed meat.

To put our Canadian numbers in context, the rate of obesity for Canadian women is 25 per cent, while in Japan it’s four per cent, France is 10 per cent, the U.K. is 28 per cent and the U.S. is 44 per cent. For men, Canada’s rate is 28 per cent, U.S. men are at 42 per cent, U.K. men are at 39 per cent, Japanese men are at eight per cent and men in France are at 10 per cent.

Canada’s obesity rate is 12.3 per cent for children, compared to 12.4 per cent in the U.K., 6.3 per cent in Japan, 4.4 per cent in France and 21.7 per cent in the U.S.

The study had some good news. The global prevalence of underweight adults decreased to seven per cent in 2022 in women from 14.5 per cent in 1990 and to 6.2 per cent in men in 2022 from 13.7 per cent in 1990.

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What to make of all this? Any solutions?

The authors of the study concluded,: “There is an urgent need for obesity prevention, supporting weight loss and reducing disease risk in those with obesity. Prevention and management are especially important because the age of onset of obesity has decreased, which increases the duration of exposure.”

They also argue, “A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity.”

In other words, eat healthy food starting in childhood and we’ll all do better.

If only it were that simple.

Many of the richest nations, where a higher percentage of people could most easily afford healthy food, have poor outcomes.

Another idea came from Dr. Sylvain Charlebois of Agri-Food Analytics Lab at Dalhousie University. “Why, whenever we discuss the obesity epidemic, do we always point fingers at the food industry and so-called ‘ultra-processed foods’? Shouldn’t we also encourage consumers to take some responsibility for their choices, even just a little?”

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It’s a fair question, but, again, there’s no shortage of people who have the goal of making better choices, for example by eating healthier, exercising more, losing weight and improving their health. Yet few achieve this goal.

The Lancet authors acknowledge this. “Most efforts to prevent obesity have focused on individual behaviours or isolated changes to the built or food environment. These have had little impact on obesity prevalence.”

What to do then?

My own weight and health has shot up and down in my adult life so I’m not here to lecture you with my pet ideas. Instead, I am here to again sound this alarm.

There’s far too little public discussion, debate and focus on this issue. If we acknowledge metabolic disease as the problem that it is, the real front line of public health and our own individual and collective futures, maybe we’ll stop ignoring the alarm, stop hitting the snooze button on a true existential crisis of our times.

dstaples@postmedia.com

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