Yesterday marked European Obesity Day. The aim of this day is for European countries to make efforts to bring together healthcare, patient and political communities who are keen to raise awareness of obesity and the many other diseases on which it impacts. This year’s theme is ‘Tackling obesity together’.
Obesity places a big burden and strain on healthcare services and society as a whole. The rate of obesity in Europe is high, increasing annually. Obesity induces a further burden due to the high morbidity and mortality rate that is directly or indirectly related to it.
It also leads to a decrease in the quality of a person’s life. Obesity plays a central role in the development of many risk factors and chronic diseases, including type 2 diabetes, cardiovascular diseases and certain cancers. Excess weight and obesity are responsible for about 80 per cent of cases of type 2 diabetes, 35 per cent of ischaemic heart disease and 55 per cent of hypertensive disease among adults in the European region. The risk of developing more than one of these comorbidities greatly increases when body weight increases.
The high burden and costs of obesity are of serious concern, so much so that it justifies the need for both European and national programmes against obesity to tackle this problem.
According to the World Health Organisation, obesity is one of the greatest public health challenges of the 21st century and latest estimates in EU countries indicate that overweight affects 30-70 per cent, with obesity affecting 10-30 per cent of adults.
The situation in Malta is no different to that being experienced in the rest of Europe and indeed the world over. According to the European Health Interview Survey issued by the Health Information and Research Directorate in 2014, 59.6 per cent of adults are overweight or obese.
The basic cause of obesity and excess weight is an energy imbalance between the number of calories consumed and the number used. However, it is not so simple. Obesity is a multi-factorial issue in a rapidly changing society. Various changes in food production, processing and marketing and changes in physical activity are linked to obesity.
Over the years, we have seen an increased intake of energy-dense foods that are high in fat; and an increase in physical inactivity due to the increasingly sedentary nature of many forms of work, changing modes of transportation and increasing urbanisation of the localities we live in.
Of particular concern is the growing incidence of childhood obesity in Europe
Many simplify the problem of obesity and shift the onus onto individual responsibility. However, obesity is a disease often caused by factors largely beyond an individual’s control, as the environment plays a significant role in promoting it.
Of particular concern is the growing incidence of childhood obesity in Europe. Childhood obesity, particularly during the second decade of life, is now acknowledged to be an increasingly strong predictor of adult obesity, especially for extremely overweight children of obese parents. There is also increasing evidence that obesity has damaging social, economic and health consequences. Hence, childhood obesity is now recognised as an important public health issue.
Over these past years, the health authorities have carried out various initiatives to counteract overweight and obesity by creating awareness, lobbying for an enabling environment, working with various stakeholders and offering free weight management services so that weight gain is halted and gradually reversed.
The obesity strategy ‘A healthy weight for Life: A national strategy for Malta’, which was launched in 2012, outlines the government’s vision and action to tackle the issue of obesity. A crucial factor in this strategy is that it adopts a plan which includes various stakeholders through a government-and-society approach. These stakeholders include agriculture, transport, commerce and industry, education, mass media and communication. Following a healthy lifestyle includes eating healthily, performing regular exercise and trying to avoid some of the environmental factors that can cause obesity, such as stress and sedentary work and living styles. Many lifestyle habits begin during childhood. Therefore, parents and families should encourage their children to make healthy choices, such as following a healthy diet, being physically active and committing to these choices together as a family.
Making the healthy food choice includes the recommended amount of five portions of fruit and vegetables a day, limiting the intake of processed and sugar-sweetened products.
One needs to keep in mind portion sizes, especially when eating out, as the portions served in many restaurants are often large enough for more than one adult.
Although much of our day consists of sedentary time at work or school, one should aim to participate in activities of moderate physical activity for at least 30 minutes a day.
Keeping track of one’s weight, body mass index and the waist circumference can help one identify the signs of weight gain – which will be much easier to address in the early stages than when reaching obesity. Support is available through free weight management classes organised by the Health Promotion and Disease Prevention Directorate. Call 2326 6000 for more information.
Dr Charmaine Gauci is Superintendent of Public Health.