Obesity in Pakistan; Current and Future Perceptions
Maira Siddiqui1, Hareem Ayub1, Rabia Hameed1, Muhammad Ilyas Nadeem2,4,TengkuAriff Mohammad3, Nordin Simbak2, Ahmad Zubaidi A Latif2, YasrulIzad Abubakar2 and Atif Amin Baig2*
1Food Science & Technology, Jinnah University for Women, Pakistan
2Faculty of Medicine, Universiti Sultan Zainal Abidin, Malaysia
3 Universiti Sultan Zainal Abidin, Malaysia
4 Faculty of Health and Life Sciences, MSU, Malaysia
Submission: September 24, 2018;Published: November 14, 2018
*Corresponding author: Atif Amin Baig, Faculty of Medicine, Universiti Sultan Zainal Abidin, Malaysia
How to cite this article: Maira Siddiqui, Hareem Ayub, Rabia Hameed, Atif Amin Baig, et al. Obesity in Pakistan; Current and Future Perceptions. Curr
Trends Biomedical Eng & Biosci. 2018; 17(2): 555958. DOI: 10.19080/CTBEB.2018.17.555958.
Obesity is currently one of the most common health issues that is increasing day by day, and nearly 30% of world population is overweight or obese. More than 60% of global disease burden will be attributed to chronic disorder associated with obesity by 2020 according to WHO. Obesity is also a cause of many non-communicable diseases (NCD) due to which globally 60-70% deaths occur. Pakistan being the 9th most obese nation in the world suffering from its epidemic, affecting all age group, especially in children and females as compared to men and its ratio will be doubled in coming years due to high carbohydrate intake and physical inactivity and other environmental factors. Nutrigenetics and nutrigenomics which represent a unique approach in nutrition research, combining the application of powerful functional genomics technologies and play an important role in development and treatment of obesity and these preventive measures are required at the population level to control this global health issue.
Obesity is a state that is associated with having overindulgence of body fat, defined by genetic and environmental factors that are hard to control with dieting. There is a difference in between overweight and obesity . Overweight denotes the occurrence of the excess of body weight. Obesity denotes the presence of high amount of body fat. All obese people are overweight, but all overweight persons are not inevitably obese in excess.
A fat cell is an endocrine cell and adipose tissue is endocrine organ. As such, adipose tissue secretes some products, like metabolites, cytokines, lipids and coagulation factors. Significantly, excess adiposity or obesity causes the increased level of circulating fatty acids and inflammation. This can lead to insulin resistance, which in turn can cause type 2 diabetes [1,2]. Facts about overweight and obesity: some recent WHO global estimates follow; in 2016, more than 1.9 billion adults aged ≥18 years were overweight. Of these over 650 million adults were obese, the worldwide prevalence of obesity nearly tripled from 1975-2016. Overweight and obesity are linked to more deaths worldwide than underweight. Globally there are more people who are obese than underweight in every region.
There are several factors that may include weighting gain among adults and youth including genes, eating habits, physical inactivity, TV, computer, phone and other sleep routine, medical conditions or medications, and where and how people live (their inhabitation) and their choice of food [3,4].The obesity was classified as per WHO obesity criteria (WHO, 200) based on BMI.
As per examine WHO states that around 26% women in Pakistan, suffer from the trouble of obesity while just 19% of the men are obese. Report of 2013 exposed that the rate was 28% for men and 38 % for women, which is a huge gap between the two genders. Obesity is higher in urban areas (56% in men and 67% in women) as compared to rural areas. Even in youth obesity is also growing at a fast pace. As per 2013 statistics, it was 10%, which is a massive figure. In 2010, approximately 3.4 million people expired because of obesity .
Pakistan is a country where the perception of the healthy diet among the general community is different. Pakistani diet is typically energy dense with a higher percentage of saturated fats, Tran’s fatty acid and free sugar contributing to high calories intake. Use of ghee, high intake of meat, judicious use of sweets in celebrating imperative events of life is common dietary practices in Pakistan. Due to accelerating prices of staple food like cereal, vegetables, and fruits, mostly people favor the cheaper ways of energy like fats and sugar. Use of industrially processed food, fast food, junk food, and sugared fizzy drink are getting very trendy in the younger generation. Rapid urbanization and modernization are also leading to the constructive high fat diet
instead of traditional low-fat diet [6-8].
Pakistan is a developing country facing a “double burden”,
comprising disease associated with under development issues
leading to poor quality of life (infectious disease and nutritional
deficiencies) and non-communicable disorders secondary
to urbanization or rapid industrialization. In Pakistan,
contributory factors are environmental changes, urbanization,
lifestyles modification, consumption of high-density diets, and
decrease physical activity, which have resulted in rising burden
of overweight and obesity. Studies have identified the variable
burden of overweight and obesity among various populations
distinct by gender and age groups, including children.
Furthermore, various studies have identified the substantial
increase in the burden of obesity particularly among children,
comprising 43 percent of Pakistan’s total population .
In Pakistan, Urban population, particularly women show
considerable higher burden of obesity as compared to men and
women from the rural population. Girls from all age groups
are predominantly more obese as compared to boys. Most of
the studies have estimated child obesity among school going
children of different age and need careful interpretation .
A study conducted in northern areas of Pakistan had
described an age-adjusted prevalence of overweight and obesity
around 13.5% and 14.1% for men and women respectively and
an increase in prevalence per year equally for both men and
women . Another study was conducted in the city of Multan,
Pakistan considering the new recommended BMI cut-off for
Asians found 46% of the people were overweight and obese,
while 24.55% were underweight .
The reason for such drastic increase in obesity in Pakistani
population is an unawareness of the harmful effect in the long
run. Approximately 52% of overweight and 73% of obese
people have not even identified their problem, and they think
that it’s normal. People think it as a symbol of health, and they
are not aware of the possible hazards to their health which can
be caused by their excessive weight, therefore, they rarely try
to lose weight. For Pakistan to progress, it is important that
awareness created among the population regarding the harmful
effects of weight gain, not only for themselves but also for the
whole economy. Research indicates that people living in large
cities in Pakistan are more exposed to the risks of obesity as
compared to those in the rural countryside. Pakistan also has
the highest-percentage of people with diabetes in south Asia.
According to one study, “fat” is more dangerous for south Asians
than for Caucasians because the fat tends to cling to organs like
the liver instead of the skin.
has 39.1% of urban population. Pakistan is a developing country,
and it faces a lot of crises in health sector due to unawareness.
In 2015, around 56.4 million deaths occurred globally and of it,
70% death caused by non-communicable disease (NCD). Most
common NCDs include cardiovascular disorders (CVD), diabetes,
and cancer. Around 455 deaths of all NCD occurred due to CVD,
1.6 million deaths due to diabetes and 8.8 million death due
to cancer. It is easy to say that obesity came along with other
diseases which can be a major issue and it is proven from many
types of research that obesity is a major cause of NCD leading to
severe cardiovascular problems, diabetes and premature death.
In Pakistan, 46% of deaths occur due to NCD of about 380,000 in
males and 300,000 in females and majority of NCD death linked
On the other hand, obesity believed for approximately 80-
85% in developing the risk of type 2 diabetes it is estimated
that diabetic patients will rise to 13.9 million by 2020 and obese
people are 80 times more likely to develop type 2 diabetes.
Many studies reveal the fact that abdominal fat causes fat cells
to release pro-inflammatory chemicals due to which body cells
become sensitive to insulin and altering the function of insulin
responsive cells and their ability to respond to insulin. Today
our country is in a phase where diabetes is very common and
affects people at every age, and most of the cases of diabetes are
directly linked to obesity [10-13].
Many health problems like high blood pressure, myocardial
infarction, and hypertension are the risk factors for stroke.
Moderate elevation of arterial blood pressure leads to shortened
life expectancy. All these factors increase the risk of heart disease.
Asthma, cancer and cancer-related mortality, sleep apnea,
osteoarthritis and gynaecological complications are also related
with obesity. In Pakistan, 30 to 40 % of all death is caused by
CVD. The CHD death in Pakistan has reached about 200,000 per
year that is 410/100,000 of the total population. CVD mortality
and morbidity has been shown to be elevated in individuals that
are overweight, particularly with central deposition of fat [14-
Currently due to ease of access to food and minimal physical
activity and because of globalization of processed food and
fast food as it is much cheaper than healthy food, urbanization,
socioeconomic status (are the factors) due to which one-fourth
population of Pakistan lie in the category of overweight as per
Asian specific BMI. In Khyber Medical University Journal, a
study was conducted which showed that 16.2% of the student
were obese and 15% were overweight, showing that younger
generation of Pakistan is at increased risk of mortality and
morbidity because of obesity-related complication and disease
Fats, or lipids, are the third main class of the macronutrients
needed in human nutrition. The lipids are found primarily in meat
and dairy food, at least, these are the most visible sources, but most foods contain some fats. Fats are an important component
of our diet, and at least a minimum intake is essential. However,
many problems are associated with excessive intake of dietary
fat, including obesity, cardiovascular disease, and some forms of
cancer. An important component of lipids is the fatty acids.
Levels of fat intake are highly correlated with weight. High
consumption of dietary fat is associated with both increased
body fat and obesity. Fats are the most concentrated source of
food energy, supplying nine calories per gram, more than doubles
the calorie content of the protein and carbohydrates .
Besides getting fattier, we are also developing more metabolic
disorders, such as type 2 diabetes, which is marked by hormonal
abnormalities in the processing and storage of nutrient and is
far more common in obese individuals than in lean ones .
Genetic factors also have a strong influence on obesity and
are associated with body mass index (BMI). Eating behaviour
has been linked to the FTO gene in humans. FTO affects eating
behavior and influence obesity [19-21].
Pakistan being 9th most obese nation  requires
developing a national stratagem to control obesity in its
populace by implementing the recommendation of the WHO
global strategy on a diet, physical movement and health. The
accomplishment program should integrate all stakeholders like
health department, print and social media, nongovernmental
institution, and private sectors. The major focal point should be
the measures compulsory for
a. Rising the public awareness about the healthy diet,
physical activities and its impact on public health.
b. Education programs in school and colleges should be
approved from corner to corner to the country regarding
healthy eating habits and promoting physical activities in
c. Legislation with appropriate implementation of schoolbased
programs for sports and physical activities should be
d. Sports grounds and stadium amenities may be provided
in every city
e. The nation should be mobilized to adopt the habit of
regular physical activity of 150 minutes per week for adult
and 60 minutes for children.
f. Special emphasis may be laid on a healthy diet and
avoiding the use of extra fats and sugar for energy. People
should encourage for utilizing fresh fruits and vegetables,
fruits, legumes, whole grains and higher fibers diets .
g. By adopting a healthy life style, using balanced diet
and ensuring enough physical activities, we may be able to
maintain normal weight and health.