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For China’s Growing Middle Class, Expanding Waistlines Pose Problem

June 1, 2010 at 12:00 AM EDT
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In the second in his series of reports from China on global health issues, Ray Suarez reports on the dramatic increase in obesity as the country's growing class of educated and well-paid consumers adopt some Western-style shopping and eating habits.
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GWEN IFILL: Now: the second in our Global Health Unit reports from China.

Tonight, Ray Suarez looks at the growing problem of obesity.

RAY SUAREZ: China’s economy is getting bigger, an amazing 9 percent to 10 percent a year, even during a worldwide recession.

China’s cities are getting bigger. Vast apartment complexes rise from land cleared for rebuilding. There’s a constant hum of construction cranes and motion across the horizon. China’s middle class is getting bigger, better educated, better paid. Millions of new consumers flock to the new shopping centers, freed from the hard physical labor of their parents and grandparents.

All that change has consequences. The Chinese are getting bigger, too, and fast. “The New England Journal of Medicine” reports that 19 million people in China are now obese. And while the small percentage of overweight people here still falls well short of America’s epidemic, China’s rapid rate of increased obesity, 30 to 50 percent annually — that’s six million to 10 million more each year — has alarmed health officials.

In the course of just a few decades, China has moved from being a society with a fear of periodic famine to one where the rapidly rising rate of obesity is a serious public health threat.

Dr. Mi Jie is a pediatrician who is studying the phenomenon.

DR. MI JIE, pediatrician (through translator): During the last 30 years of economic development, people’s living standards have improved rapidly. Their lifestyles have changed enormously. More money means more food.

RAY SUAREZ: Dr. Mi is trying to convince parents that giving their children more food just because they can afford more food will eventually become a health burden for that child.

DR. MI JIE (through translator): Most obese children don’t have an immediate health risk, but health problems, such as high blood pressure, diabetes and cardiovascular diseases, will occur in 20 or 30 years, when they become adults, because health problems don’t appear until adulthood. Parents don’t see the problems. And they don’t take action.

In fact, the traditional thinking in China is that children need to be fat, and that means the child is healthy and strong. This concept, of course, is wrong.

RAY SUAREZ: Western fast-food restaurants have become part of urban Chinese culture.

I just want to know what everybody’s favorite food is at McDonald’s.

CHILD: Hamburger. Coke.

WOMAN (through translator): The kids these days, they can eat whatever they want. When I was young, I was from a poor family, and we didn’t have enough to eat. All we had were potatoes.

RAY SUAREZ: Paul French is the author of a soon-to-be-released book titled “Fat China.”

PAUL FRENCH, author, “Fat China”: They are extremely proud. And what we have here, of course, is a one-child policy, which is not enforced everywhere, but is still the norm.

So, now we have a generation coming through that not only have no siblings, but have no aunts and uncles. This has led to what we might term here the six-pocket syndrome, which is where every child, or little emperor, as they’re known here, has two parents and four grandparents.

And those four grandparents and two parents don’t really have anything to spend their money on except that child. So, they are lavishing that child. They are arguably spoiling that one child. And, of course, after generations of — of not having enough, people don’t want to say no to children. They want to give them everything. They want to let them enjoy the prosperity, rather than the austerity that they knew in their childhood.

RAY SUAREZ: According to the World Health Organization, between 5 percent and 10 percent of Chinese youth are now obese. Some of them make their way to the equivalent of a fat farm.

Here at the Aimin Fat Reduction Hospital, patients are not only introduced to healthier foods and daily exercise; they’re also given traditional Chinese medical treatments, like acupuncture.

DR. SHI LIDONG, chief executive, Aimin Fat Reduction Hospital (through translator): With acupuncture, we want to control the appetite, the desire of eating, and so they won’t feel very hungry. We use it to improve digestion and to break down the fat.

RAY SUAREZ: Dr. Shi Lidong is the hospital’s chief executive.

DR. SHI LIDONG (through translator): The appearance of the body is not important to us. Our goal is to change their lifestyle, help them understand what to eat and what not to eat.

RAY SUAREZ: The parents of 19-year-old Ma Chanwang paid for his visit to Aimin. His goal is to lose 40 pounds. Now in his fifth day, he’s already lost 15.

MAN (through translator): I started gaining weight when I was 8 years old. And I never stopped gaining. I like to eat deep-fried food, and I can’t control my appetite.

RAY SUAREZ: As American-owned fast-food joints pop up around the country, they have been followed by another American cultural symbol: Weight Watchers. At Weight Watchers in Shanghai, program director Shan Jin works with clients to limit the amount of food at mealtime.

SHAN JIN, program director, Weight Watchers China: Unlike the Western countries, where people are very used to cups, spoons, teaspoons or tablespoons, we don’t have that. It’s hard for people to find out how much they — they have eaten.

RAY SUAREZ: Chinese meals are often eaten from serving dishes in the middle of the table for all to share. People eat straight from the communal serving until the food is gone. How would you know how much you have eaten? It’s tougher to limit your portions.

SHAN JIN: Sometimes, we would ask them to put their foods in the — on the plate in front of them, so that they could have a portion, they could get a sense of their portion before they eat it. And — and that would also slow the process down. So, we — we’re asking people to change their eating behavior a little bit, a tiny little bit.

RAY SUAREZ: The dramatic increase in obesity here has been followed by a similar jump in the number of type 2 diabetics. In fact, China is now home to the most cases of diabetes worldwide. And experts worry about the implications that has on the country’s fragile health care system.

PAUL FRENCH: The problem with obesity is, once people are fat, that they are prone to certain diseases. And those diseases will work themselves out in the health care system. And it’s the fragility of China’s health care system that is the big worry.

RAY SUAREZ: Bigger portions of higher-fat foods are not the only culprit. Not long ago, China’s streets, even in the big cities, were full of bicyclists. Now that people have money, cars and motorbikes have taken the place of bicycles.

There are 20 million cars on the road. That number has tripled in just 10 years. The tradition of morning exercise in the park still exists, but it’s mostly China’s older generation that can be found doing their daily routines that keep them moving, keep them limber. Today, people are doing more indoor work, sitting at computer screens or television sets.

PAUL FRENCH: The great trend in China is urbanization. People are moving into the cities. They’re moving away from the countryside, 10 million, 12 million people a year. And that’s projected to go on for at least another decade. And those people are coming into the cities.

Increasingly, they’re getting white-collar office jobs, and they’re getting up in the morning. They’re getting the subway to work. They’re getting the elevator to the office. They’re sitting in a cubicle all day. Then they’re getting the elevator downstairs. They’re getting the subway home, and then they’re sitting in front of television at night and ordering in food.

So, they’re leading a much more sedentary lifestyle than they used to. And, of course, you know, many more people are driving around in cars, where they used to ride bicycles. And, also, particularly for children, sport is not a major part of the school curriculum, you know, because of the concentration on passing exams and so on.

So — so, in general, from — from toddlers up to elderly people, people are just more sedentary in the cities than they used to be.

RAY SUAREZ: Fast-moving China will get first to wherever the developing world is going, and won’t be alone in a fatter future. The World Health Organization recently described the concerns over China and worldwide obesity rates as a problem of “globesity.”

GWEN IFILL: Tomorrow, Ray continues his series on China with a visit to the 2010 World Expo in Shanghai.