Editorial

Obesity is a chronic disease and childhood prevention is crucial. It has been shown that 25 to 50 per cent of obese adolescents develop into obese adults and that the association between overweight in childhood and adulthood increases with the onset of obesity at an earlier age. Prevention avoids the potential pitfalls of dieting in children, that is, possible negative impact on growth and development, body image distortion, the learning of restrictive eating practices and eating disorders.

A succession of childhood studies, over the years, have shown increasing trends of obesity in Malta. The most recent paediatric study (published in the International Journal of Obesity) showed that up to a third of pre-school children (aged about five and a half years) are overweight or obese. A regional analysis of this study found greater levels of obesity in the southern part of the island, particularly for boys. The highest overall obesity rates were in the harbour-Cottonera area.

Obesity was found least in those about to enter private schools, followed by those about to enter Church schools and the highest levels of obesity were found in those children who were about to enter state schools.

The consequences? Overweight and obesity account for up to 16 per cent of the global burden of disease and the cost of obesity has been estimated to account for two to seven per cent of total worldwide healthcare costs. Obesity leads to hypertension and diabetes and other cardiovascular diseases, which lead to strokes and heart attacks. In addition, a fifth of obesity-related deaths are due to cancers because obesity pre-disposes to various types of cancer.

Moreover, in those who do not die straightaway of such conditions, the state bears the burden of medical treatment. In addition, it takes the brunt of sick leave and lost GDP due to lost productivity.

A simple proportion calculation based on obesity costings for large countries shows that the cost for Malta for the treatment of complications of this condition will reach €70 million! Prevention is, therefore, crucial and must be a wholesale approach incorporating home, health care, child care, school and community settings.

Prevention must embrace healthy eating, suitable physical activity, appropriate nurturing environments and fostering a healthy body image. The health and educational authorities should acquire a baseline height and weight for the future monitoring of all children as this will allow us to see whether campaigns aimed at obesity reduction have been effective or not. And for such campaigns to be effective there must be coordinated effort by policy makers and different sectors involved with education, environment and the health and safety of our children to devise ways and means to combat this disease. This study should be extended to the whole childhood population in order to identify and target those at risk of overweight and obesity.

Effective educational campaigns and strategies could reduce Malta's disease burden that is directly or indirectly attributable to this chronic disease.

One hopes that this study will galvanise the authorities to not only commission studies dealing with overweight and obesity in Malta but also embark on a concerted and coordinated national effort to curb this chronic disease.

While very few researchers have documented declining obesity trends in childhood, it is sincerely hoped that this study will serve as a catalyst to rein in obesity in Malta.