Obesity is now recognized as a progressive chronic disease similar to diabetes or high blood pressure by expert societies such as the Philippine Association of the Study of Obesity and Overweight; American Medical Association; World Obesity Federation; European Association for the Study of Obesity; US FDA, Obesity Canada; European Medicines Agency and World Health Organization. Obesity is characterized by excess body fat that can threaten or affect your health.
By 2025, it is estimated that 2.7 billion adults will be suffering from obesity. In 2016, The World Health Organization (WHO) estimated that at least 2.8 million people die each year as a result of overweight/obesity associated with the occurrence of chronic diseases that has dire social and economic consequences. The WHO also recorded that globally, more than 1.9 billion adults were already overweight, and 650 million of them were obese. Meanwhile, 340 million children and adolescents between the ages of five to 19 years old were considered obese.
In the Philippines, three out of 10 Filipino adults are overweight or obese. In a decade, the prevalence of obesity among Filipino adults almost doubled from 20.2 percent in 1998 to 37.2 percent in 2018. One out of four Filipino children aged six to 10 years old and one out of every 10 Filipino adolescents are overweight/obese as of 2018. Research has also pointed out that obese children are more likely to stay obese until they become adults. Overweight and obesity are the top nutrition issues in the eight cities of Metro Manila, according to the Food and Nutrition Research Institute, with the prevalence of overweight and obesity in highly urbanized cities (HUC) higher than the national estimates.
Changing the stigma
Knowing that obesity has become one of the most important public health concerns in the world, global healthcare company Novo Nordisk Pharmaceuticals (Philippines) Inc. has linked up with other stakeholders in an obesity awareness media forum titled “One Against Obesity” which aims to change the public’s perspective on obesity, the stigma surrounding it and how to care for people who are obese and overweight.
“There is more to obesity than what meets the eye. There are a number of environmental, physical and psychological factors involved needing a multi-stakeholder approach,” says Cihan Serdar Kizilcik, vice president and general manager of Novo Nordisk Philippines.
“First, we must understand that obesity is a critical health issue in the Philippines. We must be concerned for people with obesity not because of appearances but because of how this affects their overall wellbeing including risk for early death,” he adds.
Many representatives from the health sector including the government discussed how to overcome the challenge of obesity as a nation. Grete Sillasen, Ambassador of the Kingdom of Denmark to the Philippines, graced the forum as guest-of-honor to show her support for obesity awareness.
Dr. Mia Fojas, president of the Philippine Association for the Study of Overweight and Obesity (PASOO) shared the current statistics on obesity prevalence in the Philippines, risk factors and treatments available, while vice Ppresident Dr. Nemencio Nicodemus talked about the challenges in weight management.
Azucena Dayanghirang, executive director III of the National Nutrition Council, centered her discussion on debunking diet myths.
The Department of Health shared the various efforts of the government to combat obesity through awareness and management, while fitness coaches from FitFil gave tips on living a healthy lifestyle through its Move It to Lose It program.
What leads to weight obesity?
Roughly, a person is considered obese if he/she has a Body Mass Index (BMI), or weight and height correlation, of 30 and above, but in order to better diagnose obesity, a person needs to see a doctor so other evaluation can be made.
Other factors seen in obesity include appetite dysregulation, endocrine dysfunction and insulin resistance.
Obesity leads to higher chances of acquiring diseases such as cardiovascular disease, diabetes, certain cancers, high blood pressure and sleep apnea. Obesity can therefore result in more deaths because of the numerous non-communicable diseases with which it is associated.
The biggest factor that contributes to weight gain is associated with eating more calories than burning them through physical activity.
One’s environment also plays a role in a person’s inability to stay fit and maintain a healthy weight. Such environmental factors include the lack of affordable gyms, not having parks or sidewalks conducive to jogging or cycling and the lack of supermarkets that sell affordable healthy food.
Some medical conditions and other factors may also lead to obesity such as genetics, polycystic ovarian syndrome or PCOS in women and an underactive thyroid. There are also certain medications that may cause weight gain such as steroids and antidepressants. Lack of sleep, stress and emotional factors may also lead to higher food intake.
Need for empathy
One of the reasons it has become difficult for people living with obesity to overcome this disease is the discrimination they suffer from society. Weight stigma refers to discriminating or negatively perceiving people based on their weight and size.
The consequence of weight stigma includes low self-esteem and depression. The fear of being stigmatized may lead to avoiding medical attention, disordered eating patterns such as binge eating and increased levels of stress hormones which could impact cardiac health. In more severe cases, weight stigma may even lead to suicidal tendencies.
Obesity is preventable and manageable but it takes a shift in perspective, as well as empathy towards people living with obesity in order to make this fight successful.
The first line treatment for obesity is lifestyle therapy. This involves proper diet and exercise along with counselling to help patients overcome obstacles in weight loss.
For those with a BMI above 27 and have obesity-related complications and 30 above with or without complications, doctors may also recommend anti-obesity medication in addition to lifestyle therapy. Weight loss surgery may also be an option for patients with a BMI of 40 and above and also have obesity-related complications.
To fight obesity, society must become more sensitive and empathic towards people living with obesity in order to encourage them to live better and to fight this disease. Healthier food and lifestyle choices need to become easier and more accessible options especially in cities, combined with empathetic support from family and society. Advances in pharmacotherapeutic options can also help augment lifestyle changes in achieving and maintaining weight goals for patients with obesity.
“We need to view obesity as a chronic non-communicable disease with its own challenges including that of weight regain,” according to Dr. Nemencio Nicodemus. “To support obesity prevention and treatment, we need to provide the necessary education and treatment from doctors and other health care professionals as well as providing opportunities for lifestyle change. A five- to 10-percent weight loss will make a big difference in the quality of life but also lower the risk for heart attack, diabetes and other cardiovascular events.”