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Pacific accounts for 9 of the 10 most obese countries in the world; American Samoa tops the list

By James C. Pearce

The Pacific islands have once again topped the world obesity index. According to the most recent data published by NDC Risk Factor Collaboration, Pacific island nations account for nine of the 10 heaviest nations in 2024 and almost half of the top 30.

American Samoa tops the list with an astonishing adult obesity rate of 75.2 percent.

Tonga, Nauru, Tokelau and The Cook Islands ll made the top five with adult obesity rates ranging from 68.9 percent - 71.7 percent.

Samoa, the Federated States of Micronesia, Niue and Tuvalu made the top 10, all posting obesity rates above 60 percent.

Kiribati and The Marshall Island ranked 11th (57.2 percent ) and 12th (56.5 percent) respectively whereas French Polynesia came 14th with a 51 percent adult obesity rate.

In Polynesia and Micronesia as a whole, the rates of adults living with obesity were the highest in the world – above 60 percent.

Tonga had the highest rate for women (81 percent are considered obese); American Samoa also had the highest for men (70 percent).

The Pacific Island Times reached out to the government of American Samoa as well as its congressional delegate for comment but has so far not received a response.

Papua New Guinea wins the title of "thinnest' Oceania nation (or 99th heaviest), beating even Australia and New Zealand.

Guam, meanwhile, is much slimmer than the average U.S. citizen; 44 percent of American women and 42 percent of men live with obesity compared to 32 percent of Guam’s adults.

Up-to-date figures for the Northern Mariana Islands are currently unavailable.

The World Health Organization defines "overweight" as having a BMI equal to or over 25 and "obese" as equal to or over 30.

The measure is imperfect – most bodybuilders would be considered clinically obese despite having little to no body fat – but it remains a fairly accurate and reliable system

.Obesity kills around 4 million people every year. Millions more suffer from other health-related conditions and illnesses.

Although these figures are fairly consistent for the Pacific, it is still getting heavier. These rates are likely to be the result of changing diets and a culture that puts a value on size.

Worldwide, 1 billion people are now living with obesity (1 in 8 people) and around 43 percent of all adults are now considered "overweight."

More teenagers and children are living with obesity today than at any point in history. World obesity rates are also now exceeding the rate of people underweight, with the poorest countries facing a "double epidemic" of overweight and underweight.

Although relevant, obesity is more than a matter of personal willpower, genetics and culture. The human body has evolved to survive winters and famines, is designed to cling on to body weight and will resist efforts to lose it.

However, a superabundance of cheap, ultra-processed foods has triggered overeating just as lifestyles have become more reclusive. The Pacific is heavily reliant on imported convenience food products, which contribute to diabetes and over a dozen types of cancer.

The lack of space for cultivation and agriculture impacts the local diet negatively as less fruit, vegetables, protein and fiber are consumed.


 Pacific countries also tend to emphasize food consumption in cultural activities and genetics does play a role.

Previous studies have suggested efficient fat-producing metabolisms are prevalent among Polynesians and Micronesians.

For centuries, this would have increased and aided survival in isolated territories, particularly among the islands’ first settlers. Those genes have been passed on, however, there is also a lower engagement in physical exercise and activities across the Pacific.

In short, high obesity rates seem to be a perfect storm of factors working against the region. Weight-loss drugs are starting to arrive on the market, but are prohibitively expensive for poorer countries.

They may work in time, but reversing these worrying trends will require preventing more children and adults from getting fat in the first place. That will be an unpleasant conversation for governments and populations, but urgent intervention is necessary.


“The drivers of obesity are complex,” said Dr Mark Jacobs, WHO representative to the South Pacific. “

In many parts of the Pacific, he said, unhealthy food is cheap, convenient, and pushed heavily through advertising, while healthy foods are difficult to get and more expensive in the face of droughts, floods and rising seas.

"What we eat, how much we eat, and whether we are physically active also comes down to things like the culture around us and whether there is a safe and comfortable place to exercise," Jacobs said.

While obesity has been an increasing epidemic in the Pacific, efforts to address it are not making headway fast enough.

Health leaders at the 15th Pacific Health Ministers Meeting hosted by Tonga last September stressed the need to engage other government ministries, particularly the ministries of environment, trade, finance, customs, agriculture, fisheries and social development.


“It’s only by working together, across the whole of government and across the whole of society, that we will be able to halt rising rates of obesity,” Jacobs said.


WHO advises people in the Pacific governments make unhealthy foods and drinks more expensive, such as via taxes on sugary drinks, or make it harder for them to be imported.


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