The obesity epidemic has become a global burden, and it is generally expected that the countries with the largest appetites have the most voracious economies. In the United States, it is estimated that around 41.9 percent of the adult population in 2020 was obese, and obesity has become the second-leading cause of preventable deaths. Obesity is strongly correlated with various debilitating diseases, leading to the death of four million people annually. Within 30 years, the global population of those suffering from obesity has quadrupled from four percent to 18 percent.
However, the conception that countries with the highest obesity rates are only the most developed is a fallacy, as more money is correlated with more access to healthy foods. In reality, a multitude of underdeveloped countries suffer to an equal or similar degree when it comes to confronting obesity, Egypt having been in the top ten.
Egypt currently battles hundreds of billions of US dollars in national debt and rising health complications as more Egyptians are diagnosed with obesity. How has a nation with a serious financial crisis developed an obesity issue?
A Medical Fallacy: Egypt’s Economic Quagmire
While Egypt has received praise for its 45th international ranking with a GDP of US$250.9 billion, this recognition is diminished by the ever-increasing national debt. In 2022, Egypt reached a high of US$422 billion in national debt. Yet, with a clear lack of funding for overall development, the nation has managed to suffer from a “developed” country issue: obesity.
Looking forward, the overall national debt is predicted to increase from US$276.11 billion in 2024 to US$316 billion in 2025, with debt as a percentage of GDP only expected to decrease from 96.37 percent in 2024 to 82.62 percent in 2025. GDP is only expected to grow an average of 5.4 percent in five years. Egyptians are concerned about continuous loans from the International Monetary Fund, the World Bank, as well as other countries. Particularly, Egypt will have to balance this difficult financial situation with the needs of a growing population.
Moreover, the economic crisis is exacerbated by vast inflation. The stark contrast between Egypt’s average monthly income, US$342 per capita, and that in the United States (US$6,398) is augmented by-product costs. When comparing the nations’ pricing, US goods are found to cost 76.3 percent less than Egypt’s—a single demonstration of the drastic inflation crisis the country is currently experiencing. Therefore, the gap in per capita purchasing power is even higher than the gap in per capita income.
With a currency that has been devalued by above 50 percent (in comparison to the US dollar) and food inflation that has breached 60 percent, one might fear starvation or malnutrition. However, the nation’s unfortunate confluence of low wealth, disproportionately high prices, and low quality of life has continued to coexist with a devastating obesity crisis.
In 2022, Egypt was ranked seventh among the most obese countries with 21,670,640 obese people. After screening around 49.7 million Egyptians, the Institute for Healthcare Improvement determined in 2019 that close to 39.8 percent of the adult population was obese—strongly correlated with the 62 percent of males with Type 2 Diabetes, 13 million people with sleep apnea, six million people with hypertension, and a plethora of other health complications related to obesity.
Contributing Factors: Obesity in Egypt
Egypt is one example of the scientific phenomenon of “nutritional transition”: when economic, demographic, and other external factors cause a society to alter its traditional nutritional intake.
In Egypt, this dilemma affects all socioeconomic classes. Food inflation being over 60 percent has forced citizens to adjust accordingly. Families desperately prioritize the feeling of being full rather than meeting nutritional requirements. Focused on immediate survival, Egyptians opt for low-cost, high-calorie meals. Diets have transitioned from rice, vegetables, legumes, and spices to meats, carbohydrates, and sugar-heavy dishes. The Egyptian government has even recommended that people consume chicken feet instead of chicken meat.
Multiple political and economic factors have exacerbated this crisis. For instance, the Egyptian government subsidizes sugar and oil-based products rather than healthier alternatives, which is worsened by shops providing unhealthy snacks at lower costs. Many societal customs of Egypt are founded upon food; adding sugar to dishes or participating in grandiose meals is a cultural norm. Socioeconomic inequality also plays a role, for Egyptians with lower education (i.e., with a high school diploma or lower) and financial status are three times more likely to be obese.
Confoundingly, of these factors, the Egyptian government’s food subsidy program is the prominent cause of obesity in the population. Despite the economic disparity within the nation, obesity rates are fairly even across socioeconomic classes in Cairo. To combat the inflated food prices and prevent nationwide starvation, the subsidy program has focused on subsidizing bread, wheat flour, sugar, and cooking oil for the last 25 years. Those same items have been long recognized by health officials as fattening, with sugar supplanting the much-needed consumption of protein and fiber. This program is widely accessible to more than 80 percent of the population, so participation has led to these high-calorie items becoming common staples in the traditional kitchen.
These adverse effects of the government’s subsidy program are exacerbated by private sector practices. Egyptian restaurants that cater to late-night deliveries encourage consumption at all times of the day. The timing of this late-night dining not only deviates from the normal consumption hours but also the circadian rhythm that allows for digestion, causing the body to store the late-night meal into fat.
The Future of Fitness
Various proposed policies and health official opinions have sought to address this colossal dilemma threatening the health and survival of over a third of Egyptians. In 2018, the Ministry of Health and Population implemented the Egypt Multisectoral Action Plan For Noncommunicable Diseases Prevention (NCD) and Control 2018-2022. This initiative worked towards nine voluntary global NCD targets, including a five percent decrease in physical inactivity, a 20 percent decrease in salt consumption, and a 15 percent decrease in hypertension, diabetes, and obesity.
In addition to these sweeping measures, some medical professionals are recommending a more direct plan focusing on the youth. “Fighting this starts in schools…I know we’re not doing great economically right now, but nutrition classes and subsidizing one fruit or vegetable per day per child would give them something they don’t get at home,” states Egyptian dietician Dr. Sherine el Shimi. Similarly, Dr. Randa Abou el Naga of the Egypt World Health Organization (WHO) recommends government subsidies for more nutritionally rich products or ingredients that contribute to muscle development rather than the current options of sugar- and carbohydrate-intensive snacks. When the food most financially accessible is that of the greatest nutritional value, citizens will not be forced to sacrifice their savings for a healthy meal.
Ultimately, the coexistence of low economic growth and high obesity rates persists, as low- and middle-income nations are suffering most from high obesity rates, with Egypt previously ranking seventh with 32 percent of its youth population obese. Although Egypt is now 28th in the world for obesity prevalence, the overall obesity rate has actually increased from 31.3 percent in 2011-2012 to 35.7 percent in 2024. Egypt is one of many countries proving that obesity is far from a “developed country issue.”
