By Katalina Siasau

Tonga ranked number one worldwide as the country with the most women with obesity, according to a study released by well-known medical journal, the Lancet.

The study found that 81.5% of Tongan women over the age of 20 are living with obesity, an increase of 23.3% from 1990.

The study measured rates from across 190 countries. It shows nine out of the top ten countries with the most women with obesity in the world, are Pacific island countries, namely Tonga, American Samoa, Samoa, Tokelau, Tuvalu, Cook Islands, Nauru, Niue, Micronesia, with Tonga as the number one country.

American Samoa and Samoa were ranked second and third. The report stated that 81% of American Samoan women over the age of 20 are living with obesity, and 75% in Samoa.

However, a contrast to obesity, the study shows that less than 0.2% of women in Tonga are underweight, a decrease of 0.4% from 1990.

Huge increase over last 35 years

Moreover, the study also states that 33.9% of Tongan girls from the age 5 to 19 are living with obesity, an increase of 24.3% from 1990, therefore, ranking Tonga top three in girls age 5 to 19 living with obesity.

The Lancet reported that 63.4% of Tongan men over the age of 20 are living with obesity, ranking Tonga top six in the world rank for men with obesity. 

Meanwhile, 31.3% of Tongan boys from the age 5 to 19 are living with obesity, an increase of 24.6% from 1990, and also ranked Tonga number nine in highest percentage of boys age 5 to 19 living with obesity.

Although Tonga has been struggling with obesity for several decades, there have been attempts made by the government to tackle the problem. Solutions offered by the government include a National Guideline for Healthy Living was launched in April 2023, and community and school led programs to promote healthy lifestyles, like the Free Breakfasts for Schools programme.

Obesity, a health issue worldwide

The Lancet study shows that more than one billion people in the world are now living with obesity.

It shows that obesity rates among children and adolescents worldwide increased four times from 1990 to 2022, while obesity rates among adults have more than doubled.

The study states that countries with the highest combined rates of underweight and obesity in 2022, were including island nations in the Pacific. Tonga was number one in percentage of women living with obesity, and also place in the top ten country list of girls and boys from the age 5 to 19 who are living with obesity and men over the age of 20 living with obesity.

Overall, these trends have led to a transition where in most countries, a larger number of people are affected by obesity than underweight. In 2022 obesity rates were higher than rates of underweight for girls and boys in around two-thirds of the world’s countries (133 countries for girls and 125 countries for boys).

Shifts to less healthy foods

The study highlights an urgent need for major changes to measures aimed at tackling obesity, as well as policies to further reduce the number of people who are underweight, especially in the poorest parts of the world.

“This new study highlights the importance of preventing and managing obesity from early life to adulthood, through diet, physical activity, and adequate care, as needed,” said WHO Director General, Dr Tedros Adhanom Ghebreyesus. “Getting back on track to meet the global targets for curbing obesity will take the work of governments and communities, supported by evidence-based policies from WHO and national public health agencies. Importantly, it requires the cooperation of the private sector, which must be accountable for the health impacts of their products.”

Study co-author from the Madras Diabetes Research Foundation, Dr. Guha Pradeepa warns that major global issues risk worsening both forms of malnutrition, saying, “The impact of issues such as climate change, disruptions caused by the COVID-19 pandemic, and the war in Ukraine risk worsening both rates of obesity and underweight, by increasing poverty and the cost of nutrient-rich foods. The knock-on effects of this, are insufficient food in some countries and households and shifts to less healthy foods in others. To create a healthier world, we need comprehensive policies to address these challenges.”

The new study was conducted by the NCD Risk Factor Collaboration (NCD-RisC), in collaboration with the World Health Organization (WHO). Researchers analysed weight and height measurements from over 220 million people aged five years or older (63 million people aged five to 19 years, and 158 million aged 20 years or older), representing more than 190 countries. More than 1,500 researchers contributed to the study, which looked at body mass index (BMI) to understand how obesity and underweight have changed worldwide from 1990 to 2022.