The world is expanding, but unfortunately it's not the global economy whose waistline needs to go up a size.
The rate of worldwide obesity has been marching higher at an extraordinary rate for more than three decades now. According to the Organisation for Economic Co-operation and Development, known as the OECD, fewer than one in 10 people were considered obese in 1980. As of 2011, 19 of the 34 OECD countries have a majority of their population that's either overweight (defined as a body mass index above 25) or obese (a BMI of more than 30).
A growing problem
The reason for higher obesity rates is pretty simple among the world's economic powerhouses: living conditions, education, and incomes have been improving. Certainly the diverse eating habits of different cultures has some bearing on this as well, but the trend has been unmistakably higher across all OECD countries.
As of the OECD's most recent data available, here are the nine most obese countries in the world:
The concern with obesity is that it puts people at higher risk of developing certain cardiovascular diseases, diabetes, and even certain types of cancer. Even more than that, it can affect those around you vis-a-vis health care costs. Obesity-related costs are responsible for 1%-3% of all health expenditures in most countries, with that figure jumping to somewhere in the 5%-10% range for the U.S. which tops the list of most obese nations. Furthermore, if you add in the lost production caused by obesity-related ailments on top of these health care costs, obesity costs are more than 1% of the total U.S. GDP!
These nine countries and their inhabitants really have two choices: be proactive or reactive.
The proactive response
Being proactive is the simple act of people making a conscientious choice to live a healthier lifestyle. This approach is accomplished by exercising on a regular basis and eating more nutritious foods, as well as by government agencies encouraging healthier lifestyles for its citizens.
You might think that gyms would offer an interesting investment opportunity in a situation like this, but customer loyalty is historically very poor. The smart way to play a proactive lifestyle change from an investment perspective is to target organic and natural food companies. Whole Foods Market (NASDAQ: WFM), for instance, has built its success upon offering locally grown natural and organic foods to consumers. Although organic foods cost more than what you'd find at your traditional grocery store, they are often more nutritious. You'll also find that consumers are more than willing to pay more for food if they know it's better for them.
But, it isn't just grocers that are making the difference. Fresh-Mex chain Chipotle Mexican Grill (NYSE:CMG) offers a full line of meats that are free of antibiotics and synthetic hormones under its Food with Integrity pledge. It's another way of supporting local farmers and a big move toward encouraging healthier eating habits among its consumers.
The reactive response
Understandably, proper diet and exercise will not work for everyone. You can blame it on genetics if you'd like, but the reactive response is where medication approved by the Food and Drug Administration steps in.
Over the past year, we've had two new potential chronic weight management drugs approved by the FDA: Qsymia by VIVUS (NASDAQ:VVUS) and Belviq by Arena Pharmaceuticals (NASDAQ:ARNA). Keep in mind that these aren't wonder drugs, but they did show significant promise in trials. Belviq, for example, induced weight-loss in excess of 5% in 38% of patients during trials while also providing better glycemic balance in patients with type 2 diabetes. VIVUS' Qsymia delivered comparatively intriguing results with 62% of recommended dosage patients losing at least 5% of their body weight in trials.
Unfortunately, chronic weight management drugs aren't magic pills. Qsymia has quite a few restrictions attached to it, including recommendations by the FDA not to use it if you're pregnant or if you've had a recent history of unstable heart disease. Similarly, Belviq isn't recommended for those who are pregnant and should be closely monitored in patients with congestive heart failure. These concerns were enough to keep Qsymia (known as Qsiva in Europe) and Belviq from being approved by the European Medicines Agency (essentially the FDA of the EU) because of unique safety concerns attached with each drug.
However, there still exists plenty of promise within the U.S. and abroad for both drugs -- if they can harness that potential, that is! Arena, I've long thought, has a one-up on VIVUS in that it's chosen to partner with pharmaceutical giant Eisai Pharmaceuticals to handle its marketing and distribution, whereas VIVUS is going it alone. Eisai's experience could be the factor that makes Belviq the better selling anti-obesity drug.
Arena and Eisai's collaborative deal covers most of North and South America, including the U.S., Mexico, and Canada -- the first, second, and sixth most-obese nations -- according to the OECD. Arena also has a marketing and distribution partnership in place in South Korea with Ildong Pharmaceuticals. However, South Korea is the least obese country of all, coming in at just 3.8% of the population, so that partnership is far less important than its tie-ins with Eisai.
Another name worth keeping an eye on here is Orexigen Pharmaceuticals (NASDAQ:OREX), which is in the process of developing its own chronic weight management drug known as Contrave. The drug was rejected in 2011 because of long-term cardiovascular concerns, but Orexigen has run extended safety trials and could resubmit its new drug application before the year is out.
The battle against obesity rages on
With Qsymia only recently becoming available in the U.S. and with Belviq still awaiting final labeling from the U.S. Drug Enforcement Agency before it can find its way onto pharmacy shelves, the reactive side of the business really hasn't had much chance to shine. Hopefully, within the next three to five years we'll see the start of a decline in nationwide obesity trends among these nine most-obese countries; but it'll also take a conscientious effort by the people living there to lead healthier lives. I do feel there's ample hope down the road for a slimmer global population and plenty of potential for fatter stock prices for some of the companies mentioned here.
Fool contributor Sean Williams has no material interest in any companies mentioned in this article. You can follow him on CAPS under the screen name TMFUltraLong, track every pick he makes under the screen name TrackUltraLong, and check him out on Twitter, where he goes by the handle @TMFUltraLong.
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