Obesity: Here’s how to combat the global health endemic

According to the World Health Organization (WHO), in 2022, 1 in 8 people were obese globally. This figure implies that between 1990 and 2022, worldwide adult obesity more than doubled, and adolescent obesity quadrupled. By 2024, 35 million children under the age of 5 were overweight.

Unfortunately, the concerning numbers are not restricted to certain geographical locations. Rather, the effects spill over to various countries, indicating an overwhelming global issue that needs to be addressed now. 

According to Chowdhury Tasneem Hasin, Chief Clinical Dietitian at United Hospital, a majority of health-related complications people face in adulthood, such as blockages in the arteries, fat around the liver or a malfunctioning kidney, actually take root in their youth. 

“In urban societies such as Dhaka, the lack of physical activity is a big concern, even overshadowing the role of a poor diet in contributing to poor health,” she mentions. “The youth of today spend all day sitting and then go to the gym for heavy workouts for an hour.” 

She goes on to say that one hour of intense exercise is insufficient compared to maintaining a consistently active lifestyle throughout the day. 

Parallel to a sedentary lifestyle, poor dietary choices have emerged as a crucial factor in the obesity epidemic. 

“Food that does not come from one’s own kitchen almost always contains high amounts of monosodium, corn starch and sugar and is usually cooked in oil that has been used more than once,” shares Hasin.

We are often quick to blame fast food, but it is not just fast food that is the problem. Any food that uses unhealthy cooking techniques such as reburned oil (trans fat that settles on the liver) and high amounts of sugar and sodium (that cause water retention and bloating) is an equal culprit, that keep young people coming back without realising the dire repercussions. 

Health consequences of obesity

The health consequences of obesity in youth are profound. Type 2 diabetes, once primarily seen as a disease occurring in adults, is now increasingly being diagnosed in children and adolescents. Cardiovascular issues are also on the rise among overweight adolescents. High blood pressure, cholesterol levels, and early signs of heart disease are becoming increasingly common in this demographic. Additionally, joint problems and orthopaedic concerns, such as flat feet or discomfort in weight-bearing joints, may arise due to excess weight, leading to decreased mobility.

“The psychological impact of obesity cannot be overstated,” expresses Hasin. “Adolescents who are overweight or obese often experience low self-esteem, body image issues, and social isolation.” 

The stigma attached to obesity can result in bullying or discrimination, further intensifying feelings of depression and anxiety. The expert feels that as the mental health implications rise, adolescents may find themselves trapped in a cycle of unhealthy eating behaviours and psychological distress.

The economic burden associated with obesity extends beyond individual families. The healthcare costs incurred from treating obesity-related conditions place a significant financial strain on families and healthcare systems. These costs highlight the urgent need for effective prevention and intervention strategies.

On crash diets, intermittent fasting, and fads

“The youth of today are used to quick results,” notes Tasneem Hasin. “To get them, they resort to all kinds of diets and fads such as keto, intermittent fasting, and slimming teas.” 

However, while they deliver short-term results, most of these fads are not sustainable in the long run. 

“Completely stopping carbs can make you groggy and lethargic.” 

The dietitian also shares how local rice contains more than just carbs. It contains Vitamin B complex with biotin, which works to break down carbs. “Without it, whatever other carbs you take in throughout the day will not be broken down correctly into energy, settling instead on your liver as triglycerides.” 

Intermittent fasting is another trend that is being used without proper research. The weight loss technique may not work for everyone, especially those with diabetes or kidney issues, as it might weaken insulin regulation.

“Yes, we use intermittent fasting for patients who need to reduce a lot of weight in a short amount of time, such as before surgery,” says Hasin, but adds, “This is not sustainable, however, as the weight comes back on as soon as the patient returns to their routine.”

What then?

As no two individuals have the same metabolic rate, even if they are the same age and have the same body structure and height, there is no blanket diet that would work for everyone. However, Hasin suggests common, yet non-negotiable food groups that must remain on your plate in order to maintain a healthy weight. 

“Complex carbs such as brown bread or oatmeal can be a good source of energy,” she suggests. “A good breakfast of complex carbs and a boiled egg can set you up for the day.” As a snack, around 11 AM, she suggests a whole fruit or vegetable that contains fibre. “This can be any fruit you can eat with the peel, such as apples and guavas.” 

For lunch, a small cup of rice with a protein of choice, veggies and leafy greens makes for a good plate. She analogises the fibre in leafy greens to a broom. 

“Just like a broom, fibre found in leafy greens can clean out toxins and fat from your body and keep it from accumulating in your system.” 

Those who are overweight or suffer from a fatty liver may think of adding Vitamin C to their plates as well, as it can reduce the absorption of carbs in the body. “As sweeter fruits may not be very good for them, maybe they can reach for an orange instead of a banana.”

For an evening snack, sour yoghurt with chia seeds or cucumbers and tomatoes is a good way to get your daily dose of probiotics. 

“At night, we advise those suffering from obesity to skip all forms of carbs and just finish dinner with proteins and veggies.”

Chowdhury Tasneem Hasin advises the youth to eat as many local sour fruits as possible. “Local produce is good for you and far more sustainable for the diet than anything adapted. Winter veggies such as broccoli, beans, etc. are rich in natural fibres, readily available and pocket-friendly.”

According to Hasin, veggies that retain their original colour through the cooking process retain their nutrients. “Therefore, it is imperative that broccoli remains green and does not become olive-brown.” 

The dietitian also recommends drinking a lot of water throughout the day. “Some people say that 2 litres of water is enough, but this is not true for everyone. Those who are obese need up to 3 litres of water throughout the day to boost their metabolism, and more in summer.”

Food should be taken at least 2 hours before bedtime so it can be digested properly. 

“Speaking of bedtime, the youth these days are night owls. The body is designed for rest right after sundown, until sunrise,” shares Hasin. “Sleeping a good 8 to 10 hours and waking up at dawn or in the early hours of the morning can do wonders for your metabolism.”

Collective efforts to end the endemic

The youth of today lead very busy lives. From school to extracurricular activities, their lives are jam-packed in a way that it never was for their predecessors. If one wishes to see any light at the end of this tunnel, each one of the youth touch points has to be addressed. 

Implementing educational programmes in schools that emphasise nutrition and healthy lifestyle choices is crucial in empowering adolescents to make informed dietary decisions. By integrating cooking classes, nutrition education, and awareness campaigns about balanced meals, portion control, physical activity, and the reduction in sugary drinks and fast-food consumption, schools can significantly influence students’ health more positively.

Healthcare providers can also play an equally important role in addressing youth obesity through routine screenings, starting open conversations about healthy lifestyles, and providing referrals to specialists and nutritionists where necessary. 

Collaborative efforts between families and healthcare professionals can lead to personalised plans that respect adolescents’ unique circumstances, including cultural and socioeconomic factors that are relevant to this age group.

Adolescents are more aware than those in previous generations and have a lot of resources at their disposal to make informed choices about their lives. A nudge in the right direction through effective modelling by parents, those who have the power to influence them, and readily available expert advice can help them make healthier decisions and break the vicious cycle of obesity. 

Photo: Collected