Originally published in Les Echos.
MARSEILLE - There are now obese mannequins for crash tests, XXL MRI machines, jumbo-sized seats in World Cup soccer stadiums. The adaptation of our daily environment to big bodies is occupying more and more engineers. That's because it's a heavyweight issue: One in three people in the world is overweight, and 671 million are considered obese. The World Health Organization has dubbed the phenomenon "globesity" because it is an issue that concerns the entire planet.
"The progression of overweight and obesity has been general and rapid" over the last 30 years, acccording to a study conducted in 188 countries and published last spring in the medical journal The Lancet. In Europe, the number of people who are overweight has tripled since the 1980s. In the United States, a third of men and women have a body mass index of 30, which is nearly double the normal corpulence of an adult.
In emerging markets, the development of the middle classes and the Westernization of lifestyles are accelerating the trend even further. According to researchers, more than half of this world's obese individuals live in China, India, Brazil, Egypt, Mexico, Pakistan and Indonesia.
This fattening of the planet is not about to reverse itself anytime soon, mainly because fast-food chains in emerging countries are peddling their recipe for success already established in the United States and Europe. In India, where 80% of the population doesn't eat beef in accordance with the Hindu religion, the Chicken Maharaja Mac has replaced the Big Mac in a market growing at a pace of nearly 30% per year.
And American giants, who can smell the money, are investing in a big way. The world fast-food leader Yum! (KFC, Pizza Hut, Taco Bell), has announced it will open 1,000 new franchises between now and 2015, at least 20,000 of them in China.
"These chains bring about a process of change in eating habits, upset the body and speed up weight gain," says Professor Frédéric Lapostolle, who has correlated the close connection between obesity and the availability of fast food by superposing on a world map the locations of McDonald's restaurants and looking at the density of the population that is overweight. "Homo obesus" will cover 60% of the planet by 2050, according to his projections.
Industry acts as the heavyweight
Industry is starting to anticipate this, as much to capture new market share as to prepare for future regulations. For a year now, Samoa Air - a small airline based in the Oceanic Islands, where the rate of obesity is among the highest in the world - has successfully tested its Class XL, which has about 30 centimeters more room and is priced according to a rate system based on the weight of the passenger and flying time. It costs a passenger weighing between 60 and 80 kilos (132-176 pounds) $50 to fly to a nearby island, and four times more than that for those who exceed the norm.
But adaptation is relevant for many businesses. Last month, the president of Humanetics, one of the primary global suppliers of mannequins used in car crash tests, announced that the company had developed its first obese model, representing a man weighing 124 kilos (273 pounds), which corresponds to a BMI of 35. "It's about reflecting the physical reality of the world population," he explained at the time. "All the more so as obese people are 78% more likely to die in a car accident because of poor position in their seat and the pressure of the seat belt and airbags in standard vehicles."
BMW is among the car manufacturers addressing the issue. "We take a scientific look at things so we can build a car that 95% of our clients can use," says Ralf Kaiser, who heads the company's ergonomics.
The idea of the king-size car is taking hold, right down to details. One of the main problems overweight drivers face, for example, is getting in and out of the car. BMW is developing on a discreet handle that would be mounted above the door. To make maneuvering easier without having to turn the body, it is also considering wide-angle video cameras that would give a driver a view of the entire circumference of the vehicle.
At Porsche, ergonomics experts have come up with an electric steering column that would rise when the car is stopped so that it is easier for obese drivers to sit down in and extract themselves from the car.
Medical adaptation
In the event of accident, obese victims in southern France would do well to call the Montpellier Samu emergency medical service. Designated as a center specializing in severe obesity, its Regional University Hospital Center acquired reanimation ambulances adapted to patients weighing up to 300 kilos (661 pounds). The ambulances are equipped with XXL equipment and vacuum mattresses for transporting obese patients on stretchers. Ambulance personnel have been trained to maneuver obese patients through difficult spaces (spiral staircases, narrow opening). Doctors are looking at new medical devices and therapeutic innovation to adapt the dosages of treatment to obese patients.
In the United States, the adaptation movement started 10 years ago. Over a third of hospitals have already invested in reinforcing or enlarging their equipment. An Indianapolis hospital, for example, acquired an MRI machine with a large diameter (which could also be of interest to claustrophobics), patient lifts affixed to the ceiling to facilitate patient transfers, wheelchairs with wide seats, and extra-large blood pressure monitors.
Such demand fuels a new industrial sector made up of numerous start-ups that see "globesity" as the market of the century. "Obesity will be an investment mega-theme for at least the next 25 years," says Sarbjit Nahal, stock strategist at BofA Merrill Lynch Global Research. He bases this prediction on a poll he conducted among 50 companies whose mission is the global fight against obesity in areas as varied as pharmaceutical products, health care, nutrition, diet products and equipment for overweight people.
All of this investment around the issue, by both private and public sectors, is driven by the huge price of doing nothing. In the U.S. alone, where 65 million additional people will be obese by 2030, the Institute of Medicine estimates the annual cost of this scourge at $190 billion and predicts a 3.6% rise in public spending because of it.
"Similar to the way it happened with smoking," notes Nahal, "it's a good bet that the burden of obesity will lead governments, companies and society in general to redouble efforts to reverse the trend."
