‘The WHO report is a wake-up call to islands governments. They must act now: put out awareness campaigns, encourage citizens to consume more natural foods, eat healthy and lead active lives...'


Healthcare is one of the more important issues concerning Pacific Islanders that does not receive the attention it deserves in regional discourse. Other than HIV/AIDS, which is widely seen as tightening its menacing grip on the region, little appears to be on government agendas—and in the regional media—about a far more worrisome health issue affecting islanders: The islands are well and truly in the midst of an obesity epidemic.

Eight Pacific Islands countries figure in a list of the ten ‘fattest’ countries in the world, says a World Health Organisation (WHO) report released last month. According to accepted definitions of obesity, over eighty percent of the populations of most of these eight countries are overweight—a couple of them around the 95 percent mark. But Pacific Islanders have always tended to be larger and heavier built than people of other ethnicities owing to both genetic and environmental factors. In fact in some societies big is traditionally equated with beauty and across the centuries, islands people have adapted well to their environments despite their large frames, leading normal, healthy lives for the most part (even if some airlines have had to frequently alter their seat configurations).

If that indeed is the case, why should the new WHO report on obesity be a worry to Pacific islands people?
Medical research has established a direct link between a high Body Mass Index (BMI) and the prevalence of heart disease, hypertension and Type 2 diabetes, besides several other ailments. So people with a BMI in excess of 30 or 32 are at risk of falling prey to obesity related ailments such as heart disease, Type 2 diabetes and a slew of other afflictions that have come to be labelled as ‘lifestyle diseases’. If Pacific Islanders have always been heavy set and have lived healthy lives despite that in the past, why should their larger than average frames be a worry now?

There are several reasons. Over the past few decades, the lifestyles of islanders has changed more rapidly than ever before. Their intake of imported, mass produced processed food, which inherently contains more fat and an assortment of chemical preservatives, has increased substantially.

Growing economies have made access to such food affordable and at times far cheaper than traditional foods (in countries like Samoa, people lament that tinned fish is cheaper than fresh catch). Poor public awareness and the near absence of governmental regulations on the nutritive parameters of imported foodstuffs have made the islands a happy dumping ground for exports of fat-laden meat products from the developed world—particularly New Zealand and Australia. Also, the consumption of sugary, carbonated drinks—full of calories but no nutritive value—has helped deposit tons of unwanted sugar in younger islanders’ bodies over the past few decades, propelled by blitzing advertising campaigns across the islands.

Add to that, an increasingly urbanised and sedentary lifestyle with ever shrinking avenues for natural exercise, more leisure that affords time for greater indulgence in imbibing alcohol and tobacco products and you have a scenario that could only have led to the intense obesity epidemic that we have upon us today.

Nutritionists worldwide have been saying that western diets are unsuitable to indigenous people—whether American Indian, Australian Aborigine, Maori or Pacific Islander. The incidence of obesity related disease is markedly higher in these ethnic groups than Caucasians. And easier and cheaper access to hamburgers, fried chicken, pizzas and fries—to the accompaniment of sugary drinks—will only make things worse in the coming years. 

So, while islanders have always seemed big framed and heavy set, it is the rapid lifestyle changes and food habits that have made today’s islanders far less healthy than their previous generations. Studies indicate that obesity related diseases are threatening to cut life expectancies especially among the young obese, who are expected to live shorter lives than their parents. 

Lifestyle ailments, particularly coronary heart disease, hypertension (high blood pressure) and Type 2 diabetes are set to take a heavy toll of not just islanders’ lives but the very economies of the islands. Poor healthcare systems that are ill equipped to handle such ailments and complications resulting from them (only Samoa has a dialysis facility), will have severe repercussions on the productivity of the workforce as well as drive up poverty.   

The WHO report is a wake-up call to islands governments. They must act now: put out awareness campaigns, encourage citizens to consume more natural foods, eat healthy and lead active lives. At the same time they need to take urgent measures to regulate the unchecked import of cheap energy rich but nutrient poor foodstuffs and beverages that are the main drivers of the obesity epidemic.

The urgency cannot be overstressed. A WHO medical expert visiting the region late last year was dismayed at the widespread prevalence of obesity related diseases like Type 2 diabetes. He stated to an alarmed medical fraternity that at this rate, Polynesians would be an extinct race by the turn of the century.

While checking the spread of HIV/AIDS is equally important, islands governments need to urgently establish separate programmes and funding mechanisms to put in place measures to counter the slow, silent killer that is obesity, both at the preventive stage and for the treatment of the growing range of related diseases—from Type 2 diabetes and coronary heart disease to urological ailments, blindness and even cancer. Obesity needs to be put on top of the agendas of islands’ governments. Right up there with HIV/AIDS and climate change. The time is now.