It’s half past three in the morning and a desk nurse staggers out of the hospital, exhausted from working a double shift. Clerking at the hospital for more than 10 years, she has seen first-hand the effects of an unhealthy lifestyle. But she’s really hungry and spending time and money cooking overpriced ingredients is not a choice. The smell of fried noodles from the street stall beckons and she can’t resist, even though she knows she is well overweight.

Urban food security is a socio-economic problem we are more familiar with than we realise. This is because food security and obesity are often viewed as separate issues. When we think of food insecurity and hunger, images of scrawny, emaciated children living in famine-struck countries come to mind. Yet food insecurity exists everywhere, and often in countries where there are food surpluses rather than food shortages. Even Thailand, which is known for its exports of fruits and rice, is no exception.

Ten million Thais are considered undernourished, according to the Thai Health Promotion Foundation. Paradoxically, many of these undernourished 10 million do not look like the impoverished children in our minds. Based on statistics gathered by the Health Information System Development Office, one in three Thais is overweight and one in 10 is on the verge of obesity.

How is it possible that obesity and food insecurity can coexist in a world where enough food is produced for everyone to enjoy a healthy life? Astoundingly, researchers from the National Health Interview Survey found that people working in healthcare, particularly women, have the second highest obesity rates behind the protection services.

Obesity is prevalent in our society and contrary to popular belief, undernourishment does not equal underweight.  How is this possible?

“Food security exists when all people, at all times, have physical and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life,” was the definition agreed at the 1996 World Food Summit.

And if we take a step back to reflect upon and understand food security, we find that the complexity of the problem extends beyond the dimension of food availability or food production. Aside from food availability, access, utilisation, and stability are other dimensions that require serious consideration. Access, for instance, is still an issue. Food-insecure and low-income people can be especially vulnerable to obesity. With lack of access to hygienic, sanitary and healthy foods that are also affordable, and constantly exposed to the marketing of fast foods, they fall victim to nutrition deficiencies and diet-related chronic diseases.

Even though health and organic foods are a rising trend, a Consumer Report study reveals they are typically 20 to 100 percent more expensive than their conventional counterparts and thus only affordable to the privileged few. Those who cannot afford the luxury of health foods are reliant on ‘normal’ agricultural produce. But the amount of chemical fertilisers and pesticides used in this agricultural produce is worrying.

Mr. Chamnean Buacheen, a vegetable grower, says: “I’m scared when eating vegetables and try to wash them carefully before I eat them.” He said he needed to apply large quantities of chemical pesticides to his vegetables so that they look perfect.

“We use chemicals. They kill pests. We can sell vegetables,” said Mr. Chamnean who has grown vegetables for 20 years.

Past efforts to tackle food security have been too narrowly focused on production. That needs to change and extra effort must be made to increase awareness that food availability does not mean food security. Simply getting rid of hunger does not mean food is secure. In the next 35 years, nine billion people are expected to be living on this planet. The problem of food insecurity is not as simple as availability. Not only is food production a misunderstood issue, but the availability of unhealthy food also contributes to food insecurity. Urban poverty and low incomes are overarching issues that negatively influence access to safe and healthy foods.

Unless the dimensions of food security other than availability such as accessibility, affordability, utilization and stability are addressed, the number of people wholly dependent on malnourished food (many of them office workers) will prevail and the numbers of overweight and undernourished will continue to rise.