Offniel Lamont | Strengthening systems for healthier lives: Tackling obesity in the Caribbean

OBESITY HAS emerged as a global epidemic, and the Caribbean region is not exempt from its impact. Despite positive developments, the region continues to face considerable obstacles in reversing trends that place millions at risk for the development of non-communicable diseases (NCDs), including diabetes, hypertension, and cardiovascular disease.

CHRONIC STRUGGLE

According to the Caribbean Public Health Agency (CARPHA), over 50 per cent of adults in the region are categorised as overweight or obese, and childhood obesity has more than doubled in the last three decades. As of 2022, 8.6 per cent of children under five in Latin America and the Caribbean were overweight, surpassing the global average of 5.6 per cent. This trend has been escalating, with the region experiencing a 1.2 percentage point increase between 2012 and 2022, compared to a 0.1 percentage point rise globally.

This surge in obesity is attributed to several factors, including the widespread availability of ultra-processed products, decreased physical activity, and socioeconomic disparities that limit access to healthy food options and safe recreational spaces. These elements contribute to obesogenic environments, particularly in urban areas where more than 81 per cent of the population resides.

Several Caribbean countries have launched initiatives to combat obesity and promote healthier lifestyles.

SCHOOL NUTRITION POLICIES

In 2022, Barbados approved the National School Nutrition Policy, representing a significant advancement in efforts to combat childhood obesity. The subsequent launch of this policy in 2023 demonstrates the island’s commitment to implementing structured nutritional guidelines within educational institutions. Similarly, Trinidad and Tobago (2017) implemented a ban on the sale of sugar-sweetened beverages in primary and secondary schools. These frameworks enhance the nutritional quality of school meals by establishing dietary guidelines. Countries like Jamaica and Grenada are pursuing similar policies as advocates continue to seek a better Caribbean food environment.

INCREASED AWARENESS CAMPAIGNS

Governments and NGOs have intensified their public health campaigns to raise awareness about obesity and the vital benefits of active living. Leveraging social media, television, and community outreach, these initiatives are reshaping health perspectives across the region.

The region has been slow to adopt clear food labelling and strict regulations on the marketing of unhealthy foods targeted at children. Nevertheless, some member states have taken significant steps. Barbados, for instance, introduced a 10 per cent excise tax on sugar-sweetened beverages (SSB) in 2015, and increased it to 20 per cent in 2022, to decrease consumption and encourage healthier choices. Jamaica and Grenada established SSB restrictions in schools in 2019 and 2020, respectively.

The rise of community-driven wellness programmes has encouraged participation in healthier habits at the local and national levels. Saint Lucia’s National Physical Activity Program (2017) encourages exercise through community fitness sessions and the development of walking trails. The Bahamas’ Healthy Lifestyles Initiative (2018) enhances this effort by offering nutrition workshops, fitness classes, and community gardens. Medical Benefits Scheme of Antigua and Barbuda implements community-based events that aim to raise awareness regarding NCDs while providing opportunities for increased levels of physical activity (PA).

PARTNERSHIPS

Obesity prevention in the Caribbean has progressed due to the collaboration of governments, NGOs, and international agencies. From the Healthy Caribbean Coalition’s Childhood Obesity Prevention Action Plan (2017-2021) which has been instrumental in engaging civil society to address this health issue and the CARPHA Six-Point Policy Package in 2019. To the Creative Play Initiative in Barbados (2024), developed by the Pan American Health Organization (PAHO) with the Ministry of Health and Wellness, which promotes PA in schools. These and other programmes such as the Reversing the Rise in Childhood Obesity Project (2017-2020) in Saint Lucia and Grenada have focused on reducing obesogenic environments through policy reforms and educational efforts, encouraging healthier choices in communities. While progress has been made, continued investment in preventative strategies remains crucial to reversing obesity trends in the region.

STRENGTHENING SYSTEMS

For the Caribbean to see a significant and lasting reduction in obesity rates, we must move beyond isolated programmes and create sustainable frameworks.

1. The school nutrition policy must be enforced strictly, with harsh penalties for non-compliance, in addition to being adopted. Taxing sugar-sweetened drinks and offering subsidies for locally grown, fresh fruit are two measures that need to be adopted.

2. Prevention and management must become the cornerstones of our primary healthcare systems if we are to effectively tackle obesity. We need to increase access to bariatric services, fund aggressive early intervention programmes, and make investments in nutrition counselling.

3. Urban planning must prioritise the development of safe and inviting green spaces, walking paths, and recreational facilities. We should mandate daily physical education in schools and implement workplace wellness policies that actively encourage movement throughout the day.

4. The Caribbean must champion sustainable agriculture to reduce our reliance on imported processed foods. Strengthening partnerships among farmers, manufacturers, retailers, and governments is essential to guarantee that nutritious foods are not only available but also affordable for all citizens. This collaborative effort will lay the groundwork for a healthier future.

5. To effectively transform cultural attitudes toward food and PA, health education needs to be weaved into the fabric of school curricula. Launching media campaigns, leveraging digital platforms to enhance health literacy.

If we choose to maintain the status quo, we are inevitably heading toward skyrocketing healthcare costs and a significant decline in our quality of life. However, by investing in the strengthening of our systems today, we can pave the way for a healthier, more productive region. Achieving this vision demands unwavering collaboration between governments, private sector leaders, and community organisations, all united in the pursuit of prioritising health in every aspect of our lives.

Offniel Lamont is physiotherapist at G.C. Foster College of Physical Education and Sport. Send feedback to columns@gleanerjm.com