The United Nations and related bodies have predicted that by 2030 – a mere six years from now – half the world’s population will be obese. This has seen a rise in the availability and acceptance of medication to reverse the trend.
This is as rates of obesity across the world skyrocket, alarmingly so. Obesity is described as an unhealthy chronic disease responsible for a myriad of non-communicable diseases, many of them life-threatening to men, women and young people alike.
“This is where big pharma has stepped in to promote drugs instead of governments and other sectors taking the lead,” said Pretoria dietician and doctor Martha Sokhulu. “There are many ways to avoid chronic illness and death and most require that people be more aware that healthier lifestyle choices have to be made.”
Worldwide, obesity has become normal, and researchers at Wits said earlier this year that obesity was “a real yet ignored global pandemic” in southern Africa affecting 41% of women and 11% of men over the age of 15 .
“This ‘obesogenic environment’ features a rapidly changing diet driven by an aggressive processed food industry and a genetic hand that predisposes one to obesity,” Wits said.
Research has shown that cost-effective pharmaceutical treatment could help solve obesity.
But, Sokhulu said, just like type 2 diabetes, which is rampant across South Africa and rendering communities dependent on drugs, it can be managed. At worse, she said, diabetes was manageable through lifestyle changes, habits and diet.
She spoke of the lifestyle factors that people needed to be aware of, among them what they eat and when they eat it, the use of tobacco and alcohol, and physical activity.
“We have too many people on diabetes medication, when they could be managing it by doing right by their own bodies,” Sokhulu said. Besides that, it could by and large be prevented, she said, adding that a severe lack of understanding clouded how people handled themselves, how they prepared meals and what they consumed.
“Yes, we have large populations which have very little to no control over what they eat because of their economic situations and access to healthy foods, but with proactive action from government, this can be handled,” she said.
The government of the United States, where obesity levels are at an all-time high, said: “Obesity has become an epidemic and a worldwide problem, and its treatment is ever-evolving.” It said apart from diet and exercise, medication and surgery remain as options. “After disappointing side effects of various obesity drugs, new treatments showed promising results.”
There are drugs that have been approved by the Food and Drug Administration (FDA) for weight reduction, except for one called tirzepatide, the World Health Organisation (WHO) said, as it is still under evaluation. “Efficacy and tolerable safety profiles of some of these drugs contribute to the management of obesity and reduce the complications associated with this chronic disease,” it said.
The Department of Health in South Africa said when preparing a study to curb obesity by 2028, that the cost and extent of obesity in South Africa is unsustainable and does not contribute towards the government’s vision of a “long and healthy life for all South Africans”.
“Obesity has increased dramatically in adults over a period of 20 years. In addition, the prevalence of obesity in children 6 - 14 years of age is higher than the global average,” the department said, adding that causes were multifactorial. It said the nutrition transition from minimally processed and locally produced food to readily available and cheap ultra-processed food and drinks that are high in sugar, salt and/or fat are among key contributing factors.
“This, in addition to sedentary lifestyles and the lack of available and safe physical activity facilities and opportunities contribute to the problem.”
It called for the creation of enabling environments where people would have access to healthy food and physical activity opportunities and receive appropriate nutritional information to make decisions that will contribute to healthy eating habits and lifestyles.
“Legislation to restrict advertising of unhealthy food and beverages to children is also paramount if we want to halt the rise of obesity in the next generation. This strategy also seeks to capacitate health workers to counsel and manage obese persons and to monitor the rate of obesity through the health system,” the department added.
However, Sokhulu and others with an interest in these matters said the arms of government rarely worked together to ensure that knowledge translated to action. Sokhulu said: “They conduct studies, they discuss it, write papers and sign them off, but there is no mechanism to ensure that responsible sectors implement.”
She said everyone in the country, wherever they are, when they drive along the road, walk down the street or pick up a product in a shop, should by now know that obesity is a pandemic they should avoid.
“But right now, the availability of drugs and their accessibility, by pharmacies that have both the money and will, is outrunning government. They are in a race to dispense drugs laden with side effects to everyone. Just like ARVs, these will become so available that everyone walking into a clinic, no matter where and what they had, will have them,” she said. And that, she said, is worse than if information was provided, resources made available and awareness created about obesity.