Obesity has a diversity of causes that are not necessarily linearly associated with each other: "They go from genes to people, families, communities, even entire societies," explained Martha Kaufer Horwitz, a member of the National Institute of Medical Sciences and Nutrition Salvador Zubirán.
Participating in the Permanent Seminar on Pandemics and their Impact on Sustainable Food At the meeting on obesity among pandemics, organized by the University Program for Sustainable Food (PUAS) of the UNAM, the expert said that it is a "socially contagious" disease because the environment can favor it.
Its causes range from purely biological, including genetic, to those that have to do with food consumption and production, sedentary lifestyles, etc. "Genetics is a factor, but the disease also needs a good environment to grow. It is also caused by social and environmental factors."
The factors that contribute to weight gain are, in general, slow metabolism, increased food consumption, and reduced physical activity. The first is because as we age, metabolism decreases and also to hormonal factors, among others.
The second has to do with the "obesogenic" environment, the lack of knowledge of healthier options to incorporate into the diet, unrefreshing sleep, excesses in food due to psychological or emotional problems, and even the consumption of some medications; the third can occur due to physical limitations, chronic fatigue, cardiorespiratory conditions, and muscular pains, among others.
Others, such as type 2 diabetes and cardiovascular disease, are caused by this condition; however, there are other consequences, such as fatty liver, musculoskeletal or renal conditions, or low self-esteem and depression, that become vicious circles that perpetuate obesity.
A person with a body mass index of 30 or more has the condition, class 1, 2, or 3. "If you want to identify an additional risk, you can measure the waist circumference"; if it is above 90 in men and 80 in women, it is a central type of obesity, which is the one that confers the greatest cardiovascular risk. A comprehensive assessment is required to determine comorbidities.
The scientist mentioned that one of the "justifications" for not treating the disease is that there are obese people who do not have comorbidities such as diabetes, hypertension, or musculoskeletal problems. But 80 percent do have metabolic alterations; "it must be treated regardless of whether these exist or not."
The objectives of treatment are, above all, to acquire healthy habits that improve quality of life and health; and to reduce comorbidities, which are usually chronic and costly to treat. "It must be recognized that each person is unique and each requires individualized treatment."
After emphasizing that "magic diets" do not exist, he advised focusing on behavioral change rather than weight loss to ensure that the former is stable and sustainable regardless of whether the patient attends a party, goes on vacation, or is confined to their home due to the pandemic. Kaufer Horwitz asserted, "You have to take the weight off, and not focus on how many kilos you lose and in how much time; you have to have realistic expectations."
The tax on soft drinks reduced their consumption
Simón Barquera Cervera, who is in charge of the Nutrition and Health Research Center at the National Institute of Public Health, agreed that the food environment is important because it affects how people buy and eat food. What we eat has more to do with things like availability, money, advertising, etc. than with our biology or genetics.
The prevalence of obesity in Mexico was not always like this, he clarified. It has been in recent years, which means that we should not accept it as part of our natural condition. It is the result of a careless environment and a lack of regulation and policies to take care of our diet.
Until 2010, this problem was part of the public health agenda. The tax on junk food and soft drinks was implemented in 2014, and warning labeling in 2020. Now there is a stabilization in the increase of prevalence even with the COVID-19 pandemic; "it may be that we are facing the beginning of the good news that the obesity curve is beginning to be controlled."
Drinking plain water and stopping the consumption of plastic-packaged products are important. Besides, junk food and sugary drinks are expensive. For example, a kilo of mangoes costs the same as two liters of coke; consuming healthy food is cheaper. It is necessary to remove all this food from schools. Contrary to what is said, the tax on soft drinks is one of the best-evaluated policies in the world; more than 30 countries have implemented it since Mexico developed it and he pondered.
"It has been found that consumption decreased five liters per capita per year; that is, thousands of tons of sugar were stopped being consumed, and that in 10 years will represent fewer deaths and health savings. If this tax could be doubled, we would have saved more lives, and if part of this revenue were used to ensure some public health strategies, this perspective would be further improved.
"It has been found that consumption decreased five liters per capita per year; that is, thousands of tons of sugar were stopped being consumed, and that in 10 years will represent fewer deaths and health savings. If this tax could be doubled, we would have saved more lives, and if part of this revenue were used to ensure some public health strategies, this perspective would be further improved, "said Barquera Cervera.
Likewise, labeling has "formidable results" in preliminary evaluations. Thousands of products have been reformulated by the junk food industry to reduce the number of stamps; they also allow consumers to evaluate the quality and make healthy choices. Because of multiple labels, approximately 20% of families stopped purchasing products.
This measure has been implemented in other Latin American countries such as Argentina, Chile, Peru, and Uruguay; Brazil and Colombia have initiatives in process, he concluded.