The fattest nations in the world are not probably the ones that first come to mind. The United States does not even make the top five. Instead, in the Pacific island states of Oceania and some Caribbean islands lead the world with at least 80 percent of the populations now overwight or obese.* In Tonga and the Federated States of Micronesia more than 90 percent of men and women ages 15 and over have body mass indices (BMI**) of more than 25 kg/m² (overweight) or more than 30 kg/m² (clinically obese). 

As with other regions of the world, increased urbanization and sedentary office cultures have encouraged the rise in obesity among Pacific islanders. According to western press reporting, the epidemic took hold in the tropical region as it transitioned away from traditional diets of fresh fish and vegetables and replaced those foods with highly processed, energy-dense, imported foods. One of the root causes of the dietary change was the price tag. Poor diets and reduced exercise are now a major public health concern for the region not only because of obesity rates but because the associated diseases are also rife, such as heart disease, stroke, and diabetes, the latter of which has a known genetic basis among locals.

The prevalence of overweight and obesity among females is also high in some Middle Eastern countries, e.g. Kuwait and Egypt. And in 2010, the same year economic policies to "tighten belts" began, Greece became the 6th worldwide and #1 in Europe by percent of overweight males.

Urgent global action and leadership is needed to help countries to more effectively intervene. Because of the established health risks and substantial increases in prevalence of those risks among obese persons, obesity has become a major global health challenge.

  • According to research from the Institute for Health Metrics and Evaluation, in 2010, overweight and obesity were estimated to cause 3.4 million deaths, 3.9 percent years of lost life, and 3.8 percent of disability-adjusted life-years (DALYs) worldwide. 
  • Not only is obesity increasing, but no national success stories to address these conditions have been reported in the past 33 years.

* Not age-adjusted crude rate

** BMI is defined as body mass divided by the square of the body height; it is universally expressed in kg/m2.

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