Intended for healthcare professionals

Practice ABC of obesity

Obesity—time to wake up

BMJ 2006; 333 doi: (Published 21 September 2006) Cite this as: BMJ 2006;333:640

wake up call for developing world too

The article on obesity by Haslam et al. is an eye opener equally to
the developing world which is gradually being affected by the epidemic of
obesity. Sri Lanka is no exception. However, unlike the developed
countries, Sri Lanka is facing this problem with the current existence of
29% underweight among children and a prevalence of 30% of anaemia among
children under five and women 1. Implications of an epidemic of obesity
may overburden a health system which is expected to cater to the need of
an increasing burden of non communicable diseases due to the
epidemiological and demographic transition

In a recent study done in four provinces in Sri Lanka, the prevalence
of obesity was estimated to be 20.3% in men and 36.5 % in women. The
authors reported that the highest prevalence of obesity was reported
from the more urbanised Western Province 2. In another study, among adults
in the most urbanised, Colombo district, prevalence of obesity was
estimated to be 32.2% 3.

There is an increasing trend in the prevalence of obesity due to the
demographic changes, urbanisation and life style changes that took place
during the last decade or so. Most of the risk factors were behaviour
related and hence influenced by urbanisation and unhealthy life styles
such as deviation from traditional Sri Lankan diet to fast food culture
and low physical activity 3.

Urban-Rural difference in these two extreme conditions prevailing
in the country was summarised explicitly in a rapid response to the BMJ by
an expatriate Sri Lankan professional:
“I increasingly encounter big 'M's, 'KFC' Colonels, pizza parlours, sari
wrapped barrels in chauffeur driven autos and third trimester looking
politicos in urban areas. Bill boards blaring, "GYM" attracts your
attention. In the rural areas, among coconut groves, paddy fields, tea
gardens etc. poverty and poor nutrition frame the picture. “4

It is high time that the public health authorities in the country
wake up, as suggested in the article, to take measures to contain the
impending epidemic of obesity before it further over burdens the health
budget of the lower middle income country.


1. World Bank. Nutrition in Sri Lanka : Rethink Yesterday, change
tomorrow. Consultation Workshop Examines Enigma of Malnutrition.
Available online URL :

2. Wijewardene K, Mohideen MR, Mendis S, Fernando DS, Kulathilaka T,
Weerasekara D, Uluwitta P. Prevalence of hypertension, diabetes and
obesity: baseline findings of a population based survey in four provinces
in Sri Lanka. Ceylon Medical Journal. 2005 Jun;50(2):62-70

3. Arambepola C, Fernando, DF. Distribution and determinants of
abdominal obesity in an adult population in the district of Colombo, Sri
Lanka. Available online

4. Amarasinghe A A W. Scenario in Sri Lanka. British Medical
Journal. 2005; 331: 1333-1336. Available online

Competing interests:
None declared

Competing interests: No competing interests

27 September 2006
Pushpa Ranjan Wijesinghe
Post Doctoral Fellow in Community Medicine
Epidemiological Unit,Ministry of Health, Sri Lanka