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Obesity in Portugal: Underdiagnosed and Undertreated



This week I am attending the 47th EASD meeting in Lisbon, Portugal.

I know the Portuguese, while eating a lot of fish and having a traditionally ‘mediterranean’ style diet, also appear to have a preference for rich egg-based desserts (apparently, even the ‘secret’ Coke formula is sweeter here) and cheeses.

Perhaps occasion to note that Portugal certainly has an obesity problem of its own, which as pointed out in a recent article by Pedro Marques-Vidal and colleagues in the Archives of Internal Medicine, is considerably under diagnosed and untreated.

Based on self-reported data from the Portugese National Health Survey conducted between February 2005 and January 2006 (participation rate, 76%) and data on dietary intake and physical activity, 15% of the 34 525 participants 15 years or older had a BMI of 30 or greater.

Among them, only 16% reported being told they were obese, of which, in turn, only 15% reported being treated for their condition.

Women, those with university level education, higher BMI levels, and/or cardiovascular risk factors including smoking, tended to be more aware of their obesity, while those with diabetes and higher BMI’s were more likely to report being treated for their excess weight.

Participants treated for obesity reported a lower consumption of bread, potatoes/pasta/rice, and a higher consumption of soup, milk/dairy products, salads/vegetables, and fruit.

In contrast, physical activity levels (available only on a handful of individuals) showed no difference between those who reported begin treated compared to those who were not.

As the authors note:

“…despite a nationwide program to fight obesity, less than one-fifth of obese subjects are diagnosed, and only 1 of 6 obese subjects diagnosed is treated. Our results also suggest that management of obesity is more frequently done with dietary than with physical activity.”

Does not sound like there is anything special going on in Portugal – I guess obesity is both underdiagnosed and undertreated in most places around the world.

This may be both due to lack of awareness and concern as well as due to the rather limited treatment options.

Looks like ‘globesity’ is alive and kicking in most places I go.

AMS
Lisbon, Portugal

2 Comments

  1. Sounds like all’s well in Portugal. Even noticed how there are fewer very fat people and better health outcomes in countries where healthy fat people are left to their own devices rather than being labeled, nagged and threatened?

    those with… higher BMI levels, and/or cardiovascular risk factors including smoking, tended to be more aware of their obesity, while those with diabetes and higher BMI’s were more likely to report being treated for their excess weight.

    Based on a lot of your posts, you should agree with this approach.

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  2. Here is a non-scientific comment:

    I think there is a cultural aspect to be taken into account. I am not Portuguese but I have been involved with the the Portuguese community in Edmonton and I can certainly tell one thing: the fact I was slim and so was my husband was often seen as unhealthy and sad (or depressing). Of course, I don’t want to create any prejudice or generalize this. All I am saying is that it the under-diagnose of obesity may be connected to a cultural value.

    On a personal note, Dr. Sharma, please try the Portuguese “bacalhau” e “pástel de nata”.

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