Overweight and obesity: an emerging epidemic in Nigeria

pharmacy

            One-third of the world’s population is now overweight or obese, while 62 percent of these individuals live in developing countries (The Atlantic, 2014). In 2014, more than 1.9 billion adults, 18 years and older, were overweight, and of these over 600 million were obese (WHO, 2015). Despite new inventions and innovations of drugs, machines and other materials now available to the health care team members, no national success story has been reported in the control of obesity across nations in the past 33 years (TheAtlantic, 2014).

World Health Organization (WHO) estimates that 12.7% of African children will be overweight by 2020 compared to 8.5% in 2010, unless this is addressed soon.

What then is obesity?

Overweight and obesity are defined by the World Health Organization (WHO) as abnormal or excessive fat accumulation that may impair health.Body Mass Index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity in adults. It is defined as a person’s weight in kilograms divided by the square of his height in meters (kg/m²)

For adults, WHO defines overweight and obesity as follows:

• Overweight is a BMI greater than or equal to 25; and
• Obesity is a BMI greater than or equal to 30.

Obesity is defined by National Institutes of Health as body mass index (a measurement obtained by dividing a person’s weight by the square of the person’s height) >/= 25kg/m2 and 30kg/m2 respectively, this definition however is not to be considered in some countries like Japan and China, who considered Obesity to be BMI above 25 and 28 respectively. A classification has grouped Obesity into five groups;

Group 1: BMI 30.0 – 34.9

Group 2: BMI 35.0 – 39.9

Group 3: BMI 40.0 – 49.9

Group 4: BMI 50.0 – 59.9

Group 5: BMI 60.0 and above

Another classification also exists:

BMI >/= 35 or 40 Severe obesity

BMI >/= 35 or 40 – 44.9 or 49.9 Morbid obesity

BMI >/= 45 or 50 Super obesity

Obesity and Developing Countries

Down the years, obesity has been thought to be a condition more pronounced in the developed nations. But the present rate of overweight and obesity in developing countries is alarming. Report says that the majority of people who are overweight or obese today can be found in the developing world rather than the developed world (Trans, 2014). Nigeria, a developing nation has a lot to do to curb this trend as data from the WHO shows that the prevalence of overweight and obesity increased by 20% between 2002 and 2010 in Nigeria.

In 2010, World Health Organization(WHO) surveyed data in Nigeria showed a prevalence of 26% and 37% in men and women respectively who are overweight, while a prevalence of     obesity was 3% and 8.1% respectively.

Factors Predisposing to Obesity

Being a major public health concern there are several factors that have been identified to the causes and predisposition to Obesity, some of which are;

• Genetic causes: Obesity is believed to ‘run’ in families, that is, there is tendency thatchildren whose parent(s) is/are obese, will likely become obese.
• Poor Dietg Excessive alcohol intake, excessive intake of processed or fast foods, overeating, excessive intake of sugary drinks and foods, excessive high fat diets, snacking in between meals, eating faster taking less time to chew foods.
• Lifestyle:Another risk factor is lack of physical activities, that is, living a sedentary lifestyle. Similarly, getting less than seven hours of sleep at night can cause changes in hormone that increase your appetite, thus leading to increase weight.
• Medications: Some medications such as corticosteroid, antidepressants have been linked to the cause of obesity.
• Endocrine factors such as hypothyroidism, hypogonadism and Cushing syndrome has also been highlighted.

The Effects of Obesity

Obesity has affected the health of individuals and the community at large in significant terms. Overweight and obesity are linked to more deaths worldwide than underweight (WHO, 2015). These effects  include:

• Cardiovascular disease (mainly heart disease and stroke) which were the leading cause of death in 2012
• Diabetes
• Musculoskeletal disorders (especially osteoarthritis – a highly disabling degenerative disease of the joints)
• Some cancers (including endometrial, breast, ovarian, prostate, liver, gallbladder, kidney and colon (WHO, 2015)
• Premature death and disability in adulthood,
• Obese children experience breathing difficulties, increased risk of fractures, hypertension, early markers of cardiovascular disease, insulin resistance and psychological effect (WHO, 2015).
• It has also affected the psychological health of people due to their perception and the way people isolate them.

Prevention and Treatment of Obesity

Obesity can be prevented and reduced by reducing weight through careful planning of diet, reducing dietary intake, reducing sugar and fat intake, Involving in exercise and physical activities, and drugs. Weight loss surgery offers the best chance of losing the most weight, but it can pose serious risks.

Institute of Nursing Research’s Recommendations

To The Individual:

1. Individuals should identify obesity as a threat to their health and immediately seek medical attention if noted
2. Individuals should take actions that prevent obesity by avoiding the predisposing risk factors.

To The Government and Non-Governmental Organizations

1. Government and NGOs should increase social marketing and education campaign, including training of women to prepare traditional low-fats, high vegetable meals.
2. Government and NGOs should increase public awareness about obesity through advertisement using Information Education and Communication (IEC) support materials such as posters and billboards showing information on Obesity and its effects
3. They should sponsor new innovations, inventions, drugs and techniques that can be used to combat obesity.
4. They should implement strategies and programs that can be used to reduce obesity and also enact laws and policies guiding food production in food industry.

To The Health Care Professionals

1.The role of the nurses and doctors in the prevention and control of obesity cannot be overemphasized. Adequate educations of pregnant woman at antenatal care, emphasizing the impacts of food during pregnancy, weaning process, encourage exclusive breastfeeding as all these contributes to the development of obesity. They should also advocate for daily exercise at least 30 min per day, educate the public on food monitoring taken by student to schools, enlighten food industries on types of food to be produced, encourage people to take more of naturally available foods than processed ones, and lastly develop structures for obese client on how to live healthy and many more. They should also develop new skills and techniques and to get new knowledge that can be used to manage obesity, this should be borne out of intensive research.

2. Pharmacists and pharmacologists should conduct more clinical trials in a bid to produce new drugs used in the treatment of obesity in addition to the existing ones and make them to circulate round the country as drugs used in obesity treatment are but a few.
3. Nutritionists should prepare a template of daily nutritional plan that can be followed by individual and family and making these available in written forms, they should also give health education to the community on the need for balance diet, and usefulness of each nutrient found in our diet.

If the above measures are taken, sooner than expected, drastic reduction will be recorded in the prevalence of obesity in our communities.

INR SAYS

Control your dietary intake!

Stay Active!!

Live Long!!!

Written By

Olawoore Samuel, Opeyemi Ajakaye, Olaniyi Gloria.

Institute of Nursing Research, Fellowship of Christian Nurses, South West Zone, Nigeria.

References

National Institute of Health (n.d) Causes of Obesity. Accessed 24^th June, 2016. Available at: www.nhs.uk/conditions/obesity/page/causes.aspx

The Atlantic (2014). Two-Thirds of Obese People Now Live in Developing Countries. Accessed: 23 June, 2016.  Available at: http://www.theatlantic.com/international/archive/2014/05/two-thirds-of-the-worlds-obese-people-now-live-in-developing-countries/371834/

Trans,M. 2014. Obesity soars to alarming levels in developing countries. Accessed 30^th June, 2016. Available at: http://www.theguardian.com/global-development/2014/jan/03/obesity-soars-alarming-levels-developing-countries;

World Health Organization. 2015. Obesity and overweight. Accessed 5^th July, 2016. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/