Temporal trends, socio-economic inequalities in obesity and responses by federal government, Nepal: a systematic review of observational studies, policies, strategies and plans, 2005-2019

Abstract

AbstractBackgroundObesity has risen to epidemic proportions in low-income countries such as Nepal whose achievements in reducing maternal and child-undernourishment is well known. However, scientific evidence concerning recent transition towards obesity and corresponding responses by the state remains scanty. This review purported to assess the trends and disparities in obesity prevalence among women and children, and to analyse the governmental policies and programmes.MethodsWe searched PubMed and Google Scholar for articles published between January 1, 2005 and April 10, 2019, and websites of Demographic and Health Survey, Non-Communicable Diseases Risk Factor Survey, and Micronutrient Status Survey. We extracted data on the prevalence of obesity and overweight from the selected studies and synthesised narratively. Overweight and obesity prevalence data from the latest available nationwide surveys were disaggregated by gender, geographical location and household wealth quintile. We retrieved the federal governmental policies, strategies and plans from the websites of Ministry of Health and Population and the National Nutrition and Food Security Secretariat, National Planning Commission.ResultsTwenty studies that reported prevalence of overweight and/or obesity, with data from 79,082 men and women aged 15 years or more and 11,866 children under five years, were included. Obesity or overweight among men and women increased from 20.0% in 2004 to 36.1% in 2016 while obesity alone rose from 5.3% to 7.5%. Prevalence of childhood obesity or overweight remained very low, although doubled between 2006 and 2016, from 0.6% to 1.2%. Prevalences of overweight and obesity were much higher among women, inhabitants of urban areas and central provinces, and the affluent. Governmental policies, strategies and plans on nutrition were primarily designed to control undernutrition, with some direct and indirect implications for preventing obesity.ConclusionsPrevalence of overweight and obesity increased substantially between 2005 and 2019, disproportionately affecting socio-economic and geographical groups in Nepal. Governmental efforts to contain the obesity epidemic should be reinforced by actions that are more specifically targeted to addressing obesogenic environments.Systematic review registrationPROSPERO CRD42019132332