China has mounted the world’s largest weight loss campaign, tapping education, exercise, and a host of drugs old and new, reports Flynn Murphy Hunger defined 20th century China. War, maladministration, and natural crises conspired to snatch food from people’s mouths. A three year famine starting in 1959 claimed tens of millions of lives,1 traumatising minds and bodies in ways that still resonate.234 Since then, agricultural and industrial revolutions have made China the world’s largest food producer, and local diets are rich in fats, animal proteins, and processed grains,5 although malnourishment remains a challenge. So swift has been the transition from scarcity to plenty that more than half of adults are now overweight or obese, with nearly one in six meeting the Chinese threshold for obesity, up from around one in 20 in 2012.6 Non-communicable diseases now dominate China’s ill health burden (box 1) and cause nine in 10 deaths. For a health system that has long focused on infectious diseases, that statistic is both an undeniable achievement and a growing problem. Box 1 ### How obesity ballooned in China Obesity was so rare in China in the last century that cohort studies emerged only after 2000. A 2021 review found “important knowledge gaps” on the link between non-communicable diseases and waist circumference, fat distribution, and body mass index in Chinese populations, particularly over the life course, with a paucity of research on weight loss interventions for adults and even less for adolescents. Evidence on lifestyle interventions for Chinese populations has grown over the past four years, such as signs that healthy low carbohydrate diets may trump calorie restriction for overweight Chinese adults, as the same team found in a March follow-up. Evidence for drug interventions is also accumulating as a result of local drug trials for market approval of glucagon-like peptide-1 drugs. … RETURN TO TEXT
Flynn Murphy (Mon,) studied this question.