Recently, an article was published in the Los Angeles Times that threw light on an issue that has been brewing in China for the past three decades. Over 200 million Chinese are now overweight, of which 75 million are clinically obese. According to the World Health Organization, obesity levels are below 5% across the country, but over 20% in some cities. Thanks to its huge population, China is home to one fifth of the world’s obese people. Pediatric health researcher Ji Chengye says “China has entered the era of obesity. The speed of growth is shocking.” But what lies behind China’s expanding waistlines, and how can this harmful trend be halted?

The foundations of obesity

Starting in late 1978, Deng Xiaoping’s opening and reform policy led to the economic boom China is witnessing today. However, a move towards urbanization paired with new wealth has caused eating habits to change, especially in the cities. Increased automation, less manual labour, and an improvement in public transport networks have meant a decline in exercise (“Luxury is idleness”, as Paul French wrote in his book Fat China – How Expanding Waistlines are Changing a Nation), and a move away from traditional diets towards fatty Western foods has seen the collective girth widen. In a bizarre dichotomy, many of China’s rural poor still suffer malnutrition, while 50% of 35 to 59 year-old city dwellers are overweight – a similar figure to Western countries.

Traditionally, being plump or fat was a sign of wealth and prosperity. The devastating famine of 1958 to 1960 was responsible for 30 million deaths, and the specter of starvation loomed large over future generations. Between 1949 and 1978, the state distributed low-quality cabbage to work units across the country, and this was the only thing that many people had to see them through the winters. Being thin was a sign not only of poverty and struggle, but an indication that all was not well spiritually. It was widely believed that an underweight person was being sucked dry from within by demons. So engrained was the fear of not getting enough food that, even up until recently, parents dosed their children up with Wahaha appetite stimulants.

While it is still relatively rare to see overweight adults in China, it is children who are suffering the worst of the obesity problem. A 2008 study across six hospitals by the Capital Institute of Pediatrics found that 10% of under-18s are obese, a rise of 47% since 2000. An influx of junk food and convenience meals from the West has meant that the likelihood of a child under 18 years old getting diabetes is now 2.5 times more likely than in 2004. Ten percent of under 18s are now obese – a rise of 47% since 2000. Hong Kong has the world’s second highest level of childhood cholesterol (after Finland, bizarrely enough), and Beijing is officially China’s fattest city.

The Solutions?

At the moment, there are scant resources to combat what will be an enormous drain on the health system when this generation of obese children reaches maturity. Being overweight is associated with conditions like hypertension, diabetes and heart disease, all of which are already on the rise. Despite an injection of US$125 billion dollars to create a public health system by 2025, China’s hospitals and resources cannot cope with the repercussions of the obesity problem. Change must come from within, and it has already begun.

In May 1998, propaganda-style national television broadcasts showed a legion of 2,500 children performing calisthenics on Tian’anmen Square to promote exercise. State-run companies have been rolling out compulsory eight-minute daily exercise regimes across all staff, which will become compulsory by 2011. In Beijing, a scheme called “Healthy Beijinger: A 10-year Plan to Improve People’s Health” aims to reduce the percentage of overweight school children from 17% to 15% by 2018.

Although not yet matching the USA (where an estimated 60% of the population are overweight), China’s obesity problem should not be underestimated. With measures afoot to combat the issue, the widening waistband should not swell much further. 

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Keywords: obesity problem China Obesity China solving China’s obesity problem