How Fat Went Global

Wasn't it once the case that people in developing nations tended to get fat only when they moved to cities?
It certainly was the case in the early phases. But now in China and Mexico, people in the rural areas are as fat or fatter than they are in the urban areas. That's because all of a sudden food is cheap in rural areas, and farmers and fishermen who used to have very labor-intensive jobs are cutting out activity in favor of technology, like tractors. That means they end up burning 1,000 fewer calories in a day, and it's very hard to just suddenly cut 1,000 calories out of their diet.

Meanwhile, malnutrition rates have been going down steadily since 1990. How is that connected with obesity going up? Is it the same forces at work, or different ones?
The programs that have been developed around the world to deal with hunger have ignored obesity. We need to change them to focus on things that benefit the malnourished while not exacerbating obesity, and that's not something the hunger-aid community has not been willing to deal with.

So, the big question: What do we do about this? How should we be rethinking policies to combat obesity around the world?
In this country, at least, the first thing we can do is what we're starting in New York right now, which is a beverage tax. Beverages are the only thing that we truly can pick up and say, "These have super-negatives." Juice, soft drinks, fruit drinks, energy drinks, all caloric beverages except skim milk—all of these have [little] value except calories. So I'd start by taxing them. It's a lot harder with fatty foods. They may have some important nutritional value. Besides, it's not fat we really care about, it's calories. So I would prefer not to do a "fat tax," but to have an added-sugar tax, as well as a tax on fried foods and certain junk foods that are really energy-dense.

Wouldn't you also want to make healthy foods cheaper? How do you do that?
That's a critical step. ... Beans and fruits and vegetables and other components of a diet that would be really healthy—we have essentially ignored those crops, and instead we have made certain foods, staples like grains and animal foods, dirt-cheap by creating a whole system around them, with big agribusinesses and government funding and lobbyists. And we've replicated that system around the world. If it were up to me, we would cut out half of the subsidies we currently put into the grain sector. We subsidize food when we have more than enough surplus, and the subsidies are not helping the farmers, they're helping the agribusinesses.

Some people are going to respond to all this by saying it should be a matter of individual responsibility — that diet and weight are a matter of choice and the government shouldn't meddle.
That's OK if those people want to pay for the extra health-care costs that come with obesity. But right now this is affecting everyone in America, because we all pay those costs. It's the same issue we had with seatbelts. People who didn't use them were only hurting themselves, physically, but in the process, they were raising insurance costs for everyone. Now we are at a point where people can't even walk and they need scooters to get around, where we have to build special beds and chairs in hospitals, where we're taking toes and feet off people that have diabetes. If the government is going to pay for all of this, that affects everyone, and we need to do something about it. But America is a society that prefers to break things and then pay to fix them.

© 2008