World's Biggest Health Burden - Obesity Overload

from health and fitness

A child in the pink of health used to be represented by a chubby toddler bursting out of his diapers. That's not the case anymore, as the health dangers posed by overweight and obesity have slowly but surely started to sink in our collective consciousness.

According to 2005 statistics from the World Health Organization (WHO), about 1.6 billion people on the planet are overweight. At least 400 million of these individuals are obese or severely over-weight. This number is projected to swell to 2.3 billion over-weight individuals in 2015, about 700 million of whom will be considered obese.

A source of public health concern is the growing number of over-weight children, placed at 20 million worldwide in 2005. These children - adults in two decades from now - will most likely become over-weight themselves and afflicted with chronic diseases.

But an even more immediate concern is how over-weight and obesity are no longer a problem of industrialised countries. In developing countries, an estimated 115 million people are suffering from obesity and obesity-related problems. In these countries, especially in urban settings, over-nutrition paradoxically co-exists with under¬nutrition. This has led the WHO to label obesity as one of the most serious public health challenges facing the world in the 21st century.

A Lack of Balance

Maintaining proper weight requires a balance between the amount of energy (calories) we consume and the amount of energy (again in calories) we burn in a day.

In general, a person becomes over-weight - having accumulated abnormal or excessive fat as to impair health - when he or she eats more than what his or her body requires in a day or engages in too little physical activity. But to frame over-nutrition and weight gain in purely physiologic terms is unwise, cautions endocrinologist Dr Kristine Denise Corvera in the Philippines. "A person's eating habits are largely dependent on the way he or she was raised, what attitudes towards food and eating his or her parents and family taught," she explains.

Also, the way the body uses calories is genetically programmed - that is, some people simply don't gain as much weight as others. Likewise, while calorie consumption and expenditure depend largely on an individual, environmental factors play a big role.

Globally, people are increasingly consuming energy-dense foods that are high in fat and sugar, and low in fibre, vitamins and minerals. High-energy, low-nutrition foods are cheap and readily available, while access to healthy food is limited - a salad at a fast-food outlet costs much more than a burger and fries. Dr Corvera urges that the public be re-educated on preparing low-cost, but healthy home-cooked meals. In a similar manner, with socio-economic development, people increasingly engage in office-based work, becoming more sedentary and less physically active.

Serious Implications

Being over-weight or obese has enormous and far-reaching consequences, including a higher risk for developing a large number of diseases:

• CARDIOVASCULAR DISEASES (CVD), INCLUDING HEART DISEASE, HYPERTENSION AND STROKE. CVD is the number one cause of mortality and morbidity worldwide, killing an estimated 17 million people a year.
• DIABETES. The WHO already considers diabetes a worldwide epidemic, and forecasts diabetes deaths to increase by more than 50% worldwide in the next decade.
• CANCER. Obesity is correlated with cancer of the uterus, breast and colon.
• OSTEOARTHRITIS AND OTHER MUSCULOSKELETAL DISORDERS. Because all these chronic conditions necessitate long-term, complicated and invariably expensive treatment, being over¬weight and obese are, therefore, implicated among the causes of rising healthcare costs worldwide.

"On an individual level, I encourage my patients to eat healthy and to get regular exercise," says Dr Kenneth Hartigan-Go, an internist and toxicologist, when asked how doctors can help combat obesity. He acknowledges, however, that obesity is not about an individual's choices alone. "Governments must exercise leadership in promoting an environment where healthy eating and regular exercise are encouraged."

Solutions To A Complex Problem

In 2004, WHO member states adopted the 'WHO Global Strategy on Diet, Physical Activity and Health' - a document that describes support actions in the adoption of healthy diets and physical activity worldwide.

A call for increased cooperation, the document lists strategies that governments, the WHO, international partners, non¬governmental organisations and the private sector can use to encourage healthy eating and increased physical activity.

"One of the most crucial strategies in controlling over-weight and obesity is making healthier diet options affordable and easily accessible," explains Tanya Zaldarriaga, programme manager at the Manila-based health policy think-tank The Zuellig Foundation. "This is especially important for the most vulnerable sectors of society - the poor and children - who have limited choices about the food they eat and the environments in which they live."

International cooperation is essential. For instance, strict government regulation in one country that seeks to promote healthier eating - by restricting the sale of certain food items, for example - will invariably affect the market in others.

Says Zaldarriaga: "Policy measures across territories should be coordinated to avoid shifting market pressure for less healthy, energy-dense foods and beverages to countries with less regulated environments."

While the onus of fostering a healthier environment falls on governments, businesses and the rest of the private sector can also do something. The WHO is encouraging the food industry to reduce the fat, sugar and salt content of processed and cooked foods, reduce portion sizes in restaurants and increase nutritious food choices.

"Many companies are now providing incentives to their employees to live healthy lifestyles," says Dr Corvera. "There are more and more employers who encourage sports activities after office hours, serve healthy food options at the company cafeteria or even give small salary rebates to employees who use the company gym. "From a public health vantage point, we need to exert increased efforts to promote physical activity at both national and community levels."

A Nurturing Environment

But perhaps the most crucial component in the fight against over-weight is one that is egregiously overlooked: mobilising the support of physicians and non-obese individuals in providing a nurturing environment for over-weight and obese individuals to strive to live healthier lives.

"Doctors are sometimes guilty of 'medicalising' obesity too much and labelling it a disease," explains Zaldarriaga. "This puts a stigma on the individual, makes him feel bad about himself."

"Doctors are sometimes guilty of 'medicalising' obesity too much and labelling it a disease," explains Zaldarriaga. "This puts a stigma on the individual, makes him feel bad about himself."