Why weight gain is a gateway to diseases

Sadly, some have succumbed to these conditions, prompting urgent calls for public awareness and preventive measures.

According to WHO report released in August 2023 titled: Country Disease Outlook for Uganda, it was reported that Uganda has a high burden of communicable and non-communicable diseases, with the latter making up to 36 percent of deaths in 2019.

NCDs are a major health problem in Uganda. The age-standardised mortality rate across four major NCDs (Cardiovascular Disease, Chronic Respiratory Disease, Cancer and Diabetes) was 709 per 100,000 in males and 506 in females in 2021.

Dr Ezra Namanya, a medical practitioner at Nyahuka Health Centre IV in Bundibugyo District, said the number of people who weigh more than 100kgs visiting the facility has increased. He added that many of them are diagnosed with non-communicable diseases (NCDs), including diabetes, cardiovascular diseases, stroke, and kidney disease.

Dr Namanya also revealed that the rise in these conditions is largely linked to genetic predisposition, unhealthy dietary habits, sedentary lifestyles, and poor health-seeking behaviours, such as neglecting regular body check-ups.

He further noted that most illnesses are preventable with proper medical guidance. “Among individuals with obesity and NCDs, our treatment primarily focuses on managing these conditions, which often places them under chronic care,’’ Dr Namanya said.

To address the growing challenge, he said the health facility has introduced a dedicated clinic day for patients with non-communicable diseases, such as Type 2 diabetes, hypertension, stroke, and coronary artery disease. On that day, patients are taken through health education talks on how they can prevent them.

Dr Namanya also clarified that while obesity significantly increases the risk of developing NCDs, individuals with lower body weights are not immune to the illnesses.

“When patients visit the facility, we calculate their Body Mass Index (BMI) by dividing their weight in kilogrammes by the square of their height in metres. A BMI greater than 30 classifies the individual as obese, while a BMI between 25 and 30 indicates overweight,” he said.

Dr Edwin Okello, a senior surgeon at Masaka Regional Referral Hospital, emphasised that a person’s weight is determined by their BMI.

“A BMI ranging between 18.5 and 24.9 is considered normal, while 25 to 29.9 is classified as overweight. A BMI of 30 to 39.9 indicates obesity and a BMI above 40 is categorised as severe obesity. It is not just about weight alone; height also plays a significant role in BMI calculation,’’ he explained.

Dr Alfred Yayi, the director of Jinja Regional Referral Hospital, advised individuals with higher body weight to engage in regular exercise and consume a diet rich in vitamins while minimising sugar and salt intake.

The Head of Programmes at Global Consumer Centre (CONSENT) and Coordinator at Food Safety Coalition Uganda (FoSCU), Mr Bernard Bwambale, said Uganda is facing a growing burden of NCDs, with currently 30 to 40 percent of deaths in health facilities across the country attributed to NCDs.

He said the diseases have plunged many families into poverty due to the high costs of treatment.

“Most people suffering from NCDs are in urban areas, where lifestyle changes have significantly impacted eating habits. Unlike rural areas, where people consume local foods rich in essential nutrients, urban residents often prefer foods high in fats and oils, which pose a danger to health,” he said.

Mr Bwambale added that while people in rural areas may also consume fatty foods, they typically burn off the excess energy through physically demanding activities such as farming. In contrast, urban lifestyles often involve sedentary behaviours, such as sitting in offices or driving, which leads to the accumulation of fats in the body.

Mr Bwambale also revealed that obesity-related diseases are common among individuals above 40 years of age and can lead to severe health complications, particularly for women.

These include low birth weight in children, irregular menstrual cycles, and conditions such as preeclampsia, a high blood pressure disorder that affects pregnant women.

“As the government invests in reducing mortality rates by building more health facilities and recruiting additional staff, we must address the root causes of NCDs,” he said.

The acting Jinja District Health Officer, Dr Aggrey Bameka, warned against eating late dinners.

“Eating too close to bedtime is a bad habit that contributes to weight gain. Always have your dinner early. Late-night meals affect digestion, absorption, and metabolism, ultimately impacting weight,’’ he said.

Dr Bameka, who also oversees non-communicable diseases at Kagoma General Hospital in Jinja, encouraged a diet high in vegetables while limiting protein and carbohydrate intake.

“Proteins like beans, soya, fish, meat, chicken, and eggs, as well as carbohydrates like posho, rice, matoke, millet flour, and cassava, should be consumed in moderation. Overweight individuals should prioritise vegetables,’’ he advised.

Ms Sarah Asiimwe, a nutritionist from Njeru Municipality in Buikwe District, recommended that individuals weighing more than 100kgs adopt a diet of soft foods, including green leafy vegetables such as spinach, kale, and collards.

“They should also include nuts like almonds and walnuts, fatty fish like salmon, mackerel, tuna, and sardines, as well as fruits, but under the guidance of a healthcare provider,’’ she said.

Dr Alfred Anyonga, the Soroti City Health Officer, said the risks of increased body weight without adequate exercise, include heart attacks, hypertension, and diabetes.

“Any weight above 75kg should prompt individuals to evaluate their lifestyle. Diets high in fatty foods often clog veins, leading to hypertension and heart attacks,’’ he said.

Dr Dan Tumusabe, a medical expert in Masindi, described obesity as a serious medical condition that can lead to chronic illnesses and even premature death.

“Obesity is a major risk factor for diseases such as heart disease, diabetes, and certain cancers. It also strains the joints, potentially causing arthritis and mobility problems,’’ he said.

Dr Tumusabe further said: “It is essential to take control of our health and adopt positive lifestyle changes like eating a nutritious diet, staying active, and seeking medical guidance.”

One such patient, the late Sarah Nyamwiza from Kyenjojo District, was diagnosed with severe hypertension and Type 2 diabetes last year but despite multiple consultations and advice from doctors to adopt a healthier lifestyle, she struggled to make the necessary changes.

Tragically, she suffered a heart attack in November and passed away aged 46.

Her son, Mr Ronald Tusiime, said: “We tried to encourage her to eat healthier and exercise, but it was hard for her to change old habits. We wish we had acted sooner.”

REMEDY
Health experts say obesity and its associated diseases are preventable. Below are some of the
key recommendations:

Balanced Diet
Experts advise the public to reduce intake of sugary and fatty foods, emphasising the importance of fruits, vegetables, and whole grains.

They say our traditional diets are healthier than the fast-foods trend that is taking over.

Regular Exercise
“Even 30 minutes of brisk walking daily can reduce the risk of developing NCDs,” says fitness expert and physiotherapist, Mr Robert Tumwesigye.

Health Check-ups
Regular visits to health facilities for screenings can help detect and manage conditions such as high blood pressure and elevated sugar levels. 

Compiled by Alex Ashaba, Moureen Biira, Malik Fahad Jjingo, Bategeka Ismail, Simon Peter Emwamu, Abubaker Kirunda, Tausi Nakato & Denis Edema