Reporting from Beijing — Tian Ning shuffled unsteadily across his room at a weight loss clinic in Beijing, not exactly looking like the picture of health, but triumphant nonetheless.
In six months, Tian has gone from the unglamorous subject of a reality intervention television show called "Tian Weighs 462 Pounds, Beijing's Fattest Man," to a man eagerly approaching his ideal weight of 220. His meals are monitored and a machine jiggles his midsection for an hour of exercise each day at the Kelikexin International Weight Loss Club. For a bit of extra exercise, he goes for walks by himself.
"When I get down to [220 pounds], I'll be ready to go home," the 29-year-old Beijing resident said recently. "I can live a normal life."
To Tian, his progress represents a new lease on life — one he hopes will include a job in computer programming and a happy marriage — as long as he can control himself in a city where inexpensive, unhealthy food abounds and exercise is not part of the daily lifestyle.
Throughout China, but especially in cities such as Beijing, Shanghai and Tianjin, the ongoing fight against growing waistlines has developed a few new wrinkles. Diet fads and weight loss centers are on the rise as the traditional Chinese diet of vegetables and rice in many cases has been expanded, adding meat, oil and plenty of sugary snacks and drinks available at fast food chains and neighborhood shops dotting city corners.
Experts say reasons for the weight gain other than lousy eating habits include poor city planning — the dearth of green space and parks in Chinese cities — and general attitudes toward exercise and leisure. Bicycling, a key way for many Chinese to remain lean, is out of fashion.
An estimated 200 million Chinese adults are considered overweight and of those about 75 million are heavy enough to be categorized as obese, according to health experts. While not as severe a problem as in the United States, where estimates place more than 60% of adults as overweight or obese, experts say China increasingly faces a population coping with heart disease, diabetes and other weight-related illnesses.
Drugs, treatment and access to good doctors are expensive and beyond the reach of average Chinese. The government is spending $125 billion to revamp the health system to cover all Chinese citizens by 2020, but the plan is not expected to cover common diseases associated with weight.
Chen Chunming, who leads research teams at the Chinese Center for Disease Control and Prevention, an agency of the Ministry of Health, said government officials have initiated efforts to address the health risks.
"The government understands that if the situation is not controlled it can get serious," Chen said. "We've already started to pay attention to the issue of obesity and overweight so we're not pessimistic about the future."
In Beijing, the city critics have called China's fattest, the municipal government last year announced a campaign called "Healthy Beijinger: A 10-year Plan to Improve People's Health."
The campaign is aimed at overall health but one of its specific goals is reducing the amount of fat Chinese adults eat each day. Officials hope to reduce the number of overweight children in high school and primary schools from 17% to 15% by 2018.
The initiative has included sending informational nutrition pamphlets as well as 600,000 tape measures to schools with instructions from the Beijing Municipal Commission of Education that students should measure their parents' as well as their own waistlines and endeavor to lose weight over the Chinese New Year holiday.
For employees of state-owned companies, communist-style group exercise, or "radio calisthenics," were brought back in August and will become mandatory sometime in 2011. The Beijing Federation of Trade Unions has hired 5,000 instructors to teach employees how to maximize the eight-minute exercise routine.
Higher incomes have meant more people are eating rich, high-caloric diets and following sedentary lifestyles, a scenario that has also translated into a thriving weight loss industry. The weight loss center that hosted Tian for free, for example, has expanded to 1,000 locations across the country since it opened in 1993.
But the ongoing growth of China's economy — and a quest for the good life — is bound to continue influencing how the population responds to calls for healthy eating and fitness, said Paul French, co-author of the recent book, "Fat China: How Expanding Waistlines are Changing a Nation."
"The idea of going and mucking around in your garden, that's like being a peasant," French said. "Why would you ride a bicycle when you can drive a car? Luxury is idleness."
Kuo is a special correspondent.
Tommy Yang in The Times' Beijing Bureau contributed to this report.