What is driving global obesity trends? Globalization or “modernization”?

Abstract

Background Worldwide obesity has more than doubled since 1980. Researchers have attributed rising obesity rates to factors related to globalization processes, which are believed to contribute to obesity by flooding low-income country markets with inexpensive but obesogenic foods and diffusing Western-style fast food outlets (dependency/world systems theory). However, alternative explanations include domestic factors such as increases in unhealthy food consumption in response to rising income and higher women’s labor force participation as countries develop economically (“modernization” theory). To what extent are processes of globalization driving rising global overweight/obesity rates versus domestic economic and social development processes? This study evaluates the influence of economic globalization versus economic development and associated processes on global weight gain. Results Using two-way fixed-effects OLS regression with a panel dataset of mean body weight for 190-countries over a 30-year period (1980–2008), we find that domestic factors associated with “modernization” including increasing GDP per capita, urbanization and women’s empowerment were associated with increases in mean BMI over time. There was also evidence of a curvilinear relationship between GDP per capita and BMI: among low income countries, economic growth predicted increases in BMI whereas among high-income countries, higher GDP predicted lower BMI. By contrast, economic globalization (dependency/world systems theory) did not significantly predict increases in mean BMI and cultural globalization had mixed effects. These results were robust to different model specifications, imputation approaches and variable transformations. Discussion Global increases in overweight/obesity appear to be driven more by domestic processes including economic development, urbanization and women’s empowerment, and are less clearly negatively impacted by external globalization processes suggesting that the harms to health from global trade regimes may be overstated. Electronic supplementary material The online version of this article (10.1186/s12992-019-0457-y) contains supplementary material, which is available to authorized users.

The COVID-19 Pandemic Lockdowns and Changes in Body Weight among Polish Women. A Cross-Sectional Online Survey PLifeCOVID-19 Study

“…Interestingly, the results of another study conducted in Poland among the population aged 15-29 years are in line with our findings and indicate the positive association between the economic situation and obesity prevalence [59]. Additionally, Fox et al [60] emphasized that women's empowerment associated with economic development, robustly predicts higher mean BMI, that could be important in our study group. As it turns out, the association is complex and differs depending on the country of study, and therefore on socio-demographic specificity.…”

A scoping review on economic globalization in relation to the obesity epidemic

“…In contrast, de Soysa et al reported that foreign direct investment, trade openness, and economic freedom were inversely associated with body weight and obesity among children and adolescents. Fox et al reported that economic globalization did not significantly predict increases in mean BMI.…”

“…The reasons for exclusion were that two articles were not directly related to economic globalization, two articles did not report any outcome pertaining to body weight status, four articles were narrative review, commentary, or study protocol instead of original study, and the other six articles were not data‐driven empirical research. In total, 16 articles met the eligibility criteria and were included in the review …”

“…Moreover, it is possible that the homogenization of “obesogenic” cultures as a product of globalization may not be as comprehensive as initially thought. Fox et al reported a lack of association linking economic and social globalization to the obesity epidemic. Their empirical analyses found that domestic factors associated with modernization including increasing GDP per capita, urbanization, and women's empowerment were associated with increases in adult mean BMI over time, and when those domestic modernization factors were accounted for, economic and social globalization did not play a noticeable role in the changes of country‐level obesity prevalence …”

Obesity: Health and Economic Consequences of an Impending Global Challenge

“…Globalization. The globalization and trade literature is much less focused (Bogin et al 2014;Fox, Feng, and Asal 2019;Popkin 2006;Reardon, Stamoulis, and Pingali 2007;Snowdon and Thow 2013;Thow 2009;Thow and Hawkes 2009;Wilkinson 2004). Globalization is very much represented by the increased flow of goods (for example, food retailers selling ultra-processed food), services, and technology, all of which are discussed below.…”