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.
* 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.
Key health indicators presented on this page cover such topics as health expenditure, life expectancy at birth, immunization coverage among children, mortality and burden of disease, stunting prevalence, years of life lost, utilization of health services, access to improved water and sanitation, health workforce, risk factors. Indicators are compiled from the World Development Indicators database of World Bank, Global Health Observatory and Statistics Database of World Health Organization.
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