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The world's expanding waistline

The shape of things to come
Dec 11th 2003 From The Economist print edition

The world is too fat. Too bad WHEN the world was a simpler place, the rich were fat, the poor were thin, and right-thinking people worried about how to feed the hungry. Now, in much of the world, the rich are thin, the poor are fat, and right-thinking people are worrying aboutobesity. Evolution is mostly to blame. It has designed mankind to cope with deprivation, not plenty. People are perfectly tuned to store energy in good years to see them through lean ones. But when bad times never come, they are stuck with that energy, stored around their expanding bellies. Thanks to rising agricultural productivity, lean years are rarer all over the globe. Modern-day Malthusians, whoused to draw graphs proving that the world was shortly going to run out of food, have gone rather quiet lately. According to the UN, the number of people short of food fell from 920m in 1980 to 799m 20 years later, even though the world's population increased by 1.6 billion over the period. This is mostly a cause for celebration. Mankind has won what was, for most of his time on this planet, hisbiggest battle: to ensure that he and his offspring had enough to eat. But every silver lining has a cloud, and the consequence of prosperity is a new plague that brings with it a host of interesting policy dilemmas. As a scourge of the modern world, obesity has an image problem. It is easier to associate with Father Christmas than with the four horses of the apocalypse. But it has a good claimto lumber along beside them, for it is the world's biggest public-health issue today —the main cause of heart disease, which kills more people these days than AIDS, malaria, war; the principal risk factor in diabetes; heavily implicated in cancer and other diseases. Since the World Health Organisation labelled obesity an “epidemic” in 2000, reports on its fearful consequences have come thick andfast. Will public-health warnings, combined with media pressure, persuade people to get thinner, just as they finally put them off tobacco? Possibly. In the rich world, sales of healthier foods are booming (see survey) and new figures suggest that over the past year Americans got very slightly thinner for the first time in

recorded history. But even if Americans are losing a few ounces, itwill be many years before the country solves the health problems caused by half a century's dining to excess. And, everywhere else in the world, people are still piling on the pounds. That's why there is now a consensus among doctors that governments should do something to stop them.

Diet by fiat?
There's nothing radical about the idea that governments should intervene in the food business.They've been at it since 1202, when King John of England first banned the adulteration of bread. Governments and people seem to agree that ensuring the safety and stability of the food supply is part of the state's job. But obesity is a more complicated issue than food safety. It is not about ensuring that people don't get poisoned: it is about changing their behaviour. Should governments be tryingto do anything about it at all? There is a bad reason for doing something, and a couple of good ones. The bad reason is that governments should help citizens look after themselves. People, the argument goes, are misled by their genes, which are constantly trying to pack away a few more calories just in case of a famine around the corner. Governments should help guide them towards better eatinghabits. But that argument is weaker in the case of food than it is for tobacco —nicotine is addictive, chocolate is not—and no better than it is in any other area where people have a choice of being sensible or silly. People are constantly torn by the battle between their better and worse selves. It's up to them, not governments, to decide who should win.

Get them young
A better argument for...