by Vinia M. Datinguinoo

	BIG PROBLEM. More adults are growing overweight, with the increasing trend being more pronounced among women. [photos by Vinia M. Datinguinoo]

LIKE MANY others in her generation, 11-year-old Clara Buenconsejo was bigger than her mother was at that age. In fact, she could no longer wear the clothes sold at the children’s section in department stores and her mother Malou had to scour shops selling surplus goods from the United States to find something that would fit her. But Clara’s size left Malou worried, not proud. The girl weighed 143 pounds, and by the time Malou brought her to a pediatric endocrinologist, Clara sported dark circles under her eyes and similar dark pigmentation on her nape, which the doctor would later point out as markers that a child is overweight.

Clara was diagnosed with borderline diabetes and put on medication for over a year to normalize her insulin level. A nutritionist also began seeing her for a weight management program, the first prescription of which was to remove all processed food from Clara’s diet — hotdogs, canned food, canned juices. After about four weeks Clara lost eight pounds. For three months she would visit the nutritionist once a week, discuss her food diary, be shown educational videos, and counseled about eating and living right. Malou would also be assisted in planning the family menu.

Two years later, Clara is now off that professional supervision. Both she and her mother are confident she no longer needs professional help to do those exercises and eat those veggies. Unfortunately, Clara’s story is becoming more common, and often, the tales of other overweight children do not have a similarly happy ending. Though still small in absolute numbers, the proportion of overweight children in the country has increased threefold between only 1998 and 2003, say experts. The World Health Organization (WHO) calls this increasing incidence an “epidemic,” which along with undernutrition in far bigger segments of the population make for a double burden that a country as poor as the Philippines is ill-equipped to handle.

More adults are also growing overweight, with the increasing trend being more pronounced among women. Government surveys show that the proportion of overweight adult women had increased from just over 39 percent in 1998 to 54.5 percent in 2003.

Doctors say that the danger in becoming overweight is that once it begins, it gets even more difficult to lose the excess weight, leading to what doctors call “overfatness.” The diseases associated with overfatness are so many that in itself, obesity is referred to as a disease. In turn, obesity is associated with health risks that run from head to toe, including stroke, cardiovascular disease, and diabetes.

It’s not hard to see why this phenomenon is taking place in the Philippines today, even as hundreds of thousands of families across the nation scrounge for food. Simply put, larger segments of the urban population now have diets where taste and convenience are considered primary, and health and nutrition only a luxury. Too often, they consume large amounts of processed food that are poor in nutrients and dense in energy. This makes them eat a lot without feeling full, which soon gets them hungry again and looking for more food.

Clara herself recounts how, up until three years ago, her family dined mostly on canned and processed food like hotdogs, corned beef, and tuna. “Para kaming refugee,” she recalls. Her mother admits,”“I was rather lazy to cook then.”

Clara could put away quite a few of those hotdogs, but her processed-food diet was not the only reason she was ballooning. Never very active as a child, she was rarely out playing in the streets. Instead, she was almost always indoors, either drawing or taking on her grandfather in a round of chess. By the time she was 11, Clara carried some 30 pounds more than what was ideal for her age and height.

HEALTH AND nutrition experts agree about the ingredients that make up what they call an “obesogenic environment,” one that makes people grow fat, fast: high-fat, high-salt, and high-sugar diets and lifestyles that involve little physical activity. There are also medical conditions that can lead to obesity such as those associated with having hormonal glands that do not function properly. Genetics could play a part as well — some people are predisposed to getting fat because of family lineage. But minding the balance of food that one takes in and energy that is taken out tempers such predisposition and allows the individual to escape growing overweight.

	Clara (right) was only 11 when she was diagnosed with borderline diabetes. Today she exercises regularly with her mother Malou (left) and follows a low-fat, low-sugar diet.

WHO estimates that more than one billion adults worldwide are overweight; of these, at least 300 million are obese. In countries such as the United States, the problem has grown so huge that one in every four children is, or is at risk of becoming, overweight or obese. Meanwhile, Asia in the past 20 years has become a focal point of international concern with rates of increasing incidence rivaling those observed in the First World half a century ago. In countries as diverse as India, New Zealand, China, and Vietnam, the WHO is noting a “disturbing” increase in the prevalence of overweight especially among children.

Here in the Philippines, pediatricians like Dr Sioksoan Chan-Cua have long been concerned about the increase in the number of obese children. Chan-Cua, who deals with illnesses related to growth and metabolism, says this is no recent trend, having noticed a growing number of obese children as early as a decade ago. Today she says, “In just one of my clinics, one whole drawer (of medical files) is for obese patients.”

Chan-Cua says many of these children are textbook cases of obesity: consuming a lot of fried and energy-dense food and drinks such as colas, and not having enough physical activity. One patient, she says, gained nine pounds in two months by spending the entire summer vacation watching TV and eating French fries. Another child drank his way to obesity by downing a liter of soda per day and doing little else other than eat, sleep, and go to school. Says Chan-Cua: “Children just don’t jump around as much as children used to.”

What is even more difficult, she says, is that most people carry the notion that plumpness in a child is good because it is “cute,” and it is a sign that the parents are not being remiss in their duty. “What these parents do not know,”says Chan-Cua, “is that it’s like a time bomb in the body.” And diffusing the time bomb becomes more difficult through time. In a recent report on diet and nutrition and their associated risks of chronic diseases, the WHO and Food and Agriculture Organization (FAO) warn about how overweight in childhood persists into adolescence and adulthood. “Overweight and obesity,” says the report, “are notoriously difficult to correct after becoming established.”

Yet even while they are young, overweight and obese children already face numerous health risks. “Children are aging prematurely,” laments nutritionist-dietician Virgith Buena, who says many of her young patients are developing illnesses that the medical community used to see only among much older people. Among her patients are two hypertensive boys; one of them is 11 years old while the other is only four — but already weighing more than 100 pounds. There is a 17-year-old boy who has just had a stroke. “Ang tindi (It’s all too much)!” says Buena, who, even as she sees one case after another, still cannot hide her grief.

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