Today (4 March) happens to be World Obesity Day, an event first observed on 11 October 2015 and moved to 4 March from last year onward. The aims of the day include “increasing awareness, encouraging advocacy, improving policies, and sharing experiences”- all part of a strategy to address the growing problem of obesity. The day also provides a timely reminder of the magnitude of this global public health problem , especially when the risk of dying from Covid-19 is substantially higher in obese people.
Obesity affects people of all ages and all social groups in both developing and developed countries, with the greatest increases being seen most recently in low- and middle-income countries. Worldwide, around 650 million adults and 125 million children are considered to be obese. Closer to home, according to the Health Survey for England 2019, 28 per cent of adults were overweight and 36 per cent obese, while the percentages for year 6 (ages 10 to 11) children were 14 and 21 respectively. During 2018/19, 11, 117 hospital admissions in England were directly attributable to obesity, including those for bariatric surgery, while obesity played a part in a further 870,000.
There is nothing much to celebrate about obesity, even as a fat pride movement, fronted by plus-size models and social media influencers, gathers momentum in response to “fat shaming” and discrimination against overweight people. Obesity not only shortens life expectancy but also increases the risk of several non-communicable diseases, such as type 2 diabetes, high blood pressure, heart disease, stroke, thirteen forms of cancer, liver disease, respiratory disease, obstructive sleep apnoea, and arthritis. During the Covid-19 pandemic, obesity has been shown to increase the likelihood of developing severe illness and the chances of dying from coronavirus infection. The highest death rates have indeed been reported from countries with the highest rates of obesity.
It is easy to measure obesity. Body weight is reflected in the body mass index (BMI), which is calculated by dividing body weight in kilograms by the square of height in metres. Abdominal fat distribution is reflected in waist circumference, which is the number of centimetres around the waist at a point midway between the bottom of the rib cage and the top of the hips. A BMI between 25 and 29 makes you overweight, while a BMI between 30 and 39 means you are obese. Morbid obesity, of the kind seen on the TV series My 600-lb Life, is defined by a BMI of 40 or above. A waist circumference of 94 cm or more in adult men, or 80 cm or above in women, indicate an overweight state. A person with a BMI in the normal range may still have an increased waist circumference and be susceptible to all the risks of being overweight.
Obesity is frequently oversimplified. It may be considered by some ill-informed people as a self-inflicted illness, brought on by an irresponsible lifestyle . While it is undoubtedly true that an unhealthy diet and a lack of physical activity are the major underlying causes of obesity, other factors, such as inherited genes, ethnic origins, mental health issues, low self-esteem, socioeconomic deprivation, and a poor environment, all play a part. Many of these factors can indeed coexist in any single obese person, making weight reduction even more difficult under the circumstances.
To tackle the growing problem of obesity, which has tripled in prevalence worldwide since 1975, you need to address the root causes. Physical inactivity, increasingly sedentary lifestyles and unhealthy diets that over-deliver on calories have all become staples of modern living. The consumption of sugary drinks and fast foods with high refined sugar and fat contents has gone up and far too much time is spent gazing at TV sets, computer screens and smartphones than ever before. Increasing awareness of the health risks of obesity is, however, beginning to transform middle-class thinking, and has led to the adoption of a variety of diets and exercise regimes, often promoted by celebrities and frequently ineffective. Unfortunately, obesity disproportionately affects low-income people in deprived areas, who may be less well-informed and less able to both access and afford healthier eating options.
This is where the government comes in. Despite increasing libertarian tendencies favouring personal freedom of choice, education, public health policies, and legislation all have a part to play in upholding the greater good. Even if you can’t control individual dietary choices, you can at least provide healthier alternatives and make the unhealthier options cost more. You can even reward healthy eaters-with shopping coupons, for example!!
The government can facilitate various anti-obesity measures. These include curbs on the seductive and misleading advertising of “junk foods”, reducing the portion sizes of prepacked and prepared foods, cutting back on the sugar content of manufactured food and drinks, calorie labelling of all out-of-home food and drink menus, including at takeaways and restaurants, and imposing levies on sugary foods . In towns and cities, local authorities can support an exercise-friendly infrastructure, enabling safe walking in parks, safe cycling along cycle paths, and safe exercise in gyms. When it comes to children, schools also have an important role to play. Our scholastic institutions can not only educate pupils about healthy eating, but also provide healthier and more nutritious school meals.
Obesity is a problem in search of solutions, although we seem to be on the right track. But there is much sorting out to do. The available treatments for weight reduction include many unproven remedies that prey upon the insecurities of the overweight and promise the most miraculous results. The lack of evidence to back up some proposed policy reforms adds to the difficulty of preventing obesity. Initiatives such as World Obesity Day will hopefully guide us along the way to a less obese society.
Ashis Banerjee