As two of the world’s major economies – the US and the euro zone – appear to be sinking under their bloated debt levels, another type of weight problem is emerging globally.

On Friday, The Independent described the UK as “the fattest nation in Europe”. The newspaper said the number of obese adults was forecast to rise by 73 percent over the next two decades, from 15 million to 26 million, resulting in more than 1 million extra cases of diabetes, heart disease and cancer.

And Bloomberg reported expanding waistlines would add $66 billion (R474bn) a year to US health costs by 2030 – about 2.6 percent of the country’s annual health-care bill.

The media coverage was prompted by a study, led by Claire Wang of Columbia University in New York and Klim McPherson of Oxford University, and published in The Lancet, ahead of next month’s UN meeting on non-communicable diseases.

The problem is not confined to advanced economies.

Reuters said on Friday, according to some estimates, a third of China’s population – 429 million – are overweight or obese, and therefore prime candidates for heart disease and diabetes. It said the obesity rate had jumped 158 percent from 1996 to 2006 and was set to rise further.

The agency was quoting Ding Zongyi, a professor at the Chinese Medical Doctor Association, who has been studying obesity in China for the past 30 years.

In China, the report said, weight was seen as a status symbol. Reuters quoted the sales manager of a fat farm saying: “In the UK, only the poor people will eat junk food, and will therefore be fat. In China, it’s the opposite. The more money you have, the fatter you are.”

It’s true that in advanced economies most people believe you can’t be too thin, just as you can’t be too rich. But, despite this perception, many people can’t stop themselves from overeating.

A recent report from the Harvard School of Public Health in the US, linked the problem to urbanisation – in cities we do less and eat more.

“More than half the world’s population lives in cities, compared with 10 percent in 1900,” Harvard said.

While food intake should be a matter of personal choice, obesity has economic implications.

Reuters quoted Barry Popkin, a professor of nutrition at the University of North Carolina: “In China, the economic costs of obesity are enormous, in terms of treatment costs, paid sick leave, loss of productivity, disability and premature death.”

The indirect effect of obesity and obesity-related dietary and physical activity patterns was worth 3.58 percent of China’s gross domestic product in 2000 and was projected to reach 8.73 percent in 2025.

South Africa has its own obesity challenges, although the figures are not readily accessible.

How to deal with the problem? Harvard proposed a tax on junk food and subsidies for the production of healthy food as well as encouraging school physical education and urban bike lanes.

But, like many behavioural problems, to solve it you have to get inside people’s heads – in other words, education. A massive rollout of information in schools and to the general public is needed to explain the role of nutrition in health – including of course the ability of HIV/Aids sufferers to fight off opportunistic infections.

Personal choice plays a critical part – learning to say “no thank you” to food. After all, individuals are best placed to get inside their own heads.