Gender discrimination has always been an issue in Nepal. In the past, we could see that people preferred sons over daughters; worryingly this trend is still in existence today. This preference has been affecting the lives of females, which could be reflected through their dietary pattern as well. Females were provided with less and low quality foods as compared to males. This fact could mislead people into thinking that females in Nepal might be undernourished as compared to males; however, to everyone’s surprise, evidence shows that there are more overweight and obese women than men. With increasing prevalence of obesity among women worldwide, the number of Nepali women suffering with obesity too is on the rise.

Fat count

Recent surveys have shown that the number of generally overweight and obese females in Nepal has doubled over this last decade, with 17.3 percent and 4.8 percent being the current prevalence respectively. Recent surveys too have shed light on the fact that Nepali women are predominantly abdominally obese, which is more dangerous for health. It has been found that waist to hip ratio, which is one strong indicator of abdominal obesity has increased from 0.55 inches in 2007 to 0.9 inches in 2013.

Worldwide, overweight and obesity are jointly declared to be one of the 10 major health risks, with obesity being the fifth major cause of death worldwide. Worldwide, overweight and obesity among both men and women have caused a 44 percent increase in diabetes, a 23 percent increase in ischemic heart disease, and a 7 to 41 percent increase in cancer, along with other diseases such as hypertension, dyslipidaemia, sleep apnoea, arthritis, gall bladder disease, osteoporosis, and depression. Non-communicable diseases which are mostly an outcome of being overweight now account for more than 44 percent of deaths and 80 percent of outpatient contacts in Nepal too.

Specific to women in Nepal, overweight and obesity could present other additional risks like diabetes during pregnancy, gestational hypertension, infertility, miscarriage along with health abnormalities in offspring. A recent study by the John Hopkins Bloomberg School of Public Health has suggested that children born to overweight and diabetic mothers have increased chances of developing autism in comparison to mothers who are healthy and non-diabetic. So, it is necessary to concern ourselves with women’s health, for the sake of future children as well. There is a need for organisations and agencies to work against overweight and obesity in women.

Changing lifestyle

Each and every contributing factor that increases waistline among females needs to be analysed and tackled wisely. There are various reasons behind female’s broadened waist and increasing weight. Firstly changing lifestyles, increasing numbers of private and public transportation, modern communication systems, and home delivery systems could have played a role in the inactive life pattern of women. This does not mean that peoples should stop using such facilities, however, people should think about making other healthy lifestyle choices—like exercising and having a balanced diet. The government could contribute to the healthy life of females by constructing women-friendly places of exercise. Uncontrolled urbanisation needs to be managed; this is depleting fertile lands and effecting agricultural practices in Nepal and consequently changing the dietary pattern of Nepalis. Soaring prices of healthy fruits, vegetables, dairy products and easy access to junk foods are a problem, especially for working women.

Another reason for the increasing obesity among women could be improper breastfeeding practices, especially seen in urban areas. The number of females replacing breastfeeding with bottle feeding has increased over the last decade, and is predicted to be increasing incessantly. This is supporting the trend of rising weight gain among women. The most distinguished cause for the escalating pattern of obesity among Nepali women is the use of contraceptives which cause hormonal imbalances and build up fat in our body. However, adopting a healthy lifestyle could lessen these side effects. So, health workers should be trained on how to counsel women on being fit along with the usual family planning details. Furthermore, awareness programs on consequences of overweight and obesity in women and its prevention strategies such as exercise and proper diet patterns are crucial to curb weight gain in females.

Though prevalence of overweight and obesity among women in Nepal is still low as compared to other countries, past data reflects that it will surely peak to new unprecedented levels. So, looking at its dangerous health consequences, especially in reproductive-aged women and their future children, appropriate steps in the form of policies and programs need to be implemented by concerned agencies. Otherwise, there is always a chance that Nepal will drown in the double burden of malnutrition—both under nutrition and over nutrition.

- Bhattarai has a BSc in Nutrition and Dietetics from the Central Campus of Technology, Norway