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In populous countries like China and India, more and more people are moving into the middle class and adopting a Western way of eating. As a result, fast food companies are experiencing significant growth in foreign markets.

Fast Casual magazine reports that India’s food service market—alone—amounted to more than $400 billion in 2015. It is expected to grow at a skyrocketing rate over the next five years. Food Logistics magazine notes that U.S. based market intelligence company, MR, estimates the global fast food market will reach $617.6 billion in 2019.

As fast food expands in key global regions, other trends are beginning to surface. In a recent WSJ post entitled “India Has a Growing Obesity Problem, Study Shows,” Reporter Suryatapa Bhattacharya explores findings from a study published in the Lancet, a British medical journal. The study compared body-mass index from 1975 to 2014 from adults in 186 countries. It showed that middle- and poorer-income countries like China, India and Brazil jumped in obesity rankings.

According to the study, China had the most obese men and women in the world in 2014. India, which had 800,000 obese women and 400,000 obese men in 1975, was found to have 20 million obese women and 9.8 million obese men in 2014—the most significant rise in obesity among the countries studied.

Another report from WSJ addresses India’s diabetes problem. The World Health Organization (WHO) found that more men die from diabetes in India than in any other country. Experts connect this to diets that are increasingly high in sugar and trans fat.

Looking at the trends above, it’s hard to ignore the connection between the global expansion of American fast food chains and the sharp rise of obesity and diabetes that seem to follow along the same path.

A couple of decades ago, North America and Europe were high-growth regions for fast food. Now, as MR reports, customers in both regions are moving toward more nutritious fare. They are increasingly in favor of the usage of hormone-free meat, natural vegetables, organic cheddar cheese, and operational transparency.

It’s a complex problem. Multi-national public corporations are fulfilling their obligations to shareholders, creating jobs and adding to local economies. Previously impoverished countries are beginning to thrive. Their citizens have more expendable income to enjoy the “extras” we take for granted…but at what cost?

As a global community, we need to take a much closer look at these trends and probe critical questions surrounding our food system. For starters, what is the real objective? For example, should developing countries benefit from what industrialized countries have already learned? We understand that fast food has an adverse impact on our wellbeing. How do you balance corporate profitability, food affordability and long-term healthcare costs? And who has responsiblity here?

These are all profound questions as the Western lifestyles migrates.