By Cecilia Attah
The global surge in obesity is a pressing concern, with predictions indicating that one billion people worldwide will grapple with this health issue by 2030. No longer confined to affluent nations, obesity is increasingly prevalent in lower and middle-income countries, particularly affecting vulnerable communities.
Obesity, characterised by excess body fat posing health risks, is linked to chronic ailments like diabetes, cardiovascular diseases, and certain cancers, making it a leading cause of preventable deaths globally. The World Health Organization (WHO) reports a threefold increase in worldwide obesity since 1975, reaching 1.9 billion overweight adults and 650 million obese adults in 2016. Low- and middle-income countries, once immune, are now witnessing a surge, especially in urban areas.
The World Obesity Atlas 2022 predicts that one billion people globally will be living with obesity by 2025, with the greatest number of people with obesity now living in low- and middle-income countries.
This indicates that the issue of obesity is indeed a global problem, affecting populations across various regions and income levels.
To combat this global issue, various approaches, including a comprehensive systems approach to obesity prevention, have been initiated. However, a scoping review suggests suboptimal reporting and limited evidence to assess the effectiveness of this approach conclusively.
In the United States, the State of Obesity 2022 report underscores the link between hunger, nutrition, and obesity-related diseases. Recommendations include curbing unhealthy food marketing to children, imposing excise taxes on sugary drinks, and enhancing maternal and child health support.
The World Heart Federation recognizes obesity as a major public health challenge that affects almost every country in the world. The organization notes that public health initiatives that target obesity can help address the issue.
Nigeria is not exempt from the obesity challenge, as a systematic review and meta-analysis of population-based studies shows the prevalence of overweight and obesity ranges from 12.3% to 41.2%, with urban areas and women experiencing higher rates.
Co-morbidities associated with obesity in Nigeria include type 2 diabetes, hypertension, and dyslipidemia. The economic impact of overweight and obesity in 2019 was estimated to be over N1 trillion (US$2.37 billion), projecting a substantial rise by 2060, Obesity not only leads to various chronic diseases but also affects productivity, income, and environmental sustainability.
Obesity in Nigeria has been linked to an increased risk of mental disorders such as depression, cognitive decline, enhanced vulnerability to brain impairment, and accelerated age-related diseases of the nervous system. Childhood obesity can significantly impact children’s physical health, social and emotional well-being, academic performance, and self-esteem, Obese children are also more likely to experience respiratory problems like asthma, sleep disorders, high blood pressure, and elevated blood cholesterol.
The rising trend of obesity in Nigeria can be attributed to several factors, including rapid economic growth, urbanization, and globalization, which have led to changes in dietary patterns and physical activity levels. As the Nigerian economy continues to improve, food availability and individuals’ dietary calorie intake may have increased, contributing to more people becoming overweight and obese. People living in urban areas tend to consume more processed, high-fat, high-sugar, and low-fiber foods, and less fruits and vegetables, than people living in rural areas. Moreover, urbanization has reduced the opportunities for physical activity, as people rely more on motorized transportation, use more electronic devices, and have less leisure time.
Beyond individual health, obesity poses a threat to Nigeria’s economic and social development, data from the global obesity observatory shows that in 2019, the economic impact of overweight and obesity in Nigeria was estimated to be over N1 trillion (US$2.37 billion) and is expected to rise to $35.8 billion in the next 37 years. This is equivalent to US$12 per capita and 0.5% of GDP. Direct costs and indirect costs made up 20.2% and 79.8% of total costs respectively
Global initiatives and policies can provide valuable insights for addressing obesity in Nigeria. For example, the “State of Obesity 2022” report emphasizes the importance of ending unhealthy food marketing to children, imposing excise taxes on sugary drinks, and expanding support for maternal and child health to combat obesity.
Evidence has shown that taxation of sugar-sweetened beverages (SSBs) is an effective policy tool for reducing their consumption and consequently reducing the prevalence of sugar-induced diseases, including obesity. At least 85 countries have implemented some type of SSB taxation.
For example, In the United Kingdom, the tax on soft drinks was projected to potentially save up to 144,000 individuals from obesity annually, prevent 19,000 cases of type 2 diabetes, and avoid 270,000 instances of decayed teeth. Similarly, in South Africa, a 10% tax on SSBs was predicted to avert 8,000 premature deaths related to type 2 diabetes. In Indonesia, empirical evidence showed that SSB taxation could help reduce the number of overweight and obese individuals and prevent over a million cases of diabetes
In 2021, the Federal Government of Nigeria introduced a Sugar-Sweetened Beverage (SSB) tax, embedded in the Finance Act of 2021, which levies a ₦10 tax on each liter of all non-alcoholic and sugar-sweetened carbonated drinks. There is a proposal to raise the tax from the current rate of 10 per cent to 20 per cent, following pressure from stakeholders, saying to raise the tax as the current rate has not achieved the impact of SSBs tax and consumption is still high.
Although, The Manufacturers Association of Nigeria’s carbonated soft drinks sub-sector (MAN) has expressed concern about the federal government’s proposed 20% ad-valorem excise tax on non-alcoholic beverages, saying that the new policy would affect the widely consumed carbonated soft drinks (CSD) segment.
While some researchers have argued that taxing soft drinks has not successfully reduced obesity or diabetes in some countries, success stories from countries like the UK and Mexico demonstrate positive outcomes, some experts have accepted the implementation of SSB tax in the country saying it can be a win-win-win strategy
evidence has shown that effective taxes on SSBs can lead to significant reductions in Disability Adjusted Life Years (DALYs). These strategies, if adapted to the Nigerian context, could contribute to a comprehensive approach to addressing obesity in the country.
Comprehensive efforts, including government policies, public awareness, and global strategies, are vital to effectively address obesity in Nigeria. Concerted action, regular evaluation, and the adoption of successful measures are imperative to control this escalating public health problem and enhance the overall well-being of the population.
In conclusion, obesity is a significant public health problem in Nigeria, with a high prevalence and rising trend over the years. Efforts to address this issue should encompass government policies, public awareness campaigns, and the adoption of successful strategies from global initiatives. By implementing comprehensive measures, Nigeria can work towards effectively preventing and controlling obesity, ultimately improving the overall health and well-being of its population.
There is a need for concerted efforts to address this issue, including population-wide awareness, health education, and promotion, as well as regular evaluation of obesity prevalence and predictors to ensure effective prevention and control.
