Globesity: Documenting an epidemic

Rome-based photographer Silvia Landi has traveled the globe documenting the lives of those struggling with obesity and its various health effects.

Worldwide, there are now more than 700 million obese people, 108 million of whom are children, according to a recent study published in the New England Journal of Medicine. The research also found that the prevalence of obesity has doubled in 73 countries since 1980, contributing to 4 million premature deaths.

And, for the first time in human history, according to a 2016 study published by the Lancet medical journal, there are more obese people than underweight people in the world.

Landi, to illustrate the growing “globesity crisis,” has attempted to document the problem in three countries: Italy, South Africa and Mexico. Italy has a high childhood obesity rate (35 percent); South Africa struggles with a high adult female obesity rate (42 percent); and Mexico has one of the highest overall obesity rates in the world — nearly 30 percent, putting it just behind the U.S., Saudi Arabia and Egypt, although at times it has been in the top spot.

Many point to obesity as a problem that the U.S. is exporting, through the growing presence of its processed-food and soda companies into nations where diets have traditionally consisted of healthy whole foods. But a slew of complex issues have contributed to the growing epidemic.

“Speaking to people I photographed, especially in South Africa,” Landi said, “I have understood that they often did not realize they have a problem.”

Read more on this story by Beth Greenfield : Exporting obesity: How the food industry is changing the world’s diet >>>

See the related story by Michael Walsh: Amid obesity epidemic, Coke shifts ‘health’ focus from exercise to calories >>>

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<p>A girl suffering from obesity sits in front of her house in the Langa township, a poor suburb of Cape Town. Obesity in South Africa affects more women than men: 69.3 per cent of South African women have unhealthy levels of body fat and more than four in 10 are clinically obese. (Photograph by Silvia Landi) </p>
Township of Langa, Cape Town, South Africa

A girl suffering from obesity sits in front of her house in the Langa township, a poor suburb of Cape Town. Obesity in South Africa affects more women than men: 69.3 per cent of South African women have unhealthy levels of body fat and more than four in 10 are clinically obese. (Photograph by Silvia Landi)

<p>A man stands in one of the main supermarkets in Langa, one of the poorest areas of Cape Town. Inside the store it’s only possible buy food and drinks high in sugar content. The origins of Globesity have often been associated with globalization and poverty, and caused by the spread of food and cheap drinks, rich in sugars and fats, which have radically changed the eating habits of people in many countries. That’s particularly true in the emerging markets of developing countries, where a high percentage of the population lives below the poverty line, without access to quality food and easy access to cheap junk food. (Photograph by Silvia Landi) </p>
Township of Langa, Cape Town, South Africa

A man stands in one of the main supermarkets in Langa, one of the poorest areas of Cape Town. Inside the store it’s only possible buy food and drinks high in sugar content. The origins of Globesity have often been associated with globalization and poverty, and caused by the spread of food and cheap drinks, rich in sugars and fats, which have radically changed the eating habits of people in many countries. That’s particularly true in the emerging markets of developing countries, where a high percentage of the population lives below the poverty line, without access to quality food and easy access to cheap junk food. (Photograph by Silvia Landi)

<p>Giovanni Calacione, 47, in his home. Calacione has suffered from severe obesity for many years and his weight has fluctuated, reaching as high as 661 lbs. He has always battled against his body, and obesity has deeply influenced his emotional and work life, he says. (Photograph by Silvia Landi) </p>
Rome, Italy

Giovanni Calacione, 47, in his home. Calacione has suffered from severe obesity for many years and his weight has fluctuated, reaching as high as 661 lbs. He has always battled against his body, and obesity has deeply influenced his emotional and work life, he says. (Photograph by Silvia Landi)

<p>Giovanni Calacione with his daughter, who helps him get up. Italy’s incidence of obesity is indeed relatively low, at 10 percent, compared with the United States, whose rate of 38 percent is the world’s highest. But its rate of childhood obesity is worrisomely high, more than 30 percent and growing. And 45 percent of Italy’s population is overweight, which, some experts warn, could signal an impending rise of adult obesity, as well. (Photograph by Silvia Landi) </p>
Monte Terminillo, Italy

Giovanni Calacione with his daughter, who helps him get up. Italy’s incidence of obesity is indeed relatively low, at 10 percent, compared with the United States, whose rate of 38 percent is the world’s highest. But its rate of childhood obesity is worrisomely high, more than 30 percent and growing. And 45 percent of Italy’s population is overweight, which, some experts warn, could signal an impending rise of adult obesity, as well. (Photograph by Silvia Landi)

<p>Wendy, a single mother, with her two children in their home. Wendy lives in Langa, the oldest township in the suburbs of Cape Town, and suffers from diabetes caused by obesity. Her diet is mainly made up of fried foods, red meat, and meals purchased at fast food restaurants. Her two children say that their diet consists of chips, fast food dishes, and sweets. (Photograph by Silvia Landi) </p>
Langa township, Cape Town, South Africa

Wendy, a single mother, with her two children in their home. Wendy lives in Langa, the oldest township in the suburbs of Cape Town, and suffers from diabetes caused by obesity. Her diet is mainly made up of fried foods, red meat, and meals purchased at fast food restaurants. Her two children say that their diet consists of chips, fast food dishes, and sweets. (Photograph by Silvia Landi)

<p>The food court of Canal Walk, one of the largest shopping centers in the suburbs of Cape Town. Adult obesity is more common globally than malnutrition, and the worldwide prevalence of obesity more than doubled between 1980 and 2014. According to the WHO data, there are around 1.9 billion adults overweight, of those 600 million are considered obese. (Photograph by Silvia Landi) </p>
South Africa, Cape Town.

The food court of Canal Walk, one of the largest shopping centers in the suburbs of Cape Town. Adult obesity is more common globally than malnutrition, and the worldwide prevalence of obesity more than doubled between 1980 and 2014. According to the WHO data, there are around 1.9 billion adults overweight, of those 600 million are considered obese. (Photograph by Silvia Landi)

<p>Antonia Casilla Guzman, 62, looks for food in her fridge to prepare a snack. Guzman suffers from obesity, and one of her daughters has had a gastric bypass operation to lose weight. Malnutrition and obesity are two sides of the same coin: While undernutrition undermines physical growth and impairs brain development, obesity can lead to non-communicable diseases such as type II diabetes, hypertension, and cancer. Experts expect that “overnutrition” is expected to become the largest social and economic burden in the region. From 2014 to 2078, overweight and obesity are projected to cost on average $13 billion in Mexico per year. (Photograph by Silvia Landi) </p>
Mexico City, Mexico

Antonia Casilla Guzman, 62, looks for food in her fridge to prepare a snack. Guzman suffers from obesity, and one of her daughters has had a gastric bypass operation to lose weight. Malnutrition and obesity are two sides of the same coin: While undernutrition undermines physical growth and impairs brain development, obesity can lead to non-communicable diseases such as type II diabetes, hypertension, and cancer. Experts expect that “overnutrition” is expected to become the largest social and economic burden in the region. From 2014 to 2078, overweight and obesity are projected to cost on average $13 billion in Mexico per year. (Photograph by Silvia Landi)

<p>The pantry of Antonia Casilla Guzman, 62. Guzman suffers from obesity and one of her daughters, has had a gastric bypass operation to lose weight. (Photograph by Silvia Landi) </p>
Mexico City, Mexico

The pantry of Antonia Casilla Guzman, 62. Guzman suffers from obesity and one of her daughters, has had a gastric bypass operation to lose weight. (Photograph by Silvia Landi)

<p>Andre Hugo, 41, waits for a preoperative medical examination in the Chrysalis Clinic for the treatment of obesity, in the Life Kinksbury Hospital. (Photograph by Silvia Landi) </p>
Cape Town, South Africa

Andre Hugo, 41, waits for a preoperative medical examination in the Chrysalis Clinic for the treatment of obesity, in the Life Kinksbury Hospital. (Photograph by Silvia Landi)

<p>Andre Hugo, 41, during the preoperative medical examination in the Chrysalis Clinic for the treatment of obesity, in the Life Kinksbury Hospital. Hugo weighs 372 lbs. (Photograph by Silvia Landi) </p>
Cape Town, South Africa

Andre Hugo, 41, during the preoperative medical examination in the Chrysalis Clinic for the treatment of obesity, in the Life Kinksbury Hospital. Hugo weighs 372 lbs. (Photograph by Silvia Landi)

<p>A woman suffering from severe obesity buys some medicine at a pharmacy. Mexico has one of the highest overall obesity rates in the world — 32.4 percent, putting it just behind the U.S., although it has at times surpassed it. (Photograph by Silvia Landi) </p>
Xochimilco, Mexico

A woman suffering from severe obesity buys some medicine at a pharmacy. Mexico has one of the highest overall obesity rates in the world — 32.4 percent, putting it just behind the U.S., although it has at times surpassed it. (Photograph by Silvia Landi)

<p>Giosefina Gaytan Caballero, 51, during a visit with Dr. J.M. Miranda at the clinic “Fundacion RH Pharma” in Mexico City. Caballero suffers from rheumatoid arthritis, and its symptoms are aggravated by her obesity. (Photograph by Silvia Landi) </p>
Mexico City, Mexico

Giosefina Gaytan Caballero, 51, during a visit with Dr. J.M. Miranda at the clinic “Fundacion RH Pharma” in Mexico City. Caballero suffers from rheumatoid arthritis, and its symptoms are aggravated by her obesity. (Photograph by Silvia Landi)

<p>Giosefina Gaytan Caballero, 51, shops in a supermarket. Caballero suffers from rheumatoid arthritis whose symptoms are aggravated by his condition of obesity. “Some would say Mexico’s traditional foods are the cause, but that’s not the case,” said Fabio Da Silva Gomes, regional advisor on nutrition at the Pan American Health Organization (PAHO), a part of the World Health Organization. “If you look at the evidence, what you really see increasing is not an epidemic of traditional soups or beans. No. What is happening is the increase of ultra-processed products and sugary drinks.” (Photograph by Silvia Landi) </p>
Mexico City, Mexico

Giosefina Gaytan Caballero, 51, shops in a supermarket. Caballero suffers from rheumatoid arthritis whose symptoms are aggravated by his condition of obesity. “Some would say Mexico’s traditional foods are the cause, but that’s not the case,” said Fabio Da Silva Gomes, regional advisor on nutrition at the Pan American Health Organization (PAHO), a part of the World Health Organization. “If you look at the evidence, what you really see increasing is not an epidemic of traditional soups or beans. No. What is happening is the increase of ultra-processed products and sugary drinks.” (Photograph by Silvia Landi)

<p>Ricardo Landi, now 37, during a preoperative medical examination in the Chrysalis Clinic for the treatment of obesity, in the Life Kinksbury Hospital in 2015. Because of his weight problem, Landi suffers from knee problems that prevent him from walking for extended periods. (Photograph by Silvia Landi) </p>
Cape Town, South Africa

Ricardo Landi, now 37, during a preoperative medical examination in the Chrysalis Clinic for the treatment of obesity, in the Life Kinksbury Hospital in 2015. Because of his weight problem, Landi suffers from knee problems that prevent him from walking for extended periods. (Photograph by Silvia Landi)

<p>Two men doing exercise in a park in the center of Mexico City. The “Gimnasios Urbanos” were built in 2016, with the goal of stimulating sports and physical exercise in the overweight population of Mexico City. (Photograph by Silvia Landi) </p>
Mexico City, Mexico

Two men doing exercise in a park in the center of Mexico City. The “Gimnasios Urbanos” were built in 2016, with the goal of stimulating sports and physical exercise in the overweight population of Mexico City. (Photograph by Silvia Landi)

<p>Two children take a snack break in Zanethemba Kidz Haven School. The school is an early childhood development center that’s focused on child educational development, nutrition, and healthcare for orphaned and displaced children in the poorest area of Phillippi. (Photograph by Silvia Landi) </p>
Township of Philipphi, Cape Town, South Africa

Two children take a snack break in Zanethemba Kidz Haven School. The school is an early childhood development center that’s focused on child educational development, nutrition, and healthcare for orphaned and displaced children in the poorest area of Phillippi. (Photograph by Silvia Landi)

<p>A shop that sells super-sized bags of fries and fried snacks. Seeking to expand beyond their saturated markets in the northern hemisphere, Fabio Da Silva Gomes of PAHO said, the processed-food and drink corporations have been “aggressively targeting countries where most of the diets and most of the food systems are still comprised of real food — foods that are grown, prepared, and shared by human beings and not by machines and industrial process. That’s why they’re being more aggressive in Latin America and the Caribbean, where no more than 35 percent of what people [traditionally] eat are in the form of ultra processed products — industrial formulations of flour, salts, sugar and cosmetics, which try to mimic real food but have very little food as ingredients.” (Photograph by Silvia Landi) </p>
Xochimilco, Mexico

A shop that sells super-sized bags of fries and fried snacks. Seeking to expand beyond their saturated markets in the northern hemisphere, Fabio Da Silva Gomes of PAHO said, the processed-food and drink corporations have been “aggressively targeting countries where most of the diets and most of the food systems are still comprised of real food — foods that are grown, prepared, and shared by human beings and not by machines and industrial process. That’s why they’re being more aggressive in Latin America and the Caribbean, where no more than 35 percent of what people [traditionally] eat are in the form of ultra processed products — industrial formulations of flour, salts, sugar and cosmetics, which try to mimic real food but have very little food as ingredients.” (Photograph by Silvia Landi)

<p>Benito Gutierréz Moreno, 40, does odd jobs in a market, including valet parking, in exchange for some pesos. He often waits all night for a car to park, and while he is waiting he drinks and eats snacks and drinks “refrescos,” or sodas, which he buys in the store. He suffers from severe obesity and is not following diets or treatments to improve his health. In Mexico, 50 percent of the population lives below the poverty line, without access to quality food and with easy access to inexpensive junk food. (Photograph by Silvia Landi) </p>
Mexico City, Mexico

Benito Gutierréz Moreno, 40, does odd jobs in a market, including valet parking, in exchange for some pesos. He often waits all night for a car to park, and while he is waiting he drinks and eats snacks and drinks “refrescos,” or sodas, which he buys in the store. He suffers from severe obesity and is not following diets or treatments to improve his health. In Mexico, 50 percent of the population lives below the poverty line, without access to quality food and with easy access to inexpensive junk food. (Photograph by Silvia Landi)

<p>Benito Gutierréz Moreno, 40, gets a snack from a street vendor. He suffers from severe obesity and says he is not aiming to change his diet or lifestyle. (Photograph by Silvia Landi) </p>
Sonora Market, Mexico City, Mexico

Benito Gutierréz Moreno, 40, gets a snack from a street vendor. He suffers from severe obesity and says he is not aiming to change his diet or lifestyle. (Photograph by Silvia Landi)

<p>A woman fills a tray of pastries at a sweets store. Mexico have very high levels of child obesity and an increasing rates of type 2 diabetes among children. The government of Mexico has been faced with the enormous fiscal and health consequences of obesity and made major regulatory changes. These include taxing two components of the diet, sugar-sweetened beverages (SSBs) and non-essential foods (unhealthy food with excessive saturated fat, sugar and/or sodium). (Photograph by Silvia Landi) </p>
Mexico City, Mexico

A woman fills a tray of pastries at a sweets store. Mexico have very high levels of child obesity and an increasing rates of type 2 diabetes among children. The government of Mexico has been faced with the enormous fiscal and health consequences of obesity and made major regulatory changes. These include taxing two components of the diet, sugar-sweetened beverages (SSBs) and non-essential foods (unhealthy food with excessive saturated fat, sugar and/or sodium). (Photograph by Silvia Landi)

<p>People fill trays of pastries at a sweets shop. Mexico has a very high level of child obesity cases, and an increasing rate of type 2 diabetes among children. (Photograph by Silvia Landi) </p>
Mexico City, Mexico

People fill trays of pastries at a sweets shop. Mexico has a very high level of child obesity cases, and an increasing rate of type 2 diabetes among children. (Photograph by Silvia Landi)

<p>Some women during a political meeting organized in the township of Khayelitsha, one of the poorest areas of Cape Town. During the meeting, free food and alcohol is offered to all present. (Photograph by Silvia Landi) </p>
Township of Khayelitsha, Cape Town, South Africa

Some women during a political meeting organized in the township of Khayelitsha, one of the poorest areas of Cape Town. During the meeting, free food and alcohol is offered to all present. (Photograph by Silvia Landi)

<p>At Mzoli’s Buthcery, a cook seasons the meat. In the tray is the portion, ordered by two people during the braai (a tipical South African BBQ). Mzoli’s a “do-it-yourself” market and eatery is located in the township of Gugulethu, a black neighbourhood 9 miles southeast of the center of Cape Town.<br> South Africa consumes about 2.9 million tons of poultry, beef and pork meat per year. (Photograph by Silvia Landi) </p>
Township of Gugulethu, Cape Town, South Africa

At Mzoli’s Buthcery, a cook seasons the meat. In the tray is the portion, ordered by two people during the braai (a tipical South African BBQ). Mzoli’s a “do-it-yourself” market and eatery is located in the township of Gugulethu, a black neighbourhood 9 miles southeast of the center of Cape Town.
South Africa consumes about 2.9 million tons of poultry, beef and pork meat per year. (Photograph by Silvia Landi)

<p>Some teenagers during a braai, at Mzoli’s Butchery, eating and drinking alcohol. Alcoholism combined with the quantity and low quality of food has increased the rate of obesity among young people. An example of the evolution of globesity is South Africa, with an obesity rate nearly double the global average and on its way to becoming one of the world’s fattest nations. (Photograph by Silvia Landi) </p>
Township of Gugulethu, Cape Town, South Africa

Some teenagers during a braai, at Mzoli’s Butchery, eating and drinking alcohol. Alcoholism combined with the quantity and low quality of food has increased the rate of obesity among young people. An example of the evolution of globesity is South Africa, with an obesity rate nearly double the global average and on its way to becoming one of the world’s fattest nations. (Photograph by Silvia Landi)

<p>A woman has breakfast with a sausage, cooked in a street braai (a typical South African BBQ), in the township of Khayelitsha, one of the poorest areas of Cape Town. (Photograph by Silvia Landi) </p>
Township of Khayelitsha, Cape Town, South Africa.

A woman has breakfast with a sausage, cooked in a street braai (a typical South African BBQ), in the township of Khayelitsha, one of the poorest areas of Cape Town. (Photograph by Silvia Landi)

<p>A woman buys meat as a snack, on the street in Khayelitsha is one of the poorest areas of Cape Town. (Photograph by Silvia Landi) </p>
Township of Khayelitsha, Cape Town, South Africa.

A woman buys meat as a snack, on the street in Khayelitsha is one of the poorest areas of Cape Town. (Photograph by Silvia Landi)

<p>Grace, a resident of Khayelitsha, and her friend Angel, eating a meat dish and drinking a fruit-flavored drink with a high sugar content. When asked if she consumes fruit in her daily diet, she answers, “Yes, I drink Coke and juice.” In South Africa, approximately two-thirds of the population are overweight and women are affected more than men: 69.3 per cent of South African women have unhealthy levels of body fat and more than four in 10 are clinically obese. (Photograph by Silvia Landi) </p>
Township of Khayelitsha, Cape Town, South Africa

Grace, a resident of Khayelitsha, and her friend Angel, eating a meat dish and drinking a fruit-flavored drink with a high sugar content. When asked if she consumes fruit in her daily diet, she answers, “Yes, I drink Coke and juice.” In South Africa, approximately two-thirds of the population are overweight and women are affected more than men: 69.3 per cent of South African women have unhealthy levels of body fat and more than four in 10 are clinically obese. (Photograph by Silvia Landi)

<p>Meat is sold on the streets of Khayelitsha, one of the poorest areas of Cape Town. In South Africa, says Aaron Motsoaledi, the country’s minister of health, “Obesity is caused by the rapid shift to urban living combined with increased consumption of Western-style diets high in sugar, fat, and salt. The problem is worsened in South Africa since it is a nation with a love of meat barbecued on the <em>braai,</em> cutting across ethnic boundaries; the two groups hit hardest by obesity are white Afrikaner males and black urban females.” (Photograph by Silvia Landi) </p>
Township of Khayelitsha, Cape Town, South Africa

Meat is sold on the streets of Khayelitsha, one of the poorest areas of Cape Town. In South Africa, says Aaron Motsoaledi, the country’s minister of health, “Obesity is caused by the rapid shift to urban living combined with increased consumption of Western-style diets high in sugar, fat, and salt. The problem is worsened in South Africa since it is a nation with a love of meat barbecued on the braai, cutting across ethnic boundaries; the two groups hit hardest by obesity are white Afrikaner males and black urban females.” (Photograph by Silvia Landi)

<p>Two shopping carts abandoned on a street. Among the trash lies an empty Coco Cola bottle. (Photograph by Silvia Landi) </p>
Township of Khayelitsha, Cape Town, South Africa

Two shopping carts abandoned on a street. Among the trash lies an empty Coco Cola bottle. (Photograph by Silvia Landi)

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