Obesity

Given the large element of chance determining the constancy of food supplies, many traditional societies have regarded famine as an event sent by God to punish the wicked (Clarkson and Crawford 2001). More recently, a view has emerged that the overcoming of food scarcity is an evolutionary marker of the human condition, revealing tensions between food availability, affordability, and inequality. For most of human history, obesity has been an irrelevance, being a physiological characteristic limited to the wealthy. The fact that a situation of mass population overweight, if not clinical obesity, has now achieved normalcy in many societies raises questions not only for public health but also for contemporary culture.

The scientific debate around food availability was instigated in the late-eighteenth century by British political economist Thomas Robert Malthus. Malthus examined the relationship between food production and population change, arguing that the human population size would grow until checked by events such as famine, disease, or war. More recently, Nobel Laureate Robert Fogel documented what he described as humanity's struggle to defeat undernutrition and the associated burdens of disease and low economic growth.

In fact, the predictive elements of both analyses have been frustrated by later events. In defiance of Malthus, agricultural productivity kept pace with population growth, increasingly rendering famine more a localized rather than universal human condition. While over eight hundred thousand people remain undernourished worldwide, the majority of the world's population is adequately fed (Devereux 2000). Fogel's studies focused on the physiological and economic benefits of improving nutrition, but the evident advantages of food abundance have now tipped the other way. The World Health Organization (WHO) has predicted that there will be 2.3 billion overweight adults in the world by 2015 with more than 700 million of these obese. The United States is the world's pacesetter. From 2003 to 2004, 17.1 percent of U.S. children and adolescents were overweight and 32.2 percent of adults were obese (Ogden et al. 2006). The costs in terms of medical care and economic performance are immense.

The WHO defines overweight as a body mass index (BMI) equal to or more than 25, and obesity as a BMI equal to or more than 30. Obesity is associated with a range of health, social, and economic consequences, but unlike most dietary-related diseases, obesity also has an additional cultural significance due to its highly visual nature.

The physiological explanation of weight gain is largely uncomplicated, although genetic factors add to the picture. When calorie consumption outpaces calorie-consuming physical activity, energy imbalance occurs, and individuals gain weight. While some economists have attempted to explain obesity principally in terms of private consumption choices in the context of technological change (Philipson and Posner 1999), the fact that individuals find it difficult to correct such imbalances suggests that a more [Page 1050]complex, and certainly more culturally informed, explanation is required.

Though it seems a statement of the obvious, population weight gain requires the societal abundance of food or at least of some types of food. In Europe after World War II, food shortages led to the creation of the Common Agricultural Policy, which in turn led to increases in farm productivity and agricultural surpluses. Subsidies and protectionist measures have since extended throughout the world. In circumstances of falling food prices and rising incomes, the proportion of household expenditure on food plummeted, leading food and drink manufacturers to invest in “value added” products, such as processed and prepared foods, and to establish global systems of product sourcing, manufacturing, distribution, and branding. New foods, often devised in laboratory conditions employing cheap, subsidized commodities, have been typically energy dense (i.e., high in calorific value) containing high levels of saturated fats, sugar, and salt. For the same consumption weight as traditional foods, consumers therefore receive a much higher calorific intake. Energy-dense foods are cheaper and thus more appealing to poorer sections of the population.

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