Lameko Viali
Internal Medicine, Oceania University of Medicine, Apia, WSM.
Cureus. 2022 Mar 16;14(3):e23239. doi: 10.7759/cureus.23239. eCollection 2022 Mar.
In obesity, abnormal or excess body fat (adiposity) impairs health, increases the risk of long-term medical complications, and results in decreased lifespan. There are many long-term medical complications to consider, such as heart disease, cancer, stroke, type 2 diabetes mellitus, and non-alcoholic fatty liver disease, among others. These are all difficult and expensive conditions to treat in a small developing country like Samoa. The prevalence of obesity in Samoa has steadily increased since the 1960s, and today, 53% of Samoa's adult population are obese. People living in the small island country of Samoa, with a total population of fewer than 200 thousand people, are one of the most obese people in the world today. Factors that have contributed to obesity over the previous four decades include urbanization, the dependence on a dietary transition from one based on fresh local food to highly processed imported food, poverty, as well as probable genetic predisposition. Efforts by the Samoa Ministry of Health and partners to reverse the trend of obesity have mainly relied on behavior change strategies since the 1970s, with no clinical evidence of success. This study critically reviews current policies and strategic plans in Samoa to reduce the obesity problem and proposes that because of the contributing structural factors, the health sector alone cannot achieve its objective without matching multi-sectorial government initiatives.
在肥胖症中，异常或过多的体脂（肥胖）会损害健康，增加长期医疗并发症的风险，并导致寿命缩短。需要考虑许多长期医疗并发症，例如心脏病、癌症、中风、2型糖尿病和非酒精性脂肪性肝病等。在萨摩亚这样的小发展中国家，这些疾病的治疗都很困难且费用高昂。自20世纪60年代以来，萨摩亚的肥胖症患病率稳步上升，如今，萨摩亚53%的成年人口肥胖。生活在总人口不到20万的小岛屿国家萨摩亚的人们，是当今世界上最肥胖的人群之一。在过去的四十年里，导致肥胖的因素包括城市化、饮食从以新鲜本地食物为主向高度加工的进口食物转变、贫困以及可能的遗传易感性。自20世纪70年代以来，萨摩亚卫生部及其合作伙伴为扭转肥胖趋势所做的努力主要依赖行为改变策略，但没有成功的临床证据。本研究批判性地审视了萨摩亚当前为减少肥胖问题而制定的政策和战略计划，并提出，由于存在结构性因素，仅靠卫生部门如果没有政府多部门的协同举措，就无法实现其目标。
