Dear Mark: Obesity as “First World Problem”?

Globe with a political map on vintage background. 3dFor today’s edition of Dear Mark, I’m not so much answering a direct question as I am riffing on an offhand comment. In the comments from last week’s post on weight loss culture, someone mentioned obesity being a “first world problem.” It made me think more deeply about the issue.

In a literal sense, yes. Obesity is often a first-world problem. If your primary concern is figuring out how to stop yourself from eating too much food, you’ve got the kind of problems starving kids in developing countries would love to have.

Yet, industrial food has a long reach. The island nations of Nauru, Micronesia, Tonga, Cook Islands, and Niue are the top 5 fattest countries in the world—even though they aren’t “first world”—because they rely almost entirely on imported, industrial food.

And if you take a look at the global fat rankings, the picture gets even murkier. The top 7 are island nations in the South Pacific. After that it’s Kuwait, whose Kuwaiti dinar is the highest valued currency in the world. Next is the United States, then Kiribati (another island nation). Dominica, Barbados, Argentina, Egypt, Malta, Greece, New Zealand, the UAE, Mexico, and Trinidad and Tobago round out the top 20. 

It isn’t clear to me that obesity is a first-world problem. It used to be, before industrial food wriggled its way into every corner of the world. Now it doesn’t discriminate.

People also use “first-world problem” another way: to shut down an argument. No one in the comment board was using it like this, mind you. It’s just been on my mind lately, so I’m going to explore it.

It’s tempting to use it that way during an argument or debate. You feel you “win,” and it’s kinda clever, and you’ll get a few chuckles. It has the veneer of valid criticism—yes, famine is objectively worse than too many fast food joints in your neighborhood—but nothing more.

Problems are problems. You can’t expect an obese man to prioritize addressing starving kids halfway across the world and feel guilty for the money and focus on eating healthy to lose 60 pounds. That’s not how people work. We care about what’s close. We care about what hits home, what affects us and ours directly.

Some would characterize this as a flaw that humans must evolve past. I disagree. I think it’s a feature.

Carrying around 60 pounds of extraneous tissue is a big deal. Fearing a single flight of stairs because you’re too heavy is not okay. Having sore knees from added stress each time you take a step is a major material consequence. These are not trifles. This is serious stuff.

And so is famine, and war, and the latest terrorist attack. But which can you actually change?

Caring about atrocities in the world feels like you’re doing something. You can even post to Facebook and help your peers feel like they’re helping. But just being aware has little to no chance of causing material benefits to those suffering. What are you going to do about them? How will you proclaim to the world how mad you are at the injustice of it all help?

There are ways to contribute to the solution, and I’m not in any way denouncing or minimizing those, but caring about larger issues still doesn’t change the truth that we inevitably have more influence on what’s closest to us.

Meanwhile, caring about those extra 60 pounds you personally carry has a higher chance of leading to meaningful change. Those changes can reverberate through your immediate circle of friends, family, and coworkers. They’ll see you lose the weight, or at least give it your all, and perhaps feel inspired to try something similar.

As you lose your weight, you can still care about bad stuff happening to other people. The two concerns can coexist.

Again, I’m not accusing any of my readers or commenters of making this argument. It does seem to happen elsewhere, though, and I don’t want people feeling like their personal concerns are “wrong” or unworthy compared to what else is going on in the world. None of us need that, and it helps no one.

I’d love to hear your take on the “first-world problem” question. Do you agree, disagree with my stance?

Thanks for reading, everyone. Take care. Be well.


TAGS:  big agra, body fat

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

If you'd like to add an avatar to all of your comments click here!

31 thoughts on “Dear Mark: Obesity as “First World Problem”?”

Leave a Reply

Your email address will not be published. Required fields are marked *

  1. Ironically first worlder’s coined the idea of there even being a culturally variable numerically ordered problems hierarchy. I don’t think they’re thinking about this stuff in those “lower worlds”. Or is that my first world based ideology ignorance exposing itself?
    I don’t know, but I disagree with the entire premise and believe that problems unique to a society are not numerically ordered like this but are just the obvious relative consequences to individual happenings and ways of doing things.

    In America, a very industrialized and capital driven socio economic way of living, of course it’s a more obvious consequence that our diet has become industrialized. Why is anyone surprised when other comparably poor nation’s that follow in our steps as a way into prosperity they incur the consequence sooner when they have a perfect established model to follow?

    This problem has no borders. Im no studied expert but seems to me that The supply chain changes made in our country to suit our burgeoning fast food industry would eventually have to ha s very broad world-wide food supply chain implications from the start to finish. These nation’s with their localized, cheap, and relatively untouched resources have to be seen as potential assets on the cheap to companies like Monsanto. Seems that these other lands may be at even greater risk than first worlder’s because they may not have the access to a knowledge base like we do here at MDA and are that much more likely to simply trust and consume what’s put in front of them.

    It really takes a communist jerk like Putin to put a stop to western companies trying to infect their people with GMOs and frankenfoods.

  2. The first time I was confronted with this term was while shopping for a new computer at Best Buy. A high-school-age sales associate that I was asking questions of dropped the phrase while I was weighing features. It’s one thing to discuss first-world problems as a willing participant, it’s another to have pretty mundane activities questioned by strangers. It reminds me of that phrase “I dream of a world where a chicken can cross the road without its motives being questioned.” 🙂

  3. Valid points, and I agree. People get fat because they eat too much of the wrong kinds of foods, period. All the rest is reasons and excuses. Reasons don’t contain calories, although they can require that adjustments be made regarding what we put in our mouths. Affluence often goes hand-in-hand with obesity (in the form of overindulgence), but so does poverty. Mexican food, for example–routinely eaten throughout much of the US as well as Mexico–is primarily peon food. It’s very starchy with few green vegetables. Delicious and cheap to make but fattening. Most of us here in the US can afford healthier fare, but starchy foods are both seductive and mildly addictive.

    We have little influence over what happens globally–or even next door, for that matter. As you say, that doesn’t mean we should stop caring, but it’s important to realize that we can only change ourselves.

    1. Shary – But I think that we do (have influence). Not you and I directly but as a nation, that until not long ago was considered the world no 1 super power. In our zealousness to bring democracy to every part of the world, we also heavily promoted and advocated the implantation of the food pyramid and other ways of life; think the movie & TV industry, coca cola, fast food (MacDonald, burger king etc.), seed oils and margarine, quick snacks (you can find the equivalence to Cheetos in many countries), and as a side note – dare I say fueled wars by selling arms to dictators? Now why did I say that we have influence? Because as consumers, we can influence the food industry (at least) to change it’s ways and what’s happening here will have ripples across the world. MDA is well know in many countries and so is the Paleo and Ketogenic diets and the number of those joining is getting larger by the day. Am I making sense?

      I just wanted to add, that new research is showing that obesity is a lot more complicated then simply “People get fat because they eat too much of the wrong kinds of foods, period. All the rest is reasons and excuses.” As someone who stayed lean and at the same weight since his army days 40+ years ago (I’m 60), it’s certainly easy to adopted this view and I did – but no longer. I know many who make bad food choices and they are still not fat. And some surprisingly enough are very healthy but that genetics. Luckily for me, I was raised on wholesome cooked foods that didn’t come with a label and was always aware of what I ate (did I ever drink coke? off course, but I also knew when to stop), so I was spared the agony. And yet, did the primal blue print helped me improve my eating and workout habits? Most definitely.

      1. You make some good points, TT, but obesity is still all about what we eat. There’s just no other way for it to occur. Some people don’t get fat from poor food choices; others do. It’s about a need to recognize which category we fall into and adjust accordingly before the pounds start to add up. That should be easy, but it isn’t. Sometimes people with a weight problem don’t even notice they are overweight until, seemingly overnight, they are 3 or 4 sizes larger. It isn’t always something that comes to one’s immediate attention.

        IMO, the worst thing anyone can say to an obese person is, “Don’t worry, it isn’t your fault.” Yet we hear and read that sort of thing all the time. Fat-shaming is cruel and unnecessary, but telling someone they aren’t responsible for their excess poundage is almost as bad. It promotes hopelessness, helplessness, and lack of positive action. I never had a lot of weight to lose, but I found it very uplifting and empowering to know I was actually doing something about it versus falling into the trap of thinking I had no control.

        1. I’ve been reading an old book (1940s, anyone can do that at their library, or t the academic library) on the liver and I am now convinced that the chem industry and/or agro industry are determined to destroy our livers. I don’t think we can have a lack of obesity without proper diet. But that means real food as defined by the Paleo’s. This isn’t a “bandwagon” opinion I have, it’s born of abandoning veganism, and studying the reasons why my body got sick. Losing weight is not as important to me as is restoring my liver. My liver is constantly in pain now. And in the 1940s they’d have done something for me. Today, it’s “oh you’re not jaundiced? go home and wait… next patient.” It’s the paleos that suggest that we eat high choline foods, high cysteine foods, high mineral content foods. The industial food pushers are definitely the problem, not any lack of self control on the victims. What you said about “didn’t notice they put on 3-4 sizes” is not the fault of the victims of foods designed to addict you and fool your body’s sense of what is enough. If you think so, then you haven’t done enough research into CCK and leptin/ghrelin and how it is fooled by sugary-salty foods.

          What I am dealing with is the result of basically having put myself on the same diet we give geese in order to make foie gras. The fastest path to that is to become vegetarian or vegan and rely on grains. The question for most people who are obese now is, how do you reverse it? We’ve obviously not studied how you can reverse the process in a goose. Geese who undergo that treatment are harvested and nothing is learned.

          In my experience even long term fasting does not fix the metabolic issue. My only hope is to heal my liver and that can take at least a year of staying away from all industrial foods and eating only real foods. I have tons of self control, but the problems we’re facing are not as simple as “eat less exercise more.” It never was. The guilty industrial chieftains would like us to think so because then they can blame us for the epidemic they unleashed.

  4. Agree with your stance, Mark. Especially what you said at the end, that you don’t want people feeling like their personal concerns are wrong or unworthy compared to everything that is going on in the world. We can care about what is going on in the world and still care about taking care of ourselves. The person you give as an example who has 60 pounds to lose could motivate others around them to take better care of themselves…there is a whole ripple effect. I don’t think there is anything superficial about wanting to look and feel your best and put your best self out into the world, and hopefully motivate others to do the same.

  5. You raise a valid question. What do you call it, when the UN so called relief agency (and rich countries) supplies 3rd world nations with poorly nourishing foods to clear it’s conscious? Doesn’t that turns it into 1st world problem? Millet for example is one of those staple foods. And interestingly enough, it makes up the balk part of Sudanese kids diet, who suffer from sky high levels of hypothyroidism.

  6. If we led the world into this problem maybe we should lead it out. That has an personal responsibility component and optimistically if you can educate and encourage others maybe a market and social changing one too.

  7. “Charity begins at home”. Remember that old adage? And by “home” it was meant your community, those geographically close to you. And I agree. We are best able to affect change when we take on locally-oriented or personal problems as our projects. Humans beings who require validation and locally-oriented projects allow us to see the fruits of our labours which, in turn, makes us want to help more.

    We are very much products of our environment. It is just as harrowing a feat for someone accustomed to a job, home, food on the table every day to find themselves living in a shelter and eating only one meal a day as it is for someone in a far away country who might only be eating once a week who sleeps on the ground without shelter. Sure, from a logical perspective it is certainly not the same. But we are not logical beings – we are emotional beings. Much of our “reality” is based on our perception due to past experience. So, by sarcastically telling someone that what they (very much) feel is a “first world problem” is condescending and apathetic. It simply makes people shut down and not ask for help.

  8. Before reading the article: Nope, obesity as “industrial” and “consumerism” problem.

    1. 1st World isn’t even a valid term today.
      It classified your affiliation in the Cold War: 1st world (NATO), 2nd (Soviet Union & co), 3rd (neutral).
      Most of 3rd world just got lumped together as backwards since they weren’t associated with the nuclear warfare debacle at all, btw. Which must surely mean they’re ALWAYS behind times, right?

      I prefer the terms developed countries and developing countries; as imperfect as they are, they paint a more accurate picture.

      1. although “developed” and “developing” assumes a “growth is good for its own sake” mindset, as if every nations’ goal is paving over every possible inch of ground they can manage. 1st, 2nd, 3rd, may be faulty, agree that “developing” is imperfect term.

  9. Obesity is a problem anywhere packaged food has a shelf life. The mini markets in developing markets are stocked with snack food. Groupo Bimbo sell 14 billion dollars of packaged bread and pastries all over Latin America. One could argue that first world procesing technology and lucrative profits due to subsidized grain and sugar components has made obesity a global epidemic.

  10. I think the phrase “first world problem” devalues some issues that are legitimate concerns for people. But, on the other hand, it puts the lid on overdramatization that seems to be prevalent in our society. I think that probably even discussing the value of the phrase is a first world problem. 😉

  11. The bottom line is always the bottom line: there’s no money in a fit, heathy, non snacking world. Big Pharma, Agra and the medical industry flourish as we (well, not me, cause I’m here) get sicker and sicker.

    1. That’s a patently false observation. If true, how come Mark’s running a multi-million dollar health food, health supplement, training and franchise business? Good on him. I hope he goes on to even bigger things. But obviously Mark saw a market opportunity and is satisfying it. Apparently in Mark’s case, capitalism isn’t too evil, is it?

      And of course, Mark’s story applies to literally thousands of such businesses exploiting the trend in health-driven solutions. This is no longer esoteric knowledge. The solutions are abundantly clear. You have to be willfully ignorant not to find them with even the most cursory of searches.

      One day, maybe Mark will tell us how he managed to thwart the attempts by “Big Pharma, Agra and the medical industry…” to prevent him from becoming a successful health capitalist. I assume they blocked him at every step…

      [Mark, baby, I love your site but for the love of all that is healthy (with particular reference to my eyes), make this comment input text darker. It’s crazy.]

      1. [And while you’re at it, please change to a serif font, for pete’s sake. There is a time & place for sans-serif, and it most definitely is not in text such as the body of comments here! The old blog before the change last year (?) was darker and a serif font, and much easier to read.]

      2. True–and I think it really was the internet that allowed businesses like Mark’s to flourish: democratization of information (linked to research papers!), then supplements and books…direct to the market, there’s no way for big Agra, Pharma, whatever to stop it. Power to the individual.

        1. What I’m actually saying is that the conspiracy angle that demonizes large companies purely for being large and insinuates that somehow they have bands of operatives out there attempting to sabotage the likes of Mark, et al. is patently false.

          And while the internet has afforded many opportunities for startups and niche businesses to thrive, plenty of alternative brands exist and have existed prior to the net. Trader Joe’s was around decades before, as were every form of green/hippy/alternative enterprise you could imagine. The internet has simply given them a wider reach. We shouldn’t forget that Apple started out in a garage long before the internet, selling its wares to like-minded individuals (despite the massive presence of IBM, etc.) and is now the world’s largest corporation, far exceeding the size of those oh-so wicked (boo, hiss) oil companies.

          The net is a model free market and that’s the essential factor in its success. The bricks and mortar business environment is so polluted with regulation, do-gooders and NIMBYs that for many the online world offers the last best hope for experimentation and innovation.

          1. It seems to me that you need to be reminded how criminal the large companies are. This food ingredient has bypassed the trans fat rules:


            Even the NYT has an expose of the intentionally addictive foods we are attacked with by these companies:


            Yes, attacked. This is physical violence. To give people foods like this and color it with cute advertising while doing science to turn your foods basically into drugs of addiction… that’s evil. And it should be criminal.

            If I gave someone a drug secretly, I’d go to jail. It would be assault. Tell me the difference.

          2. Sorry, not buying it. There will always be criminal elements in our society, but there’s no violence in the food industry. Nobody’s holding a gun to anyone’s head. We all have the right to eat as we please, whether it’s good for us or not. We also have the intelligence to be able to make better food choices if and when we choose to do so. Blaming outside factors for obesity constitutes an inability to assume any personal responsibility.

          3. Shary,
            Sort of. When you have nutritionists, doctors, government agencies and medical associations telling you that high carb, low fat is the only healthy way to eat, it takes a lot of deprogramming to view a healthy diet in any other light. When I ate according to the experts I was a ravenous food monster that felt so broken because I could eat a huge meal and have insatiable hunger 30 minutes later. It wasn’t until MDA that I even knew there was another way to eat. I remember talking to friends about giving up grains and being chastised for losing key nutrients by doing so.

            Everyone has their own story, but I can very much blame special interest groups for the weight and hunger issues of my youth.

  12. As the saying goes, “Think globally, act locally.” It means that you can effect change near home where impact is often immediate, while keeping your eye on the multitude of things we off the world can do better.

  13. I think that there are many ways that online trolls tell you to stfu and this is one of them. But I wonder why they bother. I mean if they don’t care about you then why post anything? I think like anything trolls do it’s “for the lulz.” They want you to react with a long self justification. The best reply is, “Hey guy, did you know there’s a reddit for global hunger concerns? Because we’re discussing obesity and its solutions here and you’re off topic.”

  14. Anyone who thinks obesity is a first world problem needs to read up on the double burden of malnutrition.

  15. Obesity is a global problem. And starvation and obesity can and do co-exist. Here in Ethiopia, after 2 years of drought, we anticipate 11 million people will need food aid in the next 6 months. People are indeed starving again and it’s tragic. But that’s not what I see in the capital city, Addis Ababa. My up & coming middle class Ethiopian friends consider take-out food, soft drinks, and a sedentary life signs of modernity. And they’ve got the beer bellies and muffin tops to prove it. … plus diabetes, early cardiovascular problems etc. I find there’s no contradiction in explaining to my colleagues and neighbors why I choose to walk to work, take the stairs, drink water instead of Coke, and ask for salad over fries, and also send money and fundraise for food and water aid for the places that need it.

  16. Good post, Mark. Agree with you. Not a fan of catch phrases that shut down discussion.

  17. Hi Mark and the Grokish community of Primal beings,
    I agree with your assessment. Obesity is a human metabolic problem when exposed to certain environmental stressors. It just so happens that it was mostly affecting a population of first world people. But, I have a major disagreement with the use of “first world, third world,” etc because if you look at our domestic (USA) inner cities rife with poverty and food deserts with families unable to feed themselves properly because of either money or access, it shows a “third world” problem in a “first world” country. It’s originally a largely economic disparity. And now I see a shift. It’s easier to stay fit when you can afford good food and a career that will allow enough of a work life harmony to be active. Now it’s a struggle for the impoverished to become healthy.
    Also, using the term “first world problem” with its intended meaning inherently describes a problem as minor, inconsequential, and easily solved. While obesity is a bit more complex, the Primal Blueprint and various other programs are available everywhere and is applicable almost everywhere as a tool to reclaim health and reverse this “first world” (and therefore easily solved) problem. So if we look at it from an optimistic point of view, obesity is a first world problem because it’s something that can be addressed effectively with a couple of changes in behavior.

  18. I agree. Although obesity is more prevalent in “developed” nations, a recent publication in the New England Journal of Medicine shows that obesity is rising in practically every nation on Earth ( And although the absolute numbers are smaller for developing nations, their rates of obesity are increasing fast. In addition to this article, there’s also a useful visualization tool to break down obesity rates of time by country and sociodemographics (

  19. Excellent, excellent article. I too have often shared many of these views and did so when I read the NYT article. I hope to have two points to share on this discussion.

    First, I think we should be very careful of using societal norms to justify any kind of sense of ethics or right/wrongness. Many societal norms from today and the past are abhorrent and taboo to our sensibilities of here and now; a few examples are genital mutillation of women in sub-Saharan Africa, historic cannabolism in certain Pacific Islands, and rape as “justice” in India, etc. As an anthropologist, I could go on, but the point is that to justify our feelings, our current sense of “wrongness” of obesity is merely the cultural lens through which we’re viewing the situation… and such is a very slippery slope.

    Secondly, as someone who has personally struggled with my weight (as have most of us here), I feel that one point of view has not been acknowledged: many who get to this point are simply lost, exhausted, and believe they’ve tried everything – EVERYTHING – and still haven’t been able to lose the weight. They may not have found primal; they may still be trying to eat low fat and fight through the hunger and rely on an ever-dwindling supply of will power. Nobody (today, here) wants to be fat. But there is a startling sense of worthlessness that comes with trying and failing so many times over and over again, wondering “what’s wrong with me? I’ve given this everything I had and I STILL failed!” It’s a lack of knowledge.

    I think we can distinguish between a wrong sense of accepting that “fat is how I will always be and it’s okay/good to be fat” and “fat is my current state and although I will need to work hard and sacrifice, I’m not a bad person for finding myself in this situation.” Embrace the knowledge that “I’m an okay person, but what I tried did NOT work, and I have to start with the reality of where I am.” It’s a subtle but powerful statement on not giving up, not giving in, and not accepting what others have accepted as the way they will always be.