HEALTH-LATAM: Obesity on the Rise, Especially among the Poor

By Mario Osava Reprint | | Print |

Mario Osava

RIO DE JANEIRO, Sep 25 2002 (IPS) - The problem of obesity is growing in an alarming fashion in Latin America, especially among the poor, said experts meeting this week in Brasilia, the capital of Brazil – a country where 40 percent of the population is now overweight to some degree.

Brazil, Latin America’s giant with 170 million people, is thus approaching the level of the world champion of obesity, the United States, where half of the population is overweight, Amelio de Godoy Matos, president of the Brazilian Association of Endocrinology and Metabology (SBEM), which held its 25th congress Saturday through Tuesday, told IPS.

A person is considered overweight when body mass index (BMI – weight divided by height squared) is between 25 and 30. A quotient above 30 indicates obesity.

The concern of health experts focuses on the proven link between obesity and diseases like diabetes, cardiovascular ailments and strokes.

The three basic factors that have given rise to the current “epidemic” in Latin America are “dietary changes, the sedentary nature of urban lifestyles, and a lack of information,” said Matos.

Over the past few decades, social and dietary changes in the region have led to more widespread consumption of foods that are rich in fats, like red meat, dairy products and lunch meats, as well as sweets, whereas regular consumption of such foods was largely limited to the more affluent segments of society in the past.

In addition, the rural exodus to urban areas and increasingly widespread access to cars, TV sets and computers have led to excessively sedentary lifestyles.

A study carried out in Britain found that the rise in obesity levels is more directly associated with the increase in the use of cars and TV-watching than to consumption of high-fat foods, said Matos.

Another important factor is education. Obesity is “inversely proportionate to educational levels,” and tends to be more widespread among those who are less well-informed and have less years of schooling, which does not necessarily mean the poorest sectors, said the expert.

At the same time, obesity is more common among women. In Brazil, for example, 36 percent of women are “obese” (BMI above 30), compared to 16 percent of men, he pointed out.

Although the proportion of obese men doubled from 1975 to 1989, it rose 75 percent among women.

Besides the physical factors “inherent to the female sex,” the social roles assigned to women, like those of “homemaker and cook,” especially in the lower- to middle-income segments of society, put women at greater risk of being overweight, Matos added.

On the other hand, the trend among women in the upper-income brackets in Brazil is towards weight loss, said the endocrinologist.

Obesity thus affects the people who already suffer the greatest social discrimination – poor, uneducated women, said Dr. Sandra Teixeira de Araújo with the National Feminist Network for Health and Reproductive Rights.

Poverty and precarious work conditions also make it difficult to eat regular, healthy meals. Many black women in Brazil are plagued by these problems, and tend to have less access to education and to decent incomes, as well as the greatest tendency to be overweight, said Teixeira.

Women also face higher “aesthetic demands” than men, which fuels consumption of antidepressants and diet pills, she added.

Diabetes, especially type 2 or adult onset diabetes, which can be controlled without insulin injections, is expanding in the world as a direct result of obesity.

According to World Health Organisation (WHO) projections, the number of people suffering type 2 diabetes around the world will increase 46 percent by 2010, to a total of 221 million people.

But the increase will be just 23 to 24 percent in the United States and western Europe, compared to 44 percent in South America, 50 percent in Africa, and 57 percent in eastern Europe.

Research demonstrates that maintaining one’s BMI within the “normal” range greatly reduces the risk of diabetes, the incidence of which varies between ethnic groups, with the highest levels seen among Native Americans.

The problem of obesity in Brazil was aggravated because until recently it was treated as a character flaw, arising from lack of willpower, rather than a disease. The Brazilian Association of Research on Obesity did not emerge until 1986.

For years, endocrinology paid little attention to the problem, because the data indicated that less than three percent of all cases of obesity were due to “glandular malfunction” or hormonal problems.

But the discovery of leptin, a hormone-like protein secreted in adipose cells, in 1994, and of ghrelin, which is produced in the stomach, led to a broadening of endocrinology’s interest in the question, said Matos.

Since leptin and ghrelin govern the appetite, sending signals to the brain that the body needs to be fed, their discovery has opened up new horizons for treating obesity.