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Childhood Obesity Increased More Than Tenfold Since 1975

Bruce Y. Lee
This article is more than 3 years old.
World Obesity Federation

With World Obesity Day tomorrow on October 11, here's a question. How high do childhood obesity rates have to rise before more people sound the alarm and commit effort and resources into stemming this global epidemic? How about more than a tenfold rise in the number of children and adolescents with obesity in the 40 years since 1975? Is that startling or high enough?

Well, that's the number reported by a study just published in The Lancet, and we'll see if it actually stokes greater urgency or instead sounds like a tree falling in the distant forest while most people are wearing headphones and playing on their smartphones, hundred of kilometers away. For the study, a team from the Non-Communicable Disease (NCD) Risk Factor Collaboration (NCD-RisC), led by researchers from Imperial College London and the World Health Organisation (WHO), collected, pooled and analyzed 2,416 different existing studies that measured the height and weight of a total of 31·5 million 5- to 19-year-olds from 200 countries. They found that from 1975 to 2016, the number of girls with obesity went from 5 million to 50 million, and the number of boys with obesity went from 6 million to 74 million. That doesn't even include the 213 million children and adolescents that fell in the overweight range in 2016. Those numbers are much more than a single tree falling. It's a sign that most of the forest is burning.

Hold on a second, you may ask, didn't the population of the world grow over the past 40 years? Yes, but not by ten times. The world's population went from around 4 billion to approximately 7.5 billion. Thus, doing the math reveals that worldwide the rate of child and adolescent obesity jumped from 0.7% to 5.6% (or eightfold) for girls, and from 0.9% to 7.8% (or more than 8.5-fold) for boys. Still not convinced that this is an urgent problem?

Try plotting each country's obesity prevalence over time (by year, from 1975 to 2016), which the researchers did (see here for visualizations of the data). The curves in nearly every case look like ski slopes, except that they are going the wrong direction: upwards. True, some of the curves are more like backwards bunny slopes, such as those for Bangladesh, Burkino Faso, Japan and Singapore. However, there are plenty of reverse Winter Olympic-like ski slopes. Again, most of the curves show consistent year-to-year rises over the past 40 years, not up and down like a roller coaster or interest in mutton chop sideburns or big hair.

What, then, if you don't care about other countries? Well, if you live in the South Pacific, there's a decent chance that your country or one of your neighboring countries is in the top 10 for 2016. Pacific Island nations dominate the list for girls with obesity:

  1. Nauru
  2. Cook Islands
  3. Palau
  4. Tonga
  5. Tuvalu
  6. Niue
  7. French Polynesia
  8. American Somao
  9. Marshall Islands
  10. Tokelau

And the Top 10 for boys:

  1. Cook Islands
  2. Nauru
  3. Palau
  4. Niue
  5. American Samoa
  6. French Polynesia
  7. Marshall Islands
  8. Tuvalu
  9. Kuwait
  10. Tokelau

Basically, a little more than third of the girls on Nauru and a third of the boys on the Cook Islands have obesity. Nearly a quarter of girls and boys in Tokelau have obesity.

What's that you say? You live in the U.S.? Yes, America is not first, but it does fall at 12th for boys (obesity rate 23.3%, up 5.5% 40 years prior) and 15th for girls (19.5% up from 5.6%). Add on the overweight rates, which leapt from 18.9% to 39.4% for girls and 18.9% to 44.2% for boys and over half the U.S.' child and adolescent population has obesity or is overweight.  

And while only one country in the Middle East, Kuwait, appears in the Top 10, the next 20 include multiple countries from that region. And Oman has jumped from 114th to 29th for girls and 117th to 31st for boys.

Here are the 30 countries that experienced the biggest increases in the 40 years for boys:

  1. Cook Islands
  2. Niue
  3. Palau
  4. American Samoa
  5. French Polynesia
  6. Tuvalu
  7. Marshall Islands
  8. Tokelau
  9. Nauru
  10. Tonga
  11. Kiribati
  12. Samoa
  13. Micronesia (FS)
  14. Kuwait
  15. Saudi Arabia
  16. Puerto Rico
  17. USA
  18. Brunei Darussalam
  19. Qatar
  20. Oman
  21. Argentina
  22. China
  23. Lebanon
  24. Malaysia
  25. Taiwan
  26. Bahamas
  27. Dominican Republic
  28. Suriname
  29. Egypt
  30. United Arab Emirates

And for girls:

  1. Tonga
  2. Tuvalu
  3. Niue
  4. Cook Islands
  5. Palau
  6. Marshall Islands
  7. Tokelau
  8. French Polynesia
  9. American Samoa
  10. Kiribati
  11. Samoa
  12. Micronesia (FS)
  13. Egypt
  14. Nauru
  15. Puerto Rico
  16. Dominica
  17. USA
  18. Dominican Republic
  19. Saudi Arabia
  20. Oman
  21. Bahamas
  22. Kuwait
  23. South Africa
  24. Jamaica
  25. Iraq
  26. Libya
  27. Algeria
  28. El Salvador
  29. St Vincent & the Grenadines
  30. Costa Rica

Basically, obesity rates have increased significantly in every country among the 200. This includes countries on every continent, throughout each of the continents. Even Singapore, which is the bottom of the list at number 200 experienced a doubling (0.4% to 0.8%) of obesity rates among girls.

This sure looks like a crisis, a global catastrophe in slow motion, as described earlier in Forbes. Dr. Fiona Bull, programme coordinator for surveillance and population-based prevention of noncommunicable diseases at WHO, indicated: “These data highlight, remind and reinforce that overweight and obesity is a global health crisis today, and threatens to worsen in coming years unless we start taking drastic action.”

And this crisis is costing us many lives due to health problems such as diabetes, cancer and heart disease and a ton of dollars, Euros, yen, pesos, won, lira, rupees, baht, zloty, etc. The World Obesity Federation estimated that without urgent action, the annual global medical costs for treating the consequences of obesity will reach US$1.2 trillion per year by the year 2025. That's per year and medical costs alone.

So unless you live on Mars (the planet and not the candy manufacturer), the childhood obesity epidemic is affecting your country and you. (As reported by Liz Neporent for ABC News, Mars has actually been one of the companies that has pledged to fight obesity and taken steps to do so). Here's the reaction of Michael Bloomberg, former New York City Mayor, founder of Bloomberg LP and Bloomberg Philanthropies, and the WHO's Global Ambassador for NCDs, to the study:

Obesity is truly at crisis levels: there has been a ten-fold increase in the number of obese children and adolescents over the last four decades. The crisis is especially severe in low- and middle-income countries, where obesity is rising the fastest. The result is a terrible rise in human suffering, which also carries huge economic costs and stalled human development. This new report is a timely reminder both of the scope of the crisis and the need for a more robust and urgent response. Anti-obesity policies like sugary drinks taxes are working, and the faster we spread them, the more lives we can save.

Which brings us back to the original question. What will it take to bring more attention to the global childhood obesity epidemic? Sure, there are organizations and individuals trying to bring more attention to the problem such as the WHO, the World Obesity Federation, Mayor Bloomberg, former First Lady Michelle Obama, the Obesity Action Coalition, the Obesity Society, the European Association for the Study of Obesity (EASO) and our Global Obesity Prevention Center (GOPC) at Johns Hopkins University. Sure, some steps have been taken like sugar-sweetened beverage (SSB) taxes in some cities, improved food labeling and school lunch programs during the Obamas' time in the White House, and some manufacturers reducing the amount of sugar and artificial ingredients in their products.

But a lot more needs to change to reverse or even slow any of these global trends. Childhood obesity is a complex systems problem. It is not due simply to kids making bad choices or being lazy. The world has experienced fundamental shifts in the ingredients in food and beverages (e..g., more sugar, more salt, more processing, more artificial ingredients), the way cities, communities, workplaces, schools and other locations are designed (e.g., less access to healthy food, less walkability, less access to places and equipment to play sports), the time spent on different activities (e.g., longer periods of sitting and watching screens), the things that are in our environment (e.g., more pollution, more medications) and many other systems that affect diet, physical activity, and metabolism. The question is when will more leaders around the world make addressing the obesity epidemic a priority so that real system changes can occur?

The challenge is that many people don't hurry for solutions until a problem has smacked them in the face, well past the point of simple solutions working. Problems are like fine wine, except that they taste terrible and don't come in a bottle. The longer you leave it alone, the more it ferments, and the costlier it becomes. Events like World Obesity Day are, of course, not to celebrate obesity but instead to raise awareness and essentially say, "Houston (and London, Seoul, Birmingham, Dubai, Rome, Beijing, Apia, Butte, Cairo, Auckland, Maputo and every other town and city in the world)...we have a problem."

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