April 21, 2023
KATHMANDU – Nepal, like many other countries worldwide, is facing a growing issue of obesity. The prevalence of this condition has risen significantly over the past few decades, especially in urban areas. Unfortunately, despite this alarming trend, there is a lack of awareness about the associated health risks, and obesity remains a mostly silent epidemic in Nepal.
Various factors have contributed to the rise of obesity in Nepal. The country has undergone significant socio-economic changes, leading to increased urbanisation and a shift towards more sedentary lifestyles. This change has brought about a shift in dietary habits, with people consuming more Western-style processed foods high in calories, saturated fat, and sugar and fewer traditional Nepali foods. Additionally, the availability of technology and infrastructure has led to a decline in physical activity.
Cultural attitudes toward body image may also play a role in the rise of obesity in Nepal. Many view a larger body size as a sign of wealth and prosperity, and being overweight is often desirable. Unfortunately, this attitude can discourage individuals from adopting healthier lifestyles and contribute to normalising overweight and obesity.
The dual burden of underweight and overweight/obesity is a growing challenge in many low- and middle-income countries, including Nepal. Nearly 21 percent of Nepali adults are estimated to be overweight-obese, with almost 17 percent suffering from undernutrition. In children, being underweight is much higher with a low prevalence of over-nutrition. This has shifted the focus of many policymakers and individuals towards the problem being the same in adults, which is not true. As life expectancy in Nepal increases, the most common causes of death are linked with the main killers of middle and old-aged populations, mostly non-communicable diseases.
Obesity is a significant risk factor for cardiovascular disease, the leading cause of death in Nepal. It can increase the risk of high blood pressure, heart attacks, and strokes. Additionally, obesity is linked to the rise of type 2 diabetes, which can result in blindness, kidney failure, and amputations. Some types of cancer, including breast, colon, and endometrial, are also associated with obesity. Furthermore, obesity is related to several musculoskeletal disorders, kidney diseases, poor immune status, poor maternal and child outcomes in pregnancy, and infertility.
Being overweight or obese is a major cause of death, and can reduce a person’s life expectancy by 5 to 20 years, depending on how severe the condition is and if there are other health issues. Most people who die from the problems linked to obesity live in low- and middle-income countries.
It is important to recognise that being overweight is not a person’s fault. It is a complex issue that is caused by many things. These can include what a person eats, how active they are, and how much energy they use. There are also biological, genetic, social, environmental, and behavioural factors that can all play a role in whether someone becomes overweight or obese. In developing countries, this issue is getting worse because of societal changes.
Research has shown that both personal characteristics and the environment we live in can affect our weight and health. To address this issue, we need to use a variety of approaches, including things that help individuals and things that help society as a whole.
We can take control of our health and make positive changes by focusing on healthy habits rather than strict diets or self-blame. One approach to weight loss is using the principles of calorie density, which involves choosing foods that are lower in calories but higher in volume, such as fruits, vegetables, and whole grains. Our brains are wired to consume a similar volume of food every day, with less regard for its calorie density.
It may come as a surprise, but one tablespoon of oil has approximately the same number of calories as an entire head of cauliflower. Oil is a high-calorie food, containing about 120 calories per tablespoon, whereas cauliflower is a low-calorie food, containing only about 25 calories per cup.
This comparison highlights the importance of being mindful of the calorie density of our foods. Calorie density is the number of calories in a given volume or weight of food. High-calorie density foods, such as oils, butter, and cheese, contain a large number of calories per unit of volume or weight, while low-calorie density foods, such as fruits, vegetables, and whole grains, contain fewer calories per unit of volume or weight.
By choosing lower-calorie-density foods, we can consume larger portions and still maintain a calorie deficit, which is necessary for weight loss. For example, by replacing one tablespoon of oil with a cup of cauliflower in a meal, we can save 95 calories. Over time, these small substitutions can add up and lead to significant weight loss.
It is important to note that not all high-calorie-density foods are unhealthy, and not all low-calorie-density foods are healthy. However, by being mindful of the calorie density of the foods we consume, we can make more informed decisions about our diets and strive to maintain a healthy weight. By filling up on these nutrient-dense foods, we can feel fuller and consume fewer calories. This can lead to sustainable weight loss without feeling deprived or hungry.
Another important aspect of sustainable weight loss is making small behavioural changes. These tiny changes can add up over time and lead to significant improvements in health. Examples of small behavioural changes include taking the stairs instead of the elevator, parking farther away from the store entrance, or replacing sugary drinks with water.
It’s important to remember that weight loss is not a one-size-fits-all approach. What works for one person may not work for another. By focusing on healthy habits and making small, sustainable changes, we can achieve our health goals in a way that works for us individually.
Policymakers and individuals must take steps to address obesity. Strategies such as promoting healthy eating habits, encouraging physical activity, increasing awareness, addressing cultural attitudes, providing access to healthcare, and addressing socioeconomic factors can all contribute to addressing the problem. We can create a healthier, happier, and more resilient Nepal by working together.