By Lala Sri Fadila (Undergraduate Student at School of Health and Nutrition, Universitas Gadjah Mada)
The increasing of average weight of people in some countries is associated with the incidence of obesity (Friedman, 2003). World Health Organization (WHO) defined overweight and obesity as “abnormal or excessive fat accumulation that may impair health”. Obesity can be diagnosed from BMI, someone’s weight in kilograms divided by the square of the height in meters. When the measure of BMI exceeds 25, then it is called overweight. Moreover, if the BMI exceeds 30, people are obese. Therefore, the rising number of overweight and obesity triggered the average weight of people increased.
Obesity and overweight have been major health problems worldwide. Based on data from WHO, since 1980 obesity case increased almost twofold from the previous years. Obesity also has been declared as “the global epidemic” by WHO in 1998 (Caballero, 2007). Statistics from WHO estimated that more than 1.4 billion adults, 20 years old and older, were overweight.
The obese has higher risk to get several chronic diseases, such as type 2 diabetes mellitus and cardiovascular disease (Suastika, 2006). Additionally, because of its close relation with metabolic and cardiovascular disease, obesity and overweight has become leading risks for global deaths (Barness, et al,. 2007). This condition has made obesity as a developing concern worldwide.
Nevertheless, obesity is a preventable disease. Strategies and policies are needed to prevent and overcome obesity. However, before we set the strategies and policies, we need to understand what the determinants for obesity prevalent are.
There are so many factors that can cause obesity. Among them are change of food consumption and change of lifestyle (Roemling and Qaim, 2012). These alterations may happen globally. Modern western lifestyle has a role that influences these changes (Egger and Dixon, 2014). Through globalization, modern western lifestyle entered many countries and then changed people’s behavior. Previously, people were engaged to healthy lifestyle but nowadays they left it to become contemporary society.
Modernization has impact to social, cultural, occupational, environmental and other factors of people’s lifestyle. Based on Egger and Dixon review (2014), the transformation of those factors can affect nutrition, activity, stress level, technology-induced-pathology, and inadequate sleep. It also can influence the relationships and social factors of modern society. Thus, the transformation of lifestyle has bigger effect beyond what we imagine.
Modification of dietary pattern caused the energy intake became higher than the need. The dietary changes included the increase of edible oils and caloric sweeteners using, transition to animal-source food, and decreased consumption of legumes, coarse grains, and other vegetables (Popkin, et al., 2012). Furthermore, a study by Cizza and Rother (2012) suggested that increased intake of fast food and junk food is also contributed to the obesity epidemic.
Fast food and junk food has become popular among modern people. They consume it because of its good taste and it is easy-to-serve. The current society has less time to provide their meals, leading them to consume fast food and junk food. The ingredients have to go through the process, such as deep frying, and added additives into it before become an edible fast food. The food processing of fast food and junk food itself made them to be unhealthy food that contains high calories and rich in fat. Fast food consumption has tight relation with obesity because of its increased calories and fat contents (Anderson, et al., 2011).
Alongside with the consumption of fast food and junk food, the reduced physical activity is considered as the most important factor to obesity (Cizza and Rother, 2012). Poor quality of nutrition made the body get excess energy. The energy should be burned through physical activity. However, if people live a sedentary lifestyle, the energy will remain excess in the body. Weight gain will happen as a result of this condition.
An effective way to prevent obesity means we have to prevent people from live an unhealthy lifestyle. A strategy is needed to avoid people from consume poor nutrition food and reduce their physical activity. The strategy should be focused on environment factors such as social, culture, politics and policy-making which has a big effect to social life. Furthermore, what we have to regard is the strategy must aim at the high risk people.
There are three kinds of prevention: universal prevention, selected prevention, and targeted prevention (WHO, 1998). Universal prevention related to high scale policy that can affect the entire population. It is needed to lower the prevalence and the incidence of obesity entirely. Meanwhile, selected prevention and targeted prevention are addressed to specific people. The targets are people with higher chance to suffer from obesity and also people who already overweight (Suastika, 2006).
Universal prevention can be formed as a policy that regulates fast food price. The government can set the tax through policy in such way hence fast food price will increase. The increasing of fast food price is expected to reduce fast food consumption by people.
The other example is the policy that controls food industry to use any unhealthy materials. The food industry has to reduce sugar, fat and salt usage and consumption in order to produce a healthier food that does not contain high calories and has a slight fat. The food labeling and nutrition fact of food are also needed to give information about the contents of food. This information will guide people to choose their food based on what they need and what is appropriate for them to consume. This policy is expected to guide people to get balance energy and nutrients.
Moreover, the campaigns and education are needed to raising people awareness. This strategy is related to community-based approach. Health promotional campaign should be done to make people aware about healthy food and healthy lifestyle. Awareness is not the only target; community-based action is also can empowering and encouraging society to change their behavior (Krishnan, et.al, 2010)
The proper strategy for the selected and targeted prevention is lifestyle intervention. This action is planned to help individuals to change their daily behavior. This includes giving information to participants about reducing calorie intake and increasing energy expenditure (Suastika, 2006).
To sum up, obesity has been a major health problem and leading death risk worldwide. Obesity occurs because of dietary pattern and lifestyle modification. Thus, to prevent and overcome it, an effective strategy is needed. It can be done through community-based action and individual approach to change people behavior.
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