Technical Consultation on Identifying Approaches to Control Obesity

Dr Shin Young-soo, WHO Regional Director for the Western Pacific

10 April 2011

Professor John Catford , Academic Professor, Deakin University,

Dr Jim Bishop, Chief Medical Officer Department of Health and Ageing, Australia,

Professor Boyd Swinburn, Director of the WHO Collaborating Centre for obesity prevention,

Experts in the filed of obesity prevention ,

partner agencies,

ladies and gentlemen

It's a pleasure to join you this morning for this consultation on Identifying Approaches to Control Obesity.

I would like to thank both Australia's Department of Health and Ageing and the WHO Collaborating Centre for Obesity Prevention at the Deakin University School of Health Sciences for their support for this meeting.

There are 174 WHO collaborating centres in the Western Pacific Region, providing WHO with access to the resources and technical expertise of top medical and scientific research centres.

The excellent work being undertaken on obesity control at the collaborating centre here at Deakin University shows just how valuable this cooperation can be.

It is usually communicable diseases, such as pandemic influenza, HIV/AIDS and tuberculosis, that make headlines around the world.

But for every health story that makes the morning papers or the evening news, there are many equally critical public health issues—obesity and noncommunicable diseases for example—that don’t grab the spotlight.

In the 37 countries and areas that make up the WHO Western Pacific Region, four out of every five deaths can be attributed to noncommunicable diseases.

These are diseases which can and should be prevented.

Certainly, tobacco and the harmful use of alcohol play a role in this rising tide of noncommunicable diseases.

But two other significant factors—unhealthy diets and increasingly sedentary lifestyles—also are chief contributors.

And that's why we are meeting here today—to look at the best approaches to control the risk factors that lead to overweight and obesity.

WHO data paint a grim picture.

More than 1 billion people worldwide are overweight and another 300 million people are obese.

And the number of overweight people is expected to increase by 50% by the year 2015.

Overweight and obesity are responsible for 44% of all diabetes cases globally, according to WHO data.

And physical inactivity is estimated to cause between 15% and 25% of breast and colon cancers, and is responsible for 30% of the worldwide heart disease burden.

While the number of overweight and obese people, based on body mass index, is highest in the Americas, the Eastern Mediterranean and Europe, overweight and obesity have become increasingly worrisome problems in our Region, particularly in many of the Pacific island countries.

Throughout history, changes in the ways we live, the foods we eat and the work we do have evolved slowly, allowing our bodies to adapt.

But changes over the past few decades—particularly rising urbanization, an increasingly sedentary lifestyle, and the aggressive marketing of foods unnaturally high in fat, salt and sugar—have occurred so rapidly that the human organism has not had time to adapt.

In fact, not so long ago, obesity was considered as a sign of affluence and wealth. Today, it can be a death warrant.

Think back to when you were young.

Perhaps you walked to school or rode your bicycle.

Once classes were over, maybe you helped with chores at home, or if you were lucky you rushed out to the park to play with friends.

But today, the environments in which we work, study and play are increasingly sedentary.

More and more of us rely on individual motorized transport.

And how many of us have had to pry our children or grandchildren away from the computer and encourage them to play outside?

Of course, the health costs of unhealthy lifestyle choices—and the obesity and other noncommunicable diseases that often accompany them—have been enormous.

Unlike communicable diseases, which tend to affect people quickly, noncommunicable diseases generally progress much more slowly, creating complex health needs that are expensive to treat and can overwhelm already stressed health systems.

Globally, deaths due to cardiovascular disease—with poor diets and sedentary lifestyles as key risk factors—are expected to rise more than 70% in the first 30 years of this century.

Childhood obesity is a particular concern, especially among the poor who often eat unhealthy foods because they are cheaper.

We often see street children in our cities who seem to subsist on sugar-laden soft drinks and snacks.

As public health officials we have a responsibility to protect the next generation from unhealthy diets and lifestyle choices that will only shorten their lives.

If we don't take action now, an even bigger wave of noncommunicable diseases will be upon us.

These diseases are claiming victims at increasingly younger ages, depriving many of our citizens of their most productive years.

These premature deaths not only devastate families by claiming the lives of primary wage-earners, but they weaken communities and national economies, making it more difficult to achieve equitable and sustainable development.

To the uninitiated, obesity control sounds like a "health issue" that should be solved by the health sector.

But as public health specialists, we know that by the time people enter the health system with obesity-related diseases, it's often too late to offer much help.

The battle really needs to begin at a much earlier stage.

If we want to win the battle against obesity and noncommunicable diseases, the health sector must join hands with other sectors—agriculture, education, the environment, the food industry, trade, transportation and others.

We need a "whole-of-government" and "whole-of-society" approach that engages all these sectors.

The private sector—those involved in producing, marketing and trading food—can take important steps to make our food healthier, while still enjoying healthy profits.

Actions can be taken by city planners and transportation officials to create urban environments that promote healthier and more active lifestyles.

Since eating habits are ingrained early in life, parents and family members can help children develop healthier dietary habits.

Our goal should be to make it easier for all of our people to make healthier choices.

That’s why WHO has developed a Global Strategy on Diet, Physical Activity and Health, approved by the World Health Assembly in 2004.

Since then much additional evidence has been found for interventions that can improve health and survival by reducing risk factors, many of which are related to diet and physical activity.

Now, the challenge for Member States is to implement the strategy in their local communities.

The approaches you help identify at this consultation can help us meet that challenge.

Of course, the approaches you recommend to fight obesity must take into account local customs and contexts.

We need solutions that can be tailored to meet the needs of our diverse Region. What works in Australia or Singapore might not be the best fit for Cambodia and the Lao People's Democratic Republic.

While the general principles remain the same, we have to calibrate our approaches to local realities.

And we need to speak with one voice.

Those of us in public health, in partner agencies working in development, in nongovernmental organizations and in government, need to better align our programmes for obesity prevention.

We all know that with adequate resources, commitment and sustained effort, health behaviours can be changed—with dramatic results.

You have quite a bit of work before you these next three days.

I look forward to hearing the outcome of your discussions and your recommendations, as due our Member States.

Thank you.