How the world lost its waistline

When it comes to obesity, it helps to have the flexibility of a good national outfit. The Gulf states may be among the most overweight in the world but a billowing abaya hides a multitude of sins. India has conveniently adjustable saris, loose kameezes and a spiralling weight and diabetes problem. On the other hand, skinny jeans and fitted shirts do fat no favours, showcasing rather than disguising our newly acquired Christmas rolls.

Perhaps this is why the west tends to assume the blame for breaking all obesity records – and the scales. America in particular is synonymous with fat in people’s minds: doughnuts, deep-fried butter sticks, 36 per cent of adults now bursting into the obese range. Britain, as a report just out from the Royal College of Physicians shows, pants along not far behind. A quarter of the adult population is obese, costing £5bn a year.

But the west’s own obsessive navel-gazing stops us from noticing that other stomachs are ballooning too. The epidemic is worldwide. The mammoth new Global Burden of Disease Study shows that more people are dying from diseases associated with obesity than malnutrition (everywhere but sub-Saharan Africa), and the World Health Organisation estimates the condition kills 2.6 million a year. From the doughty Pacific Islands to traditionally slender China, we are – rich and poor – getting fatter, putting an additional strain on the world’s healthcare systems.

My own Christmas overindulgence took place in Egypt, a country that is now the fattest in Africa. Apparently there’s nothing like sunset over the Nile to make you crave a bucket of KFC chicken. Down in Aswan, fast food restaurants on the river bank are crowded with passing locals. The rush is good for business but bad for an expanding national waistline. Egypt does not even make the top 100 countries in GDP per capita but when it comes to obesity, its women and men take 14th and 27th place respectively.

Overlooking the river is the mausoleum of the Aga Khan III, the only man in town who had the perfect excuse to pile on the pounds. He was literally worth his weight in gold and diamonds, paid the equivalent amount by his Ismaili followers after ritual sessions on the scales. The third of Egyptians that the latest WHO figures show to be obese are not so lucky. They will reap their reward in shortened lives, heightened health risks and rising healthcare costs.

Fat was once a status symbol across the globe. Henry VIII knew the mighty power of a mighty girth. Rotund men and curvaceous goddesses feature among Egypt’s temple carvings, and various dug-up pharaohs, still complete with embalmed skin folds, show the padding that privilege conveyed. More recently, the writer and Nobel laureate Naguib Mahfouz emphasised the attractiveness of weighty women in his famous Cairo Trilogy. Aisha, the beauty of the family, is criticised for being too slender. “The magic of the fattening potions failed on her ... [Her sister] liked to ascribe Aisha’s slenderness to the weakness of her faith.” The global stereotype of grandmothers on a one woman mission to fatten you up has deep roots.

This approach may seem refreshing to westerners accustomed to equating skinniness with success. But the combination of wealth and weight leads to problems like those seen in the Gulf. Qatar, with the world’s highest GDP per capita, also has alarming rates of childhood obesity. Too much luxury, not enough exercise. In the UAE, 25 per cent of men and 42 per cent of women are obese, leading to a recent suggestion in The National, the Abu Dhabi paper, that they don tightfitting clothes beneath their abayas. Those of us struggling to do up our belts after Christmas know that snug clothes are far too good an indicator of overeating.

But fat does not always distinguish between rich and poor economies. In Egypt, the ritzy cupcake shops of Cairo and their neighbouring gyms are reserved for the privileged. More broadly, the government subsidises bread, which is eaten in vast quantities. And it is the move away from an agricultural lifestyle towards cities, desk jobs, working mothers and hours spent sitting in traffic jams that is responsible for the general population’s weight gain.

Food companies also get the blame, usually more so than the people who devour the products they aggressively push. There are very few places now that the power of fast food advertising can’t reach. I once went white-water rafting near the source of the Ganges in India. There were no houses, no shops and few people but when I skirted a mid-river rock, it was proudly painted with a familiar red-and-white slogan. The sacred river brought to you by Coca-Cola.

After millennia in which our most basic, crucial concern was where to get enough food, how to guard it, store it and consume it safely, our instincts are understandably confused by increasingly available goodies. Not all excess flesh may be deadly. A new analysis of more than 100 studies suggests that being mildly overweight could actually lower mortality rates. But the same study shows that obesity comes with an 18 per cent higher risk of death. Changing our appetites rather than our clothes is going to be one of this century’s greatest challenges. The pharaohs buried food with them. We are in danger of using it to bury ourselves.

Alice Fishburn is deputy editor of FT Weekend Magazine

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