Most countries have more overweight than under-nourished people, and the problem appears to be getting worse. What can be done? By Fahad Badar One of the success stories of economic development in recent years has been the reduction in absolute poverty.The proportion of those living on less than $1.90 a day, adjusted for inflation, has fallen from around 20% in 2000 to below 10% today. But there is a problem with increasing living standards: Rising obesity. An estimated 5mn deaths per year are linked with being overweight, 20 times the rate of deaths owing to under-nourishment.In richer countries, obesity is most significant in poorer neighbourhoods, while in emerging economies it is a middle-class phenomenon. Some countries feature the ‘double epidemic’ of underweight people in the poorest households and obesity among many on middle incomes.The global distribution is uneven. Polynesia and the Middle East feature some of the highest rates of obesity, while the leanest include France, China and some central African countries. But it’s growing. The global rate of obesity has doubled since 1990, and the rate among children has quadrupled, according to the medical journal The Lancet.The latest statistics published by the World Health Organisation show that the GCC countries account for the highest prevalence of obesity. Among children aged under five, the proportion of those who are overweight increased from 3.5% in 2000 to 7.6% in 2020. Among those aged 5–19, GCC countries had the highest prevalence of overweight children in 2016.Among adults, obesity rates are more than double the global average: 38% in Kuwait, 35% in Qatar, 35% in Saudi Arabia, and 32% in the United Arab Emirates. Health problems associated with obesity include elevated risks of heart disease, type-2 diabetes, cancers, mental health issues, and muscular and joint problems.In the UK, the Institute for Fiscal Studies estimated that the annual cost of obesity was around £32bn ($42bn), even after accounting for the shorter life expectancy of overweight people. The direct and indirect costs included health care, social care and inactivity at work.Much attention has been focused on the role of ultra-processed foods (UPFs), which make up more than half of the calorie intake in the US and the UK. UPFs such as crisps, snacks and frozen pizzas are low on nutrients, high in palatability, and often cheap. In one controlled study, people on UPFs consumed more than another group on a diet of foods with minimal processing; they also ate more quickly, and gained weight.There seems to be an additional health risk caused by the processing itself. In one study by University College London, there was more harm from ultra-processed foods compared with non-processed foods that had the same proportion of fat, sugar and salt.In October this year, the United Kingdom introduced strict curbs on advertising foods with high fat, sugar and salt content, and banned promotions to encourage consumption of them such as ‘buy one get one free’. One problem with health warnings, taxes, or advertising curbs on UPFs is the definition.Some processed foods with relatively high fat and sugar content, such as yoghurt, have more positive nutritional value than crisps or soda. Manufacturers may adjust ingredients to just below the threshold defined as ‘high’. There have been major developments in pharmaceutical products that reduce obesity.The science behind these treatments lies in the discovery of how the gut hormone glucagon-like peptide-1, or GLP-1, increases the production of insulin, and slows the production of glucagon – which increases blood sugar levels. It also slows the rate of gastric emptying.Synthetic versions of GLP-1 are used in the branded drugs Wegovy and Ozempic which have become blockbusters. They have helped many people lose weight, but there are side effects, such as nausea. Some users have lost lean muscle as well. They are expensive, although in November, President Donald Trump announced a plan that will reduce the cost of Wegovy and Ozempic from around $1,000 a month to $350 for US citizens. They may also hold the potential to treat other conditions.This year the US Food and Drug Administration approved prescribing semaglutide, the active ingredient in Wegovy and Ozempic, to prevent heart disease in patients with type-2 diabetes, and to treat scar tissue on the liver. It could be argued that obesity is a good problem to have, as an indication that absolute poverty has fallen.The alternative argument is that a diet high in processed foods is similar to cigarette smoking, and a priority for policy makers. Investing in preventive actions to combat obesity is essential to improve public health and reduce long-term healthcare costs.By implementing targeted interventions across different age groups, from promoting healthy eating and physical activity in schools to workplace wellness programmes and community-based lifestyle initiatives for adults, we can reduce the incidence of obesity and its related chronic diseases. In parallel, establishing and implementing comprehensive national policies on the consumption of healthy oils and fats, reduction of salt levels in foods, effective taxation on sugar-sweetened beverages, clear nutrition labelling, responsible food marketing (especially to children), and support for breastfeeding in line with WHO guidelines and GCC tax regulations, are critical steps to creating a healthier food environment.Moreover, strengthening human, logistic, and institutional capacities for healthy diet surveillance, monitoring, and evaluation, with WHO support, will ensure that these measures are effectively implemented, sustained, and adapted to national needs.Such proactive actions not only enhance the quality of life but also significantly decrease the national burden of healthcare expenditures associated with obesity-related conditions.The author is a Qatari banker, with many years of experience in the banking sector in senior positions.
