BREAKING: Nigeria ranks lowest among 20 countries lacking obesity care guidelines

Nigeria has scored zero on obesity treatment and physical activity in a new global assessment of how countries are responding to the obesity epidemic, finishing last among 20 nations with an overall score of 13.1 out of 100.

 

The findings are contained in the Obesity Response Index: Country Profiles, published by Economist Impact and supported by Eli Lilly and Company. The index scored countries across four areas: policy and governance, obesity management, food quality and access, and physical activity.

 

Nigeria is the only country among the 20 assessed to score zero in two of these four areas: obesity management and physical activity. This implies that there are no functioning national systems in either category.

 

The 20 countries assessed are: Australia, Brazil, Canada, China, Finland, France, Germany, India, Italy, Japan, Mexico, Nigeria, Rwanda, Saudi Arabia, Serbia, South Africa, South Korea, Spain, the United Arab Emirates, and the United Kingdom.

 

The report found that Nigeria lacks national guidelines on how to diagnose or treat obesity.

 

It also showed that the country has no clinical pathway, a standard process linking patients to care, and no public insurance coverage for any form of obesity treatment, whether nutrition counselling, behavioural therapy, weight-loss medications or surgery.

 

All other 19 countries in the assessment provide at least some form of publicly funded obesity care. While the UK covers all four forms through its National Health Service, Brazil, Finland, France, and Serbia each cover three, and Rwanda, which ranked 18th with a score of 39.1, has national non-communicable disease management guidelines that address how obesity should be classified and treated.

 

According to the report, Nigeria’s existing Clinical Practice Guidelines for Diabetes Management acknowledge that weight loss is recommended for overweight or obese patients at risk of diabetes, but the guidelines provide no diagnosis or referral pathway for obesity itself.

 

The World Health Organisation defines overweight and obesity as abnormal or excessive fat accumulation that poses a health risk and causes about five million deaths. It pegs a body mass index of over 25 as overweight and over 30 as obese.

 

Data from the Global Obesity Observatory shows that about 9.9 per cent of women and 6.5 per cent of men in Nigeria are obese. Among children and adolescents, 10.3 per cent of girls and 8.3 per cent of boys are living with obesity in the country.

 

The country profile estimates Nigeria’s adult obesity prevalence at 14 per cent, with childhood obesity at 3.8 per cent. Nigeria’s GDP per capita stands at $807, and its healthcare spending per capita at $62, the lowest of any country in the assessment.

 

Obesity is a known driver of type 2 diabetes, hypertension, cardiovascular disease and certain cancers, conditions already placing a heavy burden on Nigeria’s health system.

 

Recently, report revealed that experts call on the Federal Government to integrate obesity prevention and treatment in Primary Healthcare Centres as part of key strategies to curb the rising burden of noncommunicable diseases in the country.

 

Another report also listed nutritionists cautioning Nigerians to avoid going to bed immediately after consuming heavy meals, warning that the habit could trigger obesity and other health complications.

 

Continuing, the report also showed that while Nigeria is not without policy commitments, there is no dedicated budget set aside to implement the national plan on obesity management.

 

One of the plans, the National Multi-Sectoral Action Plan for the Prevention and Control of Non-Communicable Diseases 2019–2025, identifies obesity as one of four key metabolic risk factors and sets a target to reduce obesity prevalence by 25 per cent before the plan ends this year.

 

The National Strategic Plan of Action on Nutrition 2021–2025 goes further, recognising rising obesity rates and setting targets to halve obesity among adolescents and adults.

 

The report acknowledges these plans as a genuine strength: Nigeria is the only country among the 20 assessed that holds both a short-term and a long-term target for reducing obesity prevalence at the same time.

 

However, without funding, the targets are unlikely to be achieved.

 

Nigeria’s score on food quality and access was 29.7 out of 100, the lowest in this pillar across all 20 countries.

 

On the positive side, Nigeria has a sugar tax covering all non-alcoholic, carbonated and sweetened drinks. The National Social Investment Programme also provides free school meals and cash transfers to low-income households, giving some families access to food support.

 

Basic nutrition labelling is required on packaged foods.

 

However, front-of-package and menu labelling are not mandated. There are no restrictions, mandatory or voluntary, on the marketing of unhealthy foods to children. And beyond the school meals component of the social investment programme, there is no dedicated national programme to improve food access for low-income Nigerians.

 

Nigeria scored zero on physical activity and has no national requirement for daily physical activity in schools.

 

The World Health Organisation recommends at least 60 minutes of physical activity every day for children. In Nigeria, no such mandate exists, meaning there is no guaranteed structured exercise time for schoolchildren nationwide.

 

The report also found insufficient evidence of any broader national policy promoting physical activity among the general population.

 

By comparison, China requires two hours of daily physical activity for primary and secondary school students, one hour during school and one hour after, and is the only country in the index to meet the WHO standard through mandatory school rules.

 

Recommended steps

The report recommends that Nigeria develop national clinical guidelines for obesity care and integrate obesity management into existing care pathways for diabetes and hypertension. It also calls for public insurance coverage to be expanded to include at least nutrition counselling and behavioural therapy.

 

On food, the report recommends restricting junk food marketing to children, mandating front-of-package nutrition labels and expanding food access programmes for low-income households.

 

On physical activity, it calls for a national school mandate requiring daily physical activity in line with WHO guidance.

 

The report concluded that while Nigeria has available policy tools, it needs political commitment, dedicated funding, and consistent implementation.

 

In a recent interview with a popular newspaper, a Deputy Director, Nursing Services, Federal Ministry of Health and Social Welfare, Oluwayomi Ale, urged policymakers to incorporate routine weight monitoring, dietary guidance, and physical activity promotion into PHCs’ services as part of key strategies to curb the rising burden of obesity in the country.

 

“Early prevention through community-based care is essential to reversing Nigeria’s obesity trend and improving long-term health outcomes.

 

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“Integrating obesity prevention into primary healthcare services by training healthcare workers in PHCs on nutrition counselling and lifestyle management will help to curb the menace,” she said.