Will China Get Fat Before It Gets Rich?

The rising wave of obesity around the world and its health and economic costs cannot be ignored—even in China. This is no longer a “western” problem. Today, 62 percent of the world’s obese people are in developing countries.

Global scourge

More than 2.1 billion people—nearly 30 percent of the global population—are overweight or obese today. That’s nearly two and a half times the number of adults and children who are undernourished. Obesity is responsible for about 5 percent of deaths worldwide. The global economic impact from obesity is roughly $2.0 trillion, or 2.8 percent of global GDP, roughly equivalent to the global impact from smoking or armed violence, war, and terrorism.  

A problem for China?

The fact of the matter is that rapid industrialization and urbanization is boosting incomes (Exhibit 1). Higher incomes mean more food and often a more sedentary lifestyle. The risk of obesity rises.

In China, the prevalence of obesity in cities is three to four times the rate in rural areas, reflecting higher incomes in urban areas and therefore higher levels of nutrition and food consumption and often less active labor. The prevalence of obese and overweight people rose at 1.2 percent a year in Chinese adult males between 1985 and 2004 and 1 percent a year in adult females.[1] Today, the top social cost to China is air pollution, the second is smoking, and obesity ranks only ninth. That ranking could rise very quickly.

Famine and feast

There is worrying evidence that obesity can entrench itself even more quickly in countries that have experienced food scarcity in the recent past. Take the Micronesian island of Nauru, which, until the mid-20th century, experienced repeated food shortages and starvation. Once food poverty was a thing of the past, the prevalence of obesity and type 2 diabetes soared to among the highest worldwide. In 2010, 94 percent of men and 93 percent of women were overweight, and approximately 71 percent of the population was obese.[2]

What needs to be done?

Without action, almost half of adults in the world will be overweight or obese by 2030. MGI’s recent economic analysis of obesity looked at 74 interventions that are being discussed or piloted somewhere in the world (including restrictions on advertising of high-calorie food and drink, calorie and nutritional labeling, and public-health campaigns); we had sufficient information to compare 44 of these internationally. The conclusion was that each single intervention is likely to have only a small impact on its own. Only a systemic, sustained portfolio of anti-obesity initiatives will work—implemented on a large scale. Everyone needs to play their part from government to retailers, consumer-goods companies, restaurants, employers, media organizations, educators, health-care providers, and individuals.

Individual responsibility for health and fitness is vital, but experience shows it is insufficient on its own. People need help and that means changes to the environment in which they are making choices. Such changes include changing marketing practices, and restructuring cities to make it easier for people to exercise.

Change is cost-effective

MGI’s initial analysis of obesity in the United Kingdom found that almost all of the 44 interventions are cost-effective. So it is well worth China experimenting with solutions and trying them out—before obesity takes hold and becomes an expensive problem.

[1] Barry M. Popkin, “Will China’s nutrition transition overwhelm its health care system and slow economic growth?” Health Affairs, volume 27, number 4, 2008.

[2] Nauru country health information profile 2011, statistical annex, World Health Organization.

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I'm a Director in McKinsey's Shanghai office and Director of the McKinsey Global Institute (MGI) in Asia. I also co-lead the Urban China Initiative (UCI), a thinktank devoted to transforming China's urban future. Visit the UCI website here.

Read my latest book, The One Hour China Book: Two Peking University Professors Explain All of China Business in Six Short Stories