At the Pakistan Endocrine Society's (PES) 5th Annual Mid-Summer Endocrine Conference, Prof. Dr AH Amir from Hayatabad Medical Complex told attendees: "This real-time research survey provides the most reliable data on the prevalence of obesity in Pakistan (and) therefore, should serve as a call to action."
The survey — conducted by the Hayatabad Medical Complex, PES, University of Manchester, University of Glasgow, and Khyber Medical College University — involved the collection of data on over 19,000 subjects from all over the country.
To highlight the severity of the problem, Amir referred to the WHO's BMI guidelines for South Asia, which are stricter than those for the rest of the world.
On a global basis, the WHO states that a BMI of 25 to 30 places one in the overweight category, while a BMI of 30 to 35 falls into the obesity class-I group. Obesity class-II covers those with a BMI of 35 to 40, and those whose BMI is 40 and higher are considered class-III obese individuals.
For South Asia, however, a BMI of 23 to 27.5 is in the overweight category, and a BMI of 27.5 to 32.5 is in obesity class-I. A 32.5 to 37.5 BMI falls into obesity class II, and those in obesity class III have a BMI of 37.5 and above.
Using these guidelines as a benchmark, the survey found 29% of Pakistan's population to be overweight, 31% in obesity class-I, 13% in obesity class-II, and 7% in obesity class-III. This represents an obesity prevalence 20% higher than the global rate of 31% (20% in obesity class-I, 7% in obesity class-II, and 7% in obesity class-III).
Diabetic dilemma
Unsurprisingly, the obese also face an elevated risk of diabetes.
At the recent 15th Annual Pakistan Endocrine Society Conference, Danish ambassador to Pakistan Rolf Michael Hay Pereira Holmboe said the country was the world's ninth most obese, and eighth most diabetic.
"A lot of work has to be done to eliminate these diseases from Pakistan," he said, adding that Denmark intended to support Pakistan in alleviating the situation, which is exacerbated by the country's lack of knowledge regarding endocrinology.
Amir — who is also the PES' former president — said endocrinology was "90% diabetes", and with at least 20% of the population already diabetic, Pakistan was in urgent need of more than its current total of only 60 endocrinologists.
He added that diabetes was the main contributor to heart disease, 50% of kidney diseases, and 50% of cases of blindness in the country.
Current PES president Prof. Dr Ali Jawa said the organisation had begun bringing its annual conferences and mid-summer symposiums from bigger to smaller cities, explaining: "People in smaller cities usually neither have resources nor access to specialised care such as endocrinology, so such symposiums provide an opportunity to local people to interact with specialists in the field."
The mid-summer symposium also saw the launch of the South Asian Federation of Endocrine Societies' (SAFES) journal on preventing, treating and managing diabetes.
The PES' efforts to educate the general public on diabetes include an upcoming session called Ramadan and Diabetes, whereby doctors will advise diabetics on how to manage their condition during Ramadan. For some, it may be necessary to forgo fasting since it can cause dehydration and lead to their medication becoming reactive.
With at least 10% of Pakistani women suffering from diabetes, the PES has also launched an awareness campaign for the prevention of gestational diabetes. Many women in the country lack education, as well as access to proper treatment, resulting in gestational diabetes negatively affecting approximately one in seven births.
This has prompted endocrine experts to raise awareness of the importance of making healthcare and education more accessible.