HEALTH

JUDY SIRIMA: Obesity an emerging epidemic

In Summary

• The association of obesity with non-communicable diseases makes this problem as a priority public health issue of this century.

• Global and national efforts to control obesity and minimise factors that contribute to obesity are essential to improving health status and life expectancy worldwide.

A man's waistline is measured
A man's waistline is measured
Image: COURTESY

Overweight and obesity represent a rapidly growing threat to the health of populations in many countries.  Obesity has become a worldwide epidemic and its prevalence has been projected to grow by 40 per cent in the next decade.

This has important implications on global health as excess weight, usually represented by a raised body mass index (BMI), affects many people worldwide —  39 per cent of adults are overweight and 13 per cent have clinical obesity globally.

According to the WHO in 2008, more than half a billion adults were obese worldwide. The worldwide prevalence has more than doubled since 1980. More recently, the analyses for the Global Burden of Disease Study 2013 further documented that the proportion of adults with a BMI of 25 or greater increased between 1980 and 2013 from about 29 per cent to 37 per cent in men and from about 30 per cent to 38 per cent in women. 

The increase in obesity worldwide has an important impact on health impairment and reduced quality of life. In particular, obesity has an important contribution to the global incidence of cardiovascular disease, type 2 diabetes mellitus, cancer, osteoarthritis, work disability and sleep apnea. Obesity has a more pronounced impact on morbidity than on mortality.

Increasing numbers of reports have also linked obesity to more severe Covid-19 illness and death. In a French study, the risk for invasive mechanical ventilation in patients with Covid-19 infection admitted to the intensive treatment unit was more than 7-fold higher for those with BMI >35 compared with BMI <25 kg/m.

Countries bearing the major burden of obesity pandemic include Papua New Guinea; 79–80 per cent obese population, Qatar 34–45 per cent obese population, Lebanon 36–38 per cent obese population and the US 32–35 percent of obese population overall.

In Kenya, the Ministry of Health National Training Guideline on Flour Fortification reveals that one in every four adults between ages 18 to 69 is obese. Women are the most affected at 39 per cent compared to 18 per cent men. This report updates and extends the findings reported in the STEPwise 2015 that 27 per cent of Kenyans are either overweight or obese, with 38.5 per cent being women and 17.5 per cent men.

The increase in overweight and obesity in adults are widely projected to continue to heighten the burden of obesity-related morbidity and mortality in the coming decades. Obesity is also emerging as a serious global health problem among children and adolescents.

The simultaneous increases in obesity in almost all countries seem to be driven mainly by changes in the global food system, which is producing more processed, affordable, and effectively marketed food than ever before. It is a known fact that countries sharing the highest burden of obesity also share the highest burden of diabetes mellitus and metabolic syndrome.

Obesity can lead to catastrophic financial losses in a community by increased health-related expenditure for treatment of non-communicable diseases while reducing overall productivity of the society.

It is reported that obesity contributes to more than 36 billion of DALYs (Disability adjusted life years) globally in addition to (2–6) per cent total health expenditure in many countries.

This association of obesity with non-communicable diseases makes this problem as a priority public health issue of this century. Global and national efforts to control obesity and minimise factors that contribute to obesity are essential to improving health status and life expectancy worldwide.

There is no single or simple solution to the obesity epidemic. It’s a complex problem and there has to be a multifaceted approach. Policy makers, state and local organisations, business and community leaders, media, school, childcare and healthcare professionals, and individuals must work together to create an environment that supports a healthy lifestyle. 

Likewise, adequate management of obesity as a chronic condition for those who are already obese is important and requires the principles of integrated care for disease management.

Judy Sirima is a publics communications Officer, Pharmacy and Poisons Board