Obesity: A staggering public health challenge in JK

Jammu and Kashmir is facing a major health challenge – obesity. More than 29 percent of women and over 20 percent of men are either overweight or obese and their body-mass index (BMI), a measure of body fat based on an adult person’s weight in relation to height, crossing 25. “Obesity is the root cause of metabolic syndrome, the biggest health challenge we are confronting today” says Dr Shariq R Masoodi, professor of endocrinology at SK Institute of Medical Sciences (SKIMS). Dr Masoodi, who sees scores of patients with obesity related issues every day, warns that obesity was spiking Kashmir’s burden of “lifestyle diseases”. His assertions find corroboration in the recently released exhaustive report on burden of diseases in India: “Health of Nation’s States”. As per the report, over 36 percent of people over the age of 40 years, across gender, lose life to cardiovascular diseases, high blood pressure, high fasting plasma glucose, high BMI, high total cholesterol and impaired kidney function feature. These conditions feature among top 10 risk factors driving death and disability. Although, these disorders existed in State earlier too, in the last one decade, the proportion of population bereft with these conditions has increased drastically. While in 1990s, the report states, only 4.8 percent of population suffered from high blood pressure, today the percentage stands doubled. People with high fasting glucose and high total cholesterol have more than doubled too. While experts refuse to call the scenario incidental, the levels of obesity in state have also multiplied in the last few decades. Noted endocrinologist and former director of SKIMS, Dr Abdul Hamid Zargar says that the rising prevalence of obesity was the “root cause of diabetes, cardiac ailments and Polycystic Ovarian Disease (PCOD) epidemic in Kashmir”. This is evident from National Family Health Survey (NFHS), the only record of the health indicators spanning over two decades available from the State. As per NFHS-3, carried out in 2006, only 6.2 percent men in J&K were obese. In 2016, when NFHS-4 was carried out, 20.5 percent men were found to have “crossed the line”. The NFHS-3 had put the percentage of overweight/obese women at 16.7 percent, a portion that almost doubled in a decade (29.1 percent in 2016). However, despite this rise in obese population, there is no system in place in J&K to address this “looming health calamity”. With our health system continuing to be cure-focused rather than preventive, men and women in J&K are continuing to add up kilos to their weight and numbers to the already obese population. What is more worrying is that the younger generation is now bearing the brunt of this trend. “Obesity in J&K is getting worse by every decade. And to make things worse, the onset of obesity is now occurring at ever-lowering age,” Dr Zargar says. Even though the NFHS does not measure the health indicators of young population, a study by SKIMS, with Dr Masoodi as lead researcher, has revealed some shocking figures. As per the study, titled ‘Prevalence of obesity and overweight in school children in Kashmir Valley’, 34.5 boys and 38.4 girls were overweight/obese. The study measured weight and other parameters of over 9000 school children (between 5-15 years of age) across Kashmir’s schools. These numbers make it clear – Kashmir’s young ones are falling prey to obesity. Asked if anything could be done to address this health risk, Dr Masoodi responded philosophically: “Acceptance is the key”. He asserts that as a first step towards addressing the issue of obesity in Kashmir, it was necessary to accept that the weight we have is not “healthy”. “Many people I see refuse to accept that they are overweight or obese,” he says. “Second,” he says, “we have to accept that we are eating more than what we are spending.” The doctors advise that creating a balance between calorie intake and expenditure, coupled with lifestyle changes could help reverse the grossly flipping weighing scales. “Exercise, exercise and exercise,” says Dr Shahnawaz Mir, endocrinologist at Kashmir’s largest general specialty hospital SMHS, “is best way to deal with obesity.” He says exercise does not necessarily mean hitting the gym but including physical activity in any form in our daily schedule. “Take the stairs, walk to office, to market, to school. Minimise use of automated machines, washing machines, lawn mowers, vacuum cleaners,” he lists out many ways in which people could spend their extra calories. For children, Dr Masoodi vouches for “reversing perceptions” related to foods. “The fact that we give a pastry or an ice-cream as a prize to our children makes them believe that these foods are really better than the foods that they eat otherwise. This needs to change.” Doctors believe that parents and schools need to create an atmosphere where physical activity for children was mandatory on a daily basis. “In most schools, sports is meant for a single day in a week and is limited to wearing a different uniform,” he rues. A few months ago, Union Ministry of Health and Family Welfare directed J&K and other states to ensure that no aerated drinks and foods high in saturated fats are available in school and college canteens. There also is a full-fledged program funded by Union health ministry, mandated to create awareness related to cardiovascular diseases, diabetes and other lifestyle diseases. However, these directions and programs have failed to take off in Kashmir. In such a scenario, doctors believe that Kashmir was at the precipice of a “health disaster”. “We need education and awareness, across age groups, across departments, across sectors. We need action. And it is needed now,” Dr Masoodi asserts.

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