fbpx

Obesity An Emerging Crisis in Pakistan

Obesity_an_emerging_health_crisesimg
Obesity_an_emerging_health_crisesimg

Obesity
An Emerging Crisis
in Pakistan

 

 

Overweight and Obesity
•Abnormal or excessive fat accumulation that may impair health
• Body mass index (BMI) is a simple and commonly used method to
identify overweight and obesity in adults
• Overweight: BMI ≥ 25 and ≤ 29.9
• Obesity: BMI ≥ 30
•In children under 5, compared with WHO growth standards
• Overweight > 2 standard deviations
• Obesity > 3 standards deviations
•In children 5-19 years
• Overweight > 1 standard deviations
• Obesity > 2 standards deviations
Ref: WHO growth standards
Obesity is associated with an elevated risk of several
major non-communicable diseases, including type 2
diabetes, coronary heart disease, stroke, asthma, and
several type of cancers.

NCDs Proportional Mortality – Pakistan
Source: WHO 2018
Obesity and Overweight – Pakistan
•NNS confirmed that obesity and overweight increased in WRA from
28% to 38% from 2011 to 2018.
•In urban areas, 43.7% of WRAs are overweight or obese.
•Approximately 17% of adolescent girls, and 18% boys are obese or
overweight.
• The prevalence of overweight among children under five has almost
doubled from 2011 to 2018.
Ref: National Nutrition Survey of Pakistan 2018

Where Are We Heading?
Major Causes of Obesity and Overweight
• Fundamental cause – an energy imbalance between calories
consumed and calories expended.
•Increased intake of energy-dense, ultra-processed foods and
beverages that are high in fat and sugars
•Decrease in physical activity

• COVID-19 further fueled the problem:
• Restricted movements and physical activity
• Limited access to healthy foods
• Increased consumption of junk (ultra-processed) foods
Unhealthy Food Leading to Obesity
•Increased sugar intake – sugary drinks
•Increased oil and fat intake
• Processed foods
• Shift from homemade to processed foods
• Fast food
•Water replaced by sugary drinks
Processed Foods
• Processed and ultra-processed foods often include unhealthy levels
of added sugar, sodium and fat.
• These ingredients make the food we eat taste better and these often
lead to serious health issues like obesity, heart disease, high blood
pressure and diabetes.
Sugary Drinks
• Intake is significantly associated with weight gain,
obesity and heart disease.
• Drinking one sugary beverage daily doubles the risk of
developing diabetes.
• A child’s risk of becoming obese increases by 60% with
each additional sugary beverage consumed daily.
• Children who drink carbonated sugary beverages have
almost double the risk of dental cavities.
• Drinking just one 20-ounce bottle of a sugary beverage
per day can result in gaining 25 extra pounds per year.
• Fatty liver disease and metabolic kidney disease are
consequences of sugary beverage intake.
Ref: SSB FACTSHEET – developed by UNC with funding in part from Bloomberg Philanthropies

Prevention is Better Than Finding a Cure ….
• Say NO to sugary drinks
• Say NO to junk foods
•Increase physical activity
• 60 minutes a day for children
• 150 minutes spread through week for adults

What Can Policy Makers Do?
•Develop national strategy to combat obesity
• Make it easier for consumers to buy healthy
foods
•Increase taxes and make it less affordable to
buy unhealthy products like sugary drinks
•Incentivize businesses to supply healthy foods
at affordable prices
• Regulate and keep strong checks on promotion
of unhealthy foods and beverages
• Promote physical activity
Impact of Taxes on Reduction of Obesity
Impact of Taxes on Reduction of Obesity

S# Country Study
Method
Impact
1 India 2014 Modeling 20 % tax leads to 3% reduction in obesity and overweight and
1.6% reduction in type 2 diabetes.
2 South Africa
2014
Modeling 20 % tax leads to 3.8% reduction in obesity prevalence in men
and 2.4% reduction in women
3 Australia
2016
Modeling 20 % tax leads to 2.7% reduction of obesity in men and 1.2% in
women. Increase in tax revenue of A$400 million annually
4 United Kingdom
2013
Modeling 20% tax reduced 2.2% of obesity and overweight in adults
Increase in tax revenue of £276 million annually
5 Ireland 2013 Modeling 10% tax leads to 1.3 % reduction in obesity and 0.7% overweight
Ref: Effectiveness of obesity prevention and control, ADB Institute 2017, N 654

Taxes Comparison- Pakistan vs Other
Countries
India
28% GST
12% Goods & Services tax
Bangladesh
40% total tax
Saudi Arabia
100% excise on energy
drinks
50% on sweetened drinks
Bahrain
100% excise tax on energy
drinks
50% on aerated drinks
Qatar
100% excise on energy
drinks
50% on sweetened
aerated drinks
Norway
3.34 NOK per litter sugary
drinks
20.32 NOK pee litter on
concentrates
United Kingdom
£0.18/litter on drinks with
>5 grams sugar/100ml
£0.24/litter on drinks >8
grams sugar/litter
Ireland
€0.20/litter on drinks with
>5 grams sugar/100ml
€0.30/litter on drinks >8
grams sugar/litter
Pakistan
11.5% FED
1% Sales tax
Ref: Global Food Research Program – University of North Carolina: August 2020

Pakistan’s Sugary Drink Market – 2018
• Carbonated drinks: 4426 million liters with value of PKRs 387 billion
• Energy drinks: 224 million liters with value of PKRs 58.7 billion
•Juices: 733 million liters and value of PKRs 79 billion
• Carbonated drinks are forecasted to grow at a Compounded Annual
Growth Rate (CAGR) of 7.3%
• Energy drinks are forecasted to grow @CAGR +14.6%
•Juice industry is growing with 20% value and 7% volume
•With current trends and CAGR, the juice industry will become 199

billion value with 1 billion liters of sale in 2023
Ref: Pakistan soft drink market digest 2019 & Passport: Juice in Pakistan March 2019
Sugary Drinks – Impact of Taxation on
Revenue
Category
Value in
PKR
(billion)
Additional FED Volume
(M
Litters)
Surcharge/Levy (per litter) in
PKR billion
3% 5% 7% 10% 4 6 8 10
Carbonated Drinks 387 11.61 19.35 27.09 38.7 4426 17.704 26.556 35.408 44.26
Energy drinks 58.7 1.761 2.935 4.109 5.87 224 0.896 1.344 1.792 2.24
Juices 79 2.37 3.95 5.53 7.9 733 2.932 4.398 5.864 7.33
Total 524.7 15.74 26.24 36.73 52.47 5383 21.532 32.298 43.064 53.83

Summary of Key Messages
• Obesity and overweight is a new health crisis in Pakistan.
• Obesity is a gate way to non communicable diseases.
• Sugary drinks, junk food and lack of physical activity are major causes for
obesity.
• Intake of sugary drinks is significantly associated with weight gain, obesity,
diabetes, heart diseases and other NCDs.
• A child’s risk of becoming obese increases by 60% with each additional
sugary beverage consumed daily.
• Increased taxation/surcharge on sugary drinks can generate more than
PKRs 100 billion revenue annually.
• Policy makers should raise taxes and surcharge/levy on sugary drinks.
• Say no to sugary drinks and junk foods.