When compared to nine other Caribbean countries, Cayman is on the higher end of the spectrum for overweight prevalence, and in the middle for obesity.
Obesity is weighing heavily on Cayman’s population, statistics show, and the figures are likely to keep ballooning unless government sectors come together to create a solution, according to several health industry leaders at the Cayman Islands National Healthcare Conference last month.
“This is the largest epidemic facing us from the chronic disease perspective, and it is a dominant cause of premature death both in the U.S. and in the Cayman Islands,” said Dr. Robert Cywes who manages the weight loss program at the Palm Beach Children’s Hospital in West Palm Beach, Florida.
According to Dr. Cywes, the average age of death for an obese American is 56, which he says is a massive reduction in life years.
More than 70 percent of men and women in the Cayman islands are considered overweight with a Body Mass Index of above 25, and more than 30 percent are obese, according to statistics provided by Dr. James Hospedales, executive director of the Caribbean Public Health Agency.
Also in Cayman, the rate of obesity among women is about 10 percent higher than among men, according to CARPHA’s figures.
When compared to nine other Caribbean countries, Cayman is on the higher end of the spectrum for overweight prevalence, and in the middle for obesity. Aruba tops the list with 80 percent of its population being overweight, and St. Kitts tops the obesity list with a rate of nearly 50 percent.
Food and beverage industry
According to several health experts at the conference, the food and beverage industry has been a major hindrance to solving the obesity problem by marketing affordable and accessible energy-dense foods and drinks.
In the last 10 years, global sales of packaged foods have jumped by 92 percent, and 1 billion people are overweight or obese worldwide, said Dr. Hospedales.
Ice cream, deep-fried foods, and french fries and frozen diners are a few examples of energy-dense foods, which have little nutritional value, causing the consumer to have to eat excessive amounts to feel full.
Dr. Cywes outlined a major link between sugar and obesity, noting that “70 to 90 percent of the average obese person’s total calorie consumption is some form of sugar.”
Clinical studies have confirmed that sucrose and particularly fructose can induce weight gain, according to the American Society for Clinical Nutrition.
While diet plays a major role in obesity prevalence, lack of physical activity is also a significant contributor. The World Health Organization states on its website that people are becoming increasingly inactive due to the sedentary nature of many jobs, changing modes of transportation, and increasing urbanization.
In Cayman, 40 percent of men and 20 percent of women reported low levels of weekly physical activity in a CARPHA study. However, a vast majority of males – 61 percent – said they were physically active.
Consequences of obesity
“Being fat does not kill anyone,” said Dr. Cywes. But obesity does put people at a higher risk of developing other fatal, chronic, noncommunicable diseases, including coronary heart disease, type 2 diabetes, stroke, and high blood pressure. Diabetes is the leading cause of death in 10 Caribbean countries, including Cayman, a presentation at the Health Conference revealed. Next is cerebrovascular disease, followed by heart disease.
An obese person is susceptible to increased physical and mental ill health, as well as psycho-sexual issues, said Dr. Hospedales. Obesity also puts a financial strain on governments and healthcare providers, since an obese person automatically has 50 percent higher lifetime direct healthcare costs than the average person, said Dr. Hospedales. “If 30 to 40 percent of your population is obese, your healthcare costs and your economy is going to be that much worse…”
Dr. Cywes also pointed to the rising costs of healthcare, “Cayman is a close community, it’s an isolated community with 55,000 people, yet we spent 10 million dollars on obesity management on this island in 2009.”
What is the solution?
Several health experts said an approach across sectors involving health, agriculture, transport, urban planning, environment, food processing, distribution, marketing and education is needed to win the war against noncommunicable diseases.
Dr. Hospedales said, “regulating the school feeding environment” and “setting standards for what we allow to be imported in the country” could be possible control measures for obesity.
Establishing a national policy on nutrition and obesity was also recommended. “[We need] a range of policy and legislative measures to tackle the obesogenic environment in which we live. It’s not just to tell people to eat less, or that you need to lose weight or you must get moving. Those are important steps, but we’ve got to change the environment, in terms of the foods that are available and the prices,” said Dr. Hospedales.
Dr. Cywes said obesity is the result of a substance abuse problem, much like cigarettes and alcohol addictions.
“This is a unique opportunity by a small government to recognize the issue of addiction and to start treating substance abuse through education, and also with a set legislation.”
He said one possible solution would be taxing unhealthy foods to make them less affordable and more of a treat.
“We can increase taxation to help pay healthcare costs and introduce measures to get people to change the way they are eating and drinking and do things to control what they consume.”