Our readers have become accustomed over time to the fact that this Column focuses on alternate ways –other than primarily using pharmaceutical drugs- to control and even reverse what are referred to as non-communicable diseases (N.C.D.) which include such conditions as diabetes, high blood pressure, heart disease and even cancer. 

It is usually overlooked to include Obesity in the list of NCD conditions. Yet, Obesity has been defined as a disease by the World Health Organization since 2013. According to recent scientific literature, Obesity is the most neglected N.C.D., while at the same time being the gateway to most other N.C.D.s. 

While obesity-related illnesses (like diabetes or high blood pressure) are frequently addressed and treated in primary healthcare settings, obesity itself is undertreated. It is considered a personal issue. Yet, on a worldwide scale, the number of obese individuals has tripled since 1975. It is therefore not surprising that Samoa is facing an epidemic of Obesity and N.C.D. with recent estimates that 85 per cent of adults are overweight and 65 per cent obese. 

Obesity is caused by the excess accumulation of fat, also called adipose tissue (A.T.) and the development of local and generalised chronic inflammation. Several mechanisms are proposed why excessive AT can cause metabolic disorders. The favoured theory is that the A.T. is increasingly been infiltrated by immune cells that produce cytokines, small proteins that are responsible for fuelling this low-grade inflammation throughout the body that may lead to liver and cardiovascular disease, type 2 diabetes, asthma, brain dysfunction and some types of cancer. Obesity is usually measured by using the Body Mass Index (B.M.I.), which is calculated by dividing the body weight (in kilograms) by the body height (in meters ^square). 

Worldwide, the upper limit of a normal B.M.I. in adults is set at 25 and obesity starts with a B.M.I. of more than 30. In between a B.M.I. of 25 and 30, one is considered overweight. However, in Samoa, overweight is considered between B.M.I. of 27 and 32 and Obesity is defined when the B.M.I. goes over 32. This is based on the assumption that the body mass of Samoans is considered larger than that of other populations. 

Over the past 10 years, we at METI have been working on the best way for overweight or obese people to lose weight and keep their weight down. And this is what we have concluded after analysing the results of several village projects. First, Health Education is important: people have to be told the plain truth about Obesity and that it is not a laughing matter. METI’s weekly interactive Health Seminar ‘wakes up’ the participants, who –in the majority- become aware of the dangers of Obesity and are prepared to take measures to bring their weight down. 

Secondly, it’s the type of food that you eat that will bring down your weight. This requires you to eat the least amount of fat possible. And that means, removing all animal products from your diet. ‘Anything with a face or a mother’ must be removed from your plate! That means, ‘no meat, no fish, no eggs and no dairy products’ and as a further measure, stop using oils to make your food. 

A few Columns ago, we gave the list of the ‘Daily Dozen’ of foods that you could use to make delicious meals with a long list of vegetables, fruits, whole grains, legumes (which are beans, peas and lentils), seeds, nuts and herbs. To help you switch to the plant-based diet, we recommend you buy METI’s Whole Food Plant-based Cookbook with 50 easy-to-follow recipes that will help you to make delicious food dishes! The trick is to eat enough bulky, yet low-calorie foods so that you will never be hungry.

And finally, if you want to be successful to lose weight, you need active support from your family and friends. You need to look for a ‘buddy’ with whom you can work together on organising the preparation of your meals. We call that person your ‘Samaria Agalelei’ (Good Samaritan) because indeed, that person is the one that will be on your side and help you to stay on course. Besides the diet intervention that METI promotes, we also encourage all our participants to exercise regularly, on average half an hour of brisk walking five times a week. This is encouraged because regular exercise has a positive effect on the mind, which will make the task of radically changing your food intake easier. 

We invite you to visit METI’s Healthy Living Clinic at House No. 51 at Moto'otua (across from the Kokobanana Restaurant) to become further acquainted with METI’s whole food plant-based diet and Lifestyle Change programs. Or call us at 30550. Learning how to follow these Programs might be your ‘game changer’!