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October, 2017 >>

Is obesity endemic to Pakistan?

Fariha Hasan  ( Dow University of Health Sciences )

Bilal Hasan  ( Aga Khan University, Karachi. )


Madam, the global epidemic of obesity has not spared Pakistan and warrants immediate attention. This is especially important in South Asia, where malnutrition is given its due attention, whereas obesity tends to be overlooked. Not only is obesity an independent determinant of poor health outcomes, it also contributes to other potentially fatal downstream effects.

A study conducted in 2006 suggested that a quarter of the Pakistani population falls in the overweight or obese category.1 This was calculated by quantifying them according to Indo-Asian specific BMI cut off values. Since then, Pakistan has been inclining towards non communicable, preventable diseases such as obesity.2 According to the 2016 World Health Organization (WHO) statistics, 20.8% of the population is overweight and 4.8% is obese.3 The constancy of these numbers over a decade implies that overweight has become endemic to Pakistani society.

Studies done in Pakistan have labelled obesity as an epidemic.4 They have emphasized on the cumulative, disastrous effect of obesity in school going children and medical students respectively.5,6 On another front, an upsetting increase in obesity has been noticed in Pakistani women of reproductive years (15-49).7 This can be explained by the 'nutrition shift' which refers to the transition in dietary habits towards nutrition related diseases. Moreover, another study done in Karachi determined a striking rate of 29% participants to be overweight, and 21% to be obese.8

The above figures do not exhibit any chance of improvement, and the tide of obesity continues to rise. However, not all is lost. Increase in body weight can be taken as a warning for ill health, and health care providers can focus their energy and resources on preventative health for the overweight population. By doing so, their transition into the obese category can be prevented. Moreover, Pakistan's strong extended family structure serves as an excellent support system. Friends and family can help each other lose weight, by sharing recipes and motivation, as an example. From a religious perspective, the month of Ramadan is also recognised as a way to self-discipline one's dietary habits for the upcoming months. In rural areas, physical activity is the mode of life. These cultural aspects of life can be utilized to prevent obesity from becoming a public health hazard in our country.  An obesity endemicity index should also be calculated, such as one described for diabetes,9 to get an objective opinion of whether obesity is epidemic in, or endemic to, Pakistan.


Disclaimer:
None to declare.
Conflict of Interest: None to declare.
Funding Disclosure: None to declare.

Reference

1. Jafar TH, Chaturvedi N, Pappas G. Prevalence of overweight and obesity and their association with hypertension and diabetes mellitus in an Indo-Asian population. CMAJ 2006; 175: 1071-7.

2. Jafar TH, Haaland BA, Rahman A, Razzak JA, Bilger M, Naghavi M, et al. Non-communicable diseases and injuries in Pakistan: strategic priorities. Lancet 2013; 381: 2281-90.

3. World Health Organization 2016. [online] [cited 2016 Dec 22]. Available from: URL: http://www.who.int/diabetes/country-profiles/pak_en.pdf?ua=1.

4. Sana Tanzil TJ. Obesity, An Emerging Epidemic in Pakistan: A Review Evidence. J Ayub Med Coll Abbottabad 2016; 28: 597-600

5. Khan ZN, Assir MZ, Shafiq M, Chaudhary AE, Jabeen A. High prevalence of preobesity and obesity among medical students of Lahore and its relation with dietary habits and physical activity. Indian J Endocrinol Metabol 2016; 20: 206-10.

6. Warraich HJ, Javed F, Faraz-Ul-Haq M, Khawaja FB, Saleem S. Prevalence of obesity in school-going children of Karachi. PloSOne 2009; 4: e4816.

7. Mehboob B, Safdar NF, Zaheer S. Socio-economic, environmental and demographic determinants of rise in obesity among Pakistani women: A Systematic Review. J Pak Med Assoc 2016; 66: 1165-72.

8. Amin F, Fatima SS, Islam N, Gilani AH. Prevalence of obesity and overweight, its clinical markers and associated factors in a high risk South-Asian population. BMC Obesity 2015; 2: 16.

9. Kalra S, Kumar A, Jarhyan P, Unnikrishnan AG. Endemic or epidemic? Measuring the endemicity index of diabetes. Indian J Endocrinol Metabol 2015; 19: 5-7.


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