China’s state-run Global Times on Tuesday reported a major milestone in China’s growing affluence: more than half of the population is now overweight, according to research unveiled at the second annual China Obesity Conference.
The conference, referred to as COC2023 for short, was organized by several Chinese research and treatment organizations. The first conference called for a comprehensive study of obesity rates, and the second event delivered just such a report, collating data on more than 20,000 patients in 20 different cities.
Extrapolating from this test group, the authors of the study concluded that the percentage of overweight adults in China has increased dramatically over the past five years, with the pace accelerating sharply in 2021.
Northern China, where the cuisine includes more flour, was said to have grown more overweight than southern Chinese residents who prefer rice. COC2023 also cited colder weather in the north as a reason its residents eat more high-calorie food.
The Chinese government is evidently very concerned about rising obesity rates, especially morbid obesity, since it threatens to put even more of a burden on healthcare systems and social services that are already facing severe funding problems due to collapsing demographics. With fewer young workers paying into the system, the last thing Chinese planners need is for rising obesity rates to impose even higher healthcare costs on the aging population.
An overweight man shows his tongue to Dr. Li Ruijun before she begins his acupuncutre treatment at the Aimin Fat Reduction Hospital, on September 1, 2003, in Tianjin, China (Iko Lee/Getty Images).
Judging by the tenor of the COC2023 conference, the Chinese government is not interested in pretending “fat is healthy,” as some in the United States have insisted. China also does not seem to buy the argument that criticism of obesity is some exotic form of “racism.”
The Global Times described COC2023 as a flinty-eyed look at how much obesity will cost China and what can be done to alleviate the problem, including discussions of gastrointestinal surgery and experimental weight loss drugs:
Some drugs have not only successfully launched through early clinical research but have also conducted long-term cardiovascular protection research and safety research after listing and have seen good weight loss effects in clinical practice. How to scientifically use these drugs to achieve better glycemic outcomes is also worth further study, experts said, noting that more experts should participate in clinical research on obesity and translate existing clinical evidence into practice.
The GLP1RA injection, developed by a Shanghai-based biotech company, was approved as a treatment for type 2 diabetes in 2016, and is expected to be China’s first new-generation weight loss drug.
A 2022 paper published by the Chinese Medical Journal asserted that China has one of the fastest-growing obesity problems in the world, with commensurate surges in cardiovascular disease, diabetes, and kidney disease. The authors of the paper recommended urgent action before the “obesity pandemic” becomes an intolerable burden on the Chinese healthcare system.
The International Journal of Obesity (IJO) in February 2021 offered some theories about China’s remarkable surge in body-weight problems:
While obesity aetiology is multifactorial, including many aspects that are still not well understood, there are also likely to be underlying factors that are specific to China, such as previous famines and social policies. But the main overall driver is likely to be China’s exceptionally rapid economic growth. While this has created more prosperity and reduced poverty, the flipside has been an equally rapid nutrition transition, away from more traditional and balanced foods to a gradual introduction of ultra-processed junk food products. Such changes in our diet are now increasingly being implicated in weight gain and obesity, as well as many other chronic diseases.
IJO speculated that China’s authoritarian government and collectivist culture might take the problem more seriously than Western nations have:
Much of the political disinterest in implementing such policies, at least in the West, can probably be traced to the public opinion that obesity is self-inflicted, and that individuals with obesity lack character and will-power. This is a flawed narrative that is now facing increasing and much welcome resistance from academics, physicians and patient groups.
Another mental barrier to action is the nanny-state argument. This holds more merit, since we do not want governments to be overly authoritarian, but rather to act in a way that facilitates healthy choices, especially for socially vulnerable groups.
IJO concluded that China can either follow the example of the West, “where obesity has been largely ignored,” or “choose a path where sound and scientifically driven policies are used to balance continued economic prosperity with the clear ambition to facilitate healthy lifestyles.”
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