The Obesity Epidemic: Call for Physical Activity and Exercise

By Zara Khalid¹, Muhammad Naveed Babur², Furqan Ahmed Siddiqi¹

Affiliations

1. Department of Rehabilitation Sciences, Foundation University, Islamabad, Pakistan
2. Faculty of Allied Health Sciences, Superior University, Lahore, Pakistan

doi: 10.29271/jcpsp.2022.04.556

Sir,

As per World Health Organization, the rate of obesity has increased three-folds since 1975. It was reported in 2016 that more than 1.9 billion adult population was overweight and 650 million adults were obese. Due to the increasing prevalence, overweight and obesity have been declared as an epidemic by the WHO.¹ These are major risk factors for non-communicable diseases, including cardiovascular diseases, musculoskeletal disorders, diabetes and some cancers. Globally, obesity is a higher predictor of mortality than being underweight, yet it is preventable.¹

The incidence rates of overweight and obesity are rapidly rising among children and adolescents in Pakistan, despite the existing high level of under-nutrition.² Pakistan ranks 8^th among the 10 countries hosting half of the obese population in the world. Overweight and obesity have been found more prevalent in middle-aged adults (35-64 years), females and urbanites in Pakistan.³ This situation demands immediate action. Literature also highlights the specifically emergent pattern of visceral obesity among South Asians, directly linked to metabolic disorders; hence, increasing the burden of morbidity and mortality. The assessment of obesity should thus rely on anthropometric measures (waist and hip circumference, waist-hip ratio, waist-height ratio, etc.) and visceral fat evaluation instead of only focusing on body mass index.⁴

WHO has initiated the global action plan on physical activity 2018-2030: “More active people for a healthier world;” so that policy actions could effectively enhance physical activity.¹ Evidence has established that the central tool for obesity prevention and management is exercise, in addition to other interventions. The numerous benefits of physical activity and exercise go beyond mere fat loss and weight maintenance. It improves physical fitness and mental health; and helps in combating obesity-associated low-grade, chronic inflammation.⁵ It is, likewise, essential to frequently interrupt the sedentary time with light, moderate or vigorous-intensity physical activity, as rising sedentary behaviours are equally responsible for damaging cardiometabolic health. According to guidelines by the American College of Sports Medicine, the minimum recommended level of physical activity for adults is 150 minutes of moderate-intensity exercise per week. Whereas, in order to induce significant weight loss, aerobic endurance, resistance or intermittent exercise training for approximately 225 to 420 minutes per week is adequate.⁵ 

The effective confrontation of this epidemic in Pakistan warrants a dire need to implement primary preventive care. At a community level, access to exercise facilities should be enhanced and collaboration with NGOs should be encouraged for overcoming financial constraints and provision of human and physical resources. At the governmental level, ameliorative steps should be taken such as imposing higher taxes on unhealthy food items, educating about healthy food consumption via mandatory mention of caloric values and ingredients on all food items and strongly advocating for exercise as a life-essential through print and electronic media. It is high time that healthcare practitioners realise the vital role of exercise and favour its optimal utilisation to help attain unique health benefits.^4,5

Moreover, data on causes of obesity and its management approaches are available mostly from developed countries.⁶   Further research on these avenues is required by developing countries, as well.

CONFLICT OF INTEREST:
The authors declared no conflict of interest.

AUTHORS’ CONTRIBUTION:
ZK: Study concept, designed the work and did initial drafting of content.
MNB: Drafted the work and did critical review of draft.
FAS: Critical review, editing and final approval of the manuscript.

REFERENCES

1. Organization WH. Obesity and Overweight 2021 [30th August 2021]. Available from: https://www.who.int/news- room/fact-sheets/detail/obesity-and-overweight.
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3. Asif M, Aslam M, Altaf S, Atif S, Majid A. Prevalence and sociodemographic factors of overweight and obesity among Pakistani adults. J Obes Metab Syndr 2020; 29(1):58. doi: 10.7570/jomes19039.
4. Khan SH. Asian obesity paradox: Implications for healthcare management approaches. J Coll Physicians Surg Pak 2021; 31(7):757-8. doi: 10.29271/jcpsp.2021.07.757.
5. Petridou A, Siopi A, Mougios V. Exercise in the management of obesity. Metab 2019; 92:163-9. doi: 10.1016/j.metabol. 2018.10.009.
6. Caballero B. Humans against obesity: Who will win? Adv Nutr 2019; 10(suppl_1):S4-S9. doi: 10.1093/advances/nmy 055.