In the 33 countries of the Organisation for Economic Co-operation and Development (OECD), one in six adults is now obese (having a body mass index of 30 or more). The fattest countries are the United States and Mexico, the leanest Asian countries including Japan and South Korea.
China does not belong to the OECD group and is a long way from the wealth per capita boasted by most of these countries. So it would be logical to assume that something like obesity rates wouldn’t even factor in its list of health concerns. But in China, as in other developing countries like Brazil and India, obesity rates are growing fast. Only a generation ago, hardly anyone in China was overweight. Now, some experts are warning of an ‘obesity explosion’, as the dietary habits of the new middle classes change. And hospitals, clinics and camps are springing up across China to treat the growing number of obese.
Liu Tao is only 12 years old, but at 115 kg (around 40kg above the weight someone his age and height should be), he is a day patient at one of these hospitals. Here he has sessions of acupuncture and massage and clinic workers advise his parents on healthier diets. With many families having just one child because of China’s family planning policies, single children can be very spoilt and allowed to eat whatever they want. There are also very few public recreational spaces in urban areas, so children have difficulty finding places for outdoor play and sporting activities.
There are already an estimated 100 million Chinese who are obese. If obesity rates keep rising, this is going to prove a huge problem in the long term, putting strain on an already overburdened healthcare system. Obese people are much more likely to suffer from a range of illnesses, including diabetes and heart problems. On average, health-care spending for an obese person is 25% higher than for someone of normal weight.
China is already some way through a series of reforms for its healthcare system, which began in rural areas in 2003 and in the cities, in 2006. These reforms aim to introduce universal medical insurance, improve primary healthcare, provide access for all to health services, introduce better management and finance of hospitals and establish essential drug systems. Already, 1.23 billion of China’s 1.33 billion people have some kind of healthcare insurance and the government is working to extend coverage to the remaining 100 million, mainly migrant workers, elderly people and children in cities. And this year, nearly 100 million children have been vaccinated against measles.
But as well as improving its basic and primary healthcare services, the Chinese government is now having to address a problem of developed countries - obesity. Officials recently launched a campaign to get people walking at least 10,000 steps a day and began promoting healthier diets for children. At a time when China still has 150 million people living below the poverty line, the country must be Janus-like and look in two directions at once to improve the nation’s health; it must support the extreme poor who don’t have enough to eat and at the same time educate its middle-classes and wealthy citizens, who are beginning to eat too much.