OBESITY is measured by body mass index, which considers a person’s height and weight. Having a body mass index above 30 makes someone obese.

The worldwide prevalence of obesity has doubled since 1980.

In 2008, 9.8 per cent of men and 13.8 per cent of women were obese, compared to 4.8 per cent for men and 7.9 per cent for women in 1980.

Six out of 10 women and four out of 10 men in Jamaica are obese or overweight. More than one in 10 of the world’s adult population is obese, with women more likely to be obese than men.

The International Obesity Task Force estimates that more than 150 million children worldwide are either overweight or obese, including about 22 million children under the age of five. In some Caribbean and Latin American nations like Mexico and Colombia, the prevalence of childhood overweight and obesity is in the range of 20-25 per cent.

CAUSE FOR CONCERN

Overall, about 2.5 million deaths are attributed to obesity worldwide. Several studies suggest that the strongest and most consistent risk factors for diabetes and insulin resistance among different populations are obesity and weight gain; for each unit increase in body mass index, the risk of diabetes increases by 12 per cent.

The World Health Organisation estimates that by 2025, prevalence rates for diabetes in developing countries will increase by 170 per cent from 84 million to 228 million representing about 70 per cent of diabetics worldwide. More recent estimates from the WHO suggest that 80 per cent of deaths and disability adjusted life years related to diabetes occur in developing countries. There is now universal agreement that the epidemic of cardiovascular disease being experienced globally is intertwined with the rising prevalence of diabetes, which is closely tied to the growing prevalence of obesity across cultures and populations. The battle against diabetes and cardiovascular disease must therefore begin with a fight against excessive weight gain and physical inactivity.

Treatment for weight-related diseases costs the USA $150 billion a year. That figure could rise by $550 billion over the next 20 years, a Duke University study has found. The direct health-care costs of diabetes range from 2.5 per cent to 15 per cent of the annual health-care budgets of many countries and may be as high as US$241 billion worldwide, with the most expense per GDP in developing countries occurring in Latin America and the Caribbean.

In recognition of the dire health and economic consequences portended by this trend, leaders of Caribbean countries met in Port of Spain, Trinidad, on September 15, 2007 in the First Caribbean Summit on Chronic Diseases and signed a declaration for the prevention of chronic diseases in the Caribbean. This declaration is intended to galvanise and mobilise the region against a cluster of health risks that include obesity, high blood pressure and diabetes.

More recently, the American Medical Association (AMA) voted to label obesity as a disease. This move means that 78 million American adults and 12 million children will now be seen as patients having a medical condition that requires treatment. The AMA’s decision means doctors will now have a duty to tell their patients that they are obese and to recommend treatment, exercise, nutrition, and prevention programmes.

Calling obesity a disease could bring new treatments, pressure the government to approve new obesity drugs, spur research, innovation and invention.

To successfully combat this epidemic, it is imperative that we evolve an approach that places a premium on health preservation as opposed to health care, as the intended outcome of a viable health care system in a low resource environment.

Professor Ernest Madu, founder of the Heart Institute of the Caribbean, is an internationally acclaimed cardiologist and expert on innovative health solutions. HIC is a centre of excellence for cardiovascular care in the English-speaking Caribbean. Please send questions and comments to emadu@caribbeanheart.com.