In Mexico, obesity and overweight have an incidence of 75.2% in the adult population −over 20 years old−, according to the National Health and Nutrition Survey (Ensanut). The high prevalence of these conditions, as well as their increase in children and adolescents, has become a public health concern because it increases the risk of developing chronic diseases such as diabetes, hypertension and cardiac complications, which translates into a loss of years of healthy life for the population.
To understand how big the problem is, a group of experts from the Institute for Obesity Research (IOR) used data obtained by the Global Burden of Disease (GBD) 2021, analyzing only those belonging to the country.
GBD is a global research program based at the Institute for Health Metrics and Evaluation at the University of Washington that quantifies health loss in different places around the world over time. Its objective is to provide precise and specific information that allows the improvement health systems globally.
“The indicator most commonly used to make health decisions is usually mortality, but not everyone who gets sick dies,” says Héctor Arreola Ornelas, research professor at the IOR and the School of Government and Public Transformation at Tec de Monterrey. “This study not only counts the people who die, but adds the years they live with unhealthy conditions.”
Focusing on Mexican data from 1990 to 2021, researchers break down how overweight and obesity have become the main risk factor for the Mexican population. “Although it does not help us understand the why, it helps us understand the what very well,” says Linda Morales, a postdoctoral researcher at the IOR who also participated in the study.
The Burden of Overweight and Obesity in Mexico
One of the many results obtained in the study is that in 2021 the country recorded 1.12 million deaths, of which more than 118 thousand were related to a high body mass index (H-BMI), representing 10.6% of the total of deaths.
This represents a 51% increase in deaths associated with H-BMI, compared to the 738 thousand that were estimated in 2019.
This is because H-BMI −associated with overweight and obesity− is related to chronic non-communicable diseases such as diabetes, kidney problems, cardiovascular diseases, certain types of cancer, digestive diseases, neurological disorders and chronic respiratory diseases.
“This single factor is associated with the top four causes of death in the country,” says Morales.
What is even more worrying is that the study estimates that H-BMI resulted in a loss of 4.2 million years of healthy life in the population. This figure is obtained by combining the years lost due to premature death and the years lived with disability.
If a person with diabetes dies at age fifty, but the life expectancy in their country is eighty years, then they lost thirty years due to premature death. If during those fifty years, this person lived twenty years with desease derived complications, such as kidney, feet or eye problems, then they lived twenty years with a disability. In total, they lost fifty years of healthy life.
“The problem is bigger than we think,” says Morales.
Tabasco is the state with the highest rate of deaths related to this factor, while Sinaloa has the lowest. However, the prevalence of overweight and obesity can be observed throughout the entire republic, in both sexes and at all ages: “It is no longer a matter of just a few of us,” says Arreola Ornelas.
GBD and BMI-E
For the researchers, it is important that the population knows that the data reported in the study is obtained based on the most rigorous information.
“The GBD uses all the information sources available in a country, such as the National Health and Nutrition Survey (Ensanut) in the case of Mexico, and uses Bayesian models to obtain the estimates,” says Morales.
The key is that the evidence it uses is that which demonstrates a strong association between a risk factor and an outcome, such as H-BMI and years of healthy life lost.
Using H-BMI as an indicator of overweight and obesity is the most practical way we currently have to measure its impact. “It is the indicator that has been measured consistently for the longest time and can be used to analyze how trends are changing,” explains Arreola Ornelas.
In recent times, this index has been strongly criticized, as it could be due to a person being very muscular, and not necessarily because they have a metabolic problem: “Currently, efforts are being made to complement it with other markers, such as abdominal circumference, waist-to-hip ratio and skin fold measurements,” explains Morales.
Precise evidence to guide public policies
With a study as precise as this one, the experts hope that decision makers will promote public policies that address the many causes of the problem.
“Although some policies have been implemented, they have not been accompanied by an evaluation and have focused only on some aspects,” says Arreola Ornelas.
For the prevalence of overweight and obesity to really decrease, a comprehensive plan is needed that addresses the different aspects behind it, such as the obesogenic environment, the lack of spaces to exercise, violence in the streets that prevents people from going out, the lack of time to cook at home and lack of attention to mental illnesses, among others.
“It is a complex problem that does not depend solely on the decisions of individuals or health systems,” says Morales.
Since 1995, the first time the GBD was used in Mexico, overweight and obesity were already listed as a growing problem, but so far the country hasn’t been able to stop it.
The positive thing is that this study shows that if the risk factor is reduced to a minimum, many lives can be saved and it can also be a way of measuring the success of health systems.
“We are experiencing a tsunami of chronic non-communicable diseases, partly due to the presence of risk factors such as this,” says Arreola Ornelas. “We have to attack the problem at its roots.”
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