Dr Alfred Dawes | The Chubby Awards
The recent Jamaica Health and Lifestyle Survey has been an eye opener as to the state of health of the population. We have now reached the unenviable mark of more than half of Jamaicans being overweight or obese. Almost one in three Jamaicans are obese.
But while the survey has answered questions about the prevalence of chronic diseases, it raises even more questions surrounding the distribution of these diseases and challenges what we believe are the causes of the obesity and lifestyle disease epidemics in Jamaica.
And it with this in mind that I present the Chubby Awards.
Although 54 per cent of Jamaicans are over their expected weight, it is a whopping 67 per cent of women who are overweight or obese.
n The award for the Fattest Women goes to Trelawny, with 58 per cent of women in that parish obese.
n Trelawny is way ahead of its closest rival and next door neighbour, St James (47 per cent), who edged out Kingston (46 per cent) by one point.
As to how Trelawny, with very few fast-food joints and the parish known for yams, the supposedly healthy carbohydrate, was able to accomplish this feat is truly a mystery.
If urbanisation and fast food were the main reasons for obesity as we are told, then the runner-up parishes with the two major urban centres should be leading by miles.
Instead, the parish with a significant portion of its population in the hilly interior and the only just-growing cruise ship port of Falmouth is hands down the champion in producing overweight women.
Unless the competitors find the secret to Trelawny’s success, they will have a hard time closing such a wide gap.
Compared to the women, Jamaican men are some of the slimmest in the world. Only 15 per cent of Jamaican men are obese.
n The parish with the most obese men, surprisingly, goes to Hanover, at 23 per cent, edging out St Catherine, with 22 per cent.
n St Ann closely follows, with 19.5 per cent.
This result must again have the judges at the Ministry of Health scratching their heads as to how one of the less-developed parishes was able to win this award without heavyweights such as Kingston and St James not even making the top three.
n The Slimmaz award goes to the cool, cool parish of Manchester (32 per cent).
n Second-place winner is the Banana Republic of St Mary (34.5 per cent).
n Third place goes to St Ann, with 36.6 per cent.
Manchester, with its hilly terrain and largely rural population, is expected to have a slim population.
Winning the Slimmaz Award looks like a major accomplishment until you realise that if Manchester was a country, having 32 per cent of its women obese puts them in the 16th spot of the fattest countries worldwide.
Again we see rural, poorer parishes such as St Mary punching way above their expected weight class.
MAWGA MAN AWARD
n Next door to the parish with the fattest men we find the winner of the Mawga Man Award, Westmoreland. At two per cent of its population of men being obese, Westmoreland men are the ‘mawgaest’ in the world. Not even Japan, with 3.2 per cent, can top them.
n Portland follows with double the rate at 4.2 per cent and St Thomas third, with 7.6 per cent.
WHAT IS THE REASON?
Why is it that two adjoining parishes with a similar history and geography have the fattest and the slimmest men in Jamaica?
What are Westmoreland men doing so well that no other Jamaicans are doing?
What is really going on in Trelawny for the women there to be among the heaviest in the world?
Are they eating too much yam? Or have they somehow decided to export all the yams and use the earnings to buy rice?
Why are so many rural, underdeveloped parishes producing so many heavy men and women?
Jamaica is a small island. Our population is almost homogeneous. We eat the same foods, and we are either urban office workers or rural agrarian and small-business employees. Fast-food joints are concentrated in the urban areas. Sodas and sweetened beverages are consumed all over the island and not particularly so in one parish or another.
None of what we are told explains these findings. The survey tells us what we already know: Jamaican women are heavier than the men and both are getting heavier by the year. But why is this so? Why is there such a huge difference between the numbers of obese men and obese women? Why are the areas with the slimmest women still world leaders in high obesity rates, yet the parishes with the slimmest men have the lowest rates in the world?
OVERLY SIMPLISTIC APPROACH
It is clear that we have been following an overly simplistic approach to combating obesity without properly evaluating the data we have. There is no broad brush that will magically solve the obesity problem in Jamaica when tiny areas in a tiny island have such huge differences in obesity rates.
More research is needed. What are Jamaicans eating? What are the portion sizes? What kind of physical activities are they involved in and for how long?
And importantly, since it is the obesity rate in women that is driving up the national average, what are the best interventions to save our women?
If we do not get these answers as to why the numbers are growing as opposed to measuring the increase in numbers and coming up with knee-jerk responses based on flawed and untested theories, then we are in big, big, big trouble.
Dr Alfred Dawes is a general, laparoscopic and weight-loss surgeon; Fellow of the American College of Surgeons; senior medical officer of the Savanna-la-Mar Public General Hospital; former president of the Jamaica Medical Doctors Association. Email: firstname.lastname@example.org; email@example.com.