OBESITY PANACEA

Photo by Felicia Webb

[Note: Today’s post comes courtesy of a section of my PhD comprehensive exam that I wrote last summer.]

Obesity and chronic diseases have historically been a problem exclusive to affluent, developed countries, while developing regions of the world have had an entirely opposite public health crisis – that is, widespread undernutrition, famine, and a high prevalence of infections diseases. However, as of recent years, there has been a growing recognition of an emerging epidemic of obesity in the developing societies of Africa, Asia, and South America.

In many transitioning societies, the emerging epidemic of obesity and associated chronic disease exists alongside the remaining widespread problems of malnutrition and infections diseases, leading to what has been termed the double burden of disease. In fact, it is fairly common among developing countries to find underweight and overweight persons living in the same household, with obese mothers often caring for undernourished children. These paradoxical situations among developing societies are symptoms of what researchers call a nutritional transition, whereby changes in diet and physical activity patterns due to urbanization, industrialization, and economic growth lead to a recession in famine directly alongside the emergence of obesity.

The transition to obesity initially occurs among the wealthiest sections of society, but with time and socioeconomic development shifts to become mainly a problem of the poor. Most worrisome, is the fact that the rate of increase in obesity prevalence in developing societies can often exceed that seen in the industrialized world. Indeed, the yearly rate of increase in overweight and obesity in regions of Asia, Africa, and South America is 2-5 fold that seen in the United States.

Compounding the rapid rates of increase in obesity prevalence in these regions are the unique biological and sociocultural factors inherent to populations undergoing nutritional transition. For instance, socio-cultural differences in the perception of obesity between developing and developed societies may work to propagate the trend towards obesity in the former. Indeed, obesity is a highly stigmatized condition in industrialized countries, with social discrimination being very prevalent, even among medical professionals. On the other hand, developing societies appear to have a greater tolerance of obesity, an effect which may be partially explained by the negative association of leanness with HIV/AIDS in certain populations. Thus, the lack of sociocultural pressures to stay lean in developing societies suggest that the rise in obesity prevalence in these regions is likely to proceed unabated.

Peter