Today is the third annual UN International Yoga Day—and around China, thousands of yoga enthusiasts are performing asanas in public venues to demonstrate their newfound love of exercise. But the celebrations may be disguising bigger issues in the nation’s health and fitness culture.

China now has the largest number of obese children in the world, followed closely by India. According to a comprehensive study from the New England Journal of Medicine, there were 15 million obese children in China in 2015.

The US still tops the charts with the largest number of obese adults—estimated to be 79 million—but they are closely followed by China with 57 million. The World Obesity Federation has further announced that by 2025 China will have a staggering 50 million obese children, more than the US and India combined.

Experts are blaming the obesity epidemic on the sedentary, consumerist habits adopted by many in post-Reform China, particularly in white-collar workers who are adopting “convenience lifestyles.” However, the Global Burden of Disease report stated that affluence was not the driving factor in higher rates of obesity. Widespread marketing of affordable and easily accessible unhealthy foods is one of the main causes.

Doctors have also blamed the rocketing rates of childhood obesity on a combination of unhealthy diets and a lack of education and awareness among parents. A professor from Peking University said “fewer children were walking or cycling to school” and academic pressure is leading to less time for exercise, with some even suggesting the one-child policy has exacerbated the obesity problem by spoiling children.

Others have noted the growing consumption of red meat and higher salt intake across China, raising concerns about an early onset of diabetes and heart disease. An obesity epidemic could lead to a Type 2 diabetes epidemic, which has already been flagged by experts as a potential outcome in the near future. One in three adults with diabetes are living in China, according to a World Health Organisation report published last year. Type 2 diabetes is a chronic disease that can lead to further complications such as blindness, kidney disease, and amputation, adding strain to already over-stretched public health services.

The WHO report states that over 500 million people in China have pre-diabetes—blood sugar levels higher than normal, leading to high risk of developing Type 2 diabetes. While accurate figures are difficult to find, one study from the University of North Carolina suggests that the rate of diabetes among teenagers in China is now more than four times the rate of diabetes in teenagers from the US, totalling 1.7 million Chinese diabetic children aged between 7 and 18 and a further 27.7 million at risk of developing the disease.

In response to the obesity epidemic, there has been a rising demand for healthy, vegetarian products over the past few years, partly due to positive media coverage of healthy lifestyles. Unfortunately, one of the female beauty ideals in China include  “being thin and weak”, discouraging women from exercise that risks building muscle or strength. This is where yoga comes in—it’s one of the exercises that women are encouraged to opt for rather than running on a treadmill or going for a jog. But these gendered attitudes towards fitness and exercise are unlikely to bring about weight loss and tackle the burden of obesity.

With regards to adult obesity, a company in the northern city of Xi’an has taken matters into their own hands by implementing a rewards system to encourage their employees to lose weight. For each kilogram of weight lost, 100 yuan is rewarded, but 3 kilograms must first be lost in order to qualify for the program. Weight-loss camps for both children and adults are also on the rise. Reportedly, one camp in Shanghai had to turn people away due to high demand.

Tackling obesity in both Chinese children and adults is complicated by gender and cultural norms, rising wealth in urban areas, and accessibility to cheap, unhealthy foods. But a swift move to first tackle childhood obesity—through education, awareness, and regulations—would have a long-lasting impact on the overall obesity and diabetes epidemic in China.

Cover image from takefoto.cn