"With globalization, there's been increased availability of Western diets that have more prepared foods, fats and certain carbohydrates," said Jeffrey Sturchio, president and chief executive officer of the Global Health Council, an alliance of organizations, health care professionals and institutions devoted to improving health worldwide. "Fresh fruits and vegetables may not be available in developing countries and lower-income neighborhoods -- even in the U.S. it may be easier to find potato chips than healthier alternatives like apples, oranges and bananas."
Sturchio said that blood pressure and cholesterol medications are difficult to get in developing countries, also contributing to the rise in obesity.
"In developing countries, there is less access to these medications, so obesity may be increasing in regions that had been characterized by normal weight. Countries that have experienced conflict or natural disaster may rely on prepared foods that often contain high levels of salt, which contributes to high blood pressure," he said.
Changing views of obesity could also be contributing to the pandemic while also reducing high blood pressure and cholesterol levels.
"Others believe that social stigma is driving the obesity-related pathology," said Muennig. "As more people become obese, the logic goes, the more comfortable people feel in their own skin, and the less stressed they feel. Stress has been strongly linked to high blood pressure and cholesterol."
In an accompanying editorial, Salim Yusuf and Dr. Sonia S. Anand of McMaster University in Hamilton, Ontario, Canada say strategies to reduce obesity will likely take decades to work.
Other experts say getting rid of subsidies offered for production of certain foods, taxing certain foods and making it more difficult to purchase unhealthy foods with government aid are policies that could work.
They acknowledge, though, that these strategies would be difficult to put into practice.
"In this country some people may not want the government to interfere with individual choice by taxing certain unhealthy foods," said Sturchio. "In developing countries weak health systems pose a significant challenge. This includes everything from healthcare worker shortages to access to care and treatment."
While new strategies are needed, some say stemming the rising tide of obesity could be as simple as returning to very old habits.
"We need to restore some of what used to be the norm in terms of foods direct from nature and daily exertion," said Katz.