Issue link: https://maltatoday.uberflip.com/i/844884
maltatoday, WEDNESDAY, 5 JULY 2017 4 News Obesity cost Malta €36.3m in 2016 PAUL COCKS THE total cost of obesity in Malta for 2016 has been estimated at €36.3 mil- lion, or 5.6 percent of the country's national healthcare expenditure, ac- cording to a study carried out by PriceWaterhouseCoopers. In fact, over a quarter of the Maltese adult population over 15 years of age is obese, up from 23% in 2002 and pushing Malta further away from the 2020 target rate of obesity set at 18%. The €36.3 million total is a con- servative estimate of seven direct and five indirect obesity-related costs, of which 66% are direct costs – primary care, specialist care, hospital care, cost of allied healthcare profession- als, pharmaceutical care, weight loss interventions and public interven- tions. Indirect costs cover absenteeism, presenteeism, government subsidies, forgone earnings and forgone taxes. Other factors, such as depression, discrimination and lower educational attainment were not factored into the costings. The study also illustrates other ma- jor problems. First, Malta leads trends when it comes to childhood obesity, with 32% of Maltese 11-year-olds resulting obese while a further 38% are over- weight. Second, premature mortality di- rectly attributable to being over- weight and obesity is estimated at 17% of total deaths in Malta. The ef- fect of obesity is expected to be more widespread in the future. It is a long- term problem, which is projected to generate an additional €5.1 million in costs by 2022, on the assumption that the 2015 rate of obesity is main- tained. Established nutritionist Geoffrey Axiak told MaltaToday there were numerous reasons for the high rate of obesity among Maltese. "Unhealthy and fast lifestyles, lack of exercise and even genetics are responsible," he said. "So is the un- healthy food many people choose to eat, such as fast food and frozen, commercial food." Axiaq said other factors – including sedentary hobbies, such as playing videogames, watching TV and sitting in front of a computer – are also to blame for the prevalent obesity, par- ticularly among the younger genera- tion. He said that it is difficult "to beat obesity if one is already obese", al- though not impossible, but preven- tion remains the best tool available. "To help fight obesity in chil- dren and teens, we need to promote healthy eating habits and exercise while educating parents about the benefits of healthy diets and active lifestyles," Axiak said. He stressed the importance of choosing healthy food, such as veg- etables, fruit, fish and low-fat meats like chicken, turkey and rabbit. Fast food – if at all necessary – should only be used as a rare treat for children, but even this could be sub- stituted by outings, visits to the cin- ema or other activities. "In the case of already obese chil- dren, control their food portions, limit sugar, salt and fats," Axiak said. "It is also important to carefully choose what desserts to give chil- dren. Ideal choices would be fruit and yoghurt, with ice-cream also served in controlled portions." He agreed that most healthy food is quite expensive but insisted people could buy fruit and vegetables instead of fish and other expensive meats. "To beat obesity is difficult if one al- ready has the problem but it is never too late to deal with the problem," he said. "One can adopt a healthier life- style, a healthier diet and see results. Little by little the obesity problem can be dealt with aiming for small improvements, gradual changes and with the help of experts." In light of its pronounced effects, it is inarguable that obesity is a societal challenge, which is expected to result in higher economic and social costs as obesity rates continue in their tra- jectory. In its report, PWC argues that intervention is required on a global level in different facets of life, be it on a personal, family, commu- nity and national level. A number of interventions are al- ready in place through ongoing poli- cies within the health arena, but ex- perts agree that more needs to be done. It will be interesting to see what impact any new obesity-related inter- ventions to be implemented in Malta will have. What is obesity and how do you measure it? Obesity is defined by the World Health Organisation as the "disease in which excess body fat has accumulated to such an extent that health may be adversely affected". Typically, the Body Mass Index (BMI) (being an index of weight-for- height) is used to measure population-level obesity, this in turn enabling the categorisation of individuals depending on their BMI levels. The table below shows the classification system for adults according to BMI levels. Included are also the risks of comorbidities, these varying with BMI classification. Classification BMI (kg/m2) Risk of Comorbidities Underweight < 18.50 Low (but risk of other clinical problems increased) Normal range 18.50 – 24.99 Average Overweight: ≥ 25.00 Pre-obese 25.00 – 29.99 Increased Obese Class I 30.00 – 34.99 Moderate Obese Class II 35.00 – 39.99 Severe Obese Class III ≥ 40.00 Very Severe Over a quarter of the Maltese adult population over 15 years of age is obese Rates of BMI Categories of the Adult Population It is very important to carefully choose what desserts to give children