Obesity is a problem for the rich

The seven steps up to the sleep clinic are a hurdle for the heavy Samoan woman that she can only manage with a breather. The 34-year-old, who is around 1.55 meters tall and weighs more than 110 kilograms, is picking up a breathing apparatus from the clinic in Apia, the capital of the South Sea state of Samoa, this Saturday. "Sleep apnea, respiratory arrest during sleep - a huge problem here," says clinic director Walter Vermeulen. "People over 45 used to come, now many patients are in their twenties."

There are more obese people in Samoa and other Pacific island states than anywhere else in the world. In Samoa, according to the World Health Organization (WHO), 60 percent of women are considered seriously overweight, in Micronesia it is 75, in Tonga 78 and on Nauru 80 percent. The cost of the fat epidemic is enormous: heart disease, high blood pressure, sugar, gout. Because hardly anyone is insured, many people die from it. Every fourth person is now diabetic, said Health Minister Tuitama Talalelei Tuitama at the start of a fitness week in November 2011.

"The number of overweight and obese children among girls has increased from two percent in 1982 to 14.3 percent in 20 years," he said. Prime Minister Tuilaepa Sailele Malielegaoi, in office since 1998, is not exactly a shining example for his compatriots with his stoutness. The problem: "Preventing and treating obesity is difficult in the Pacific countries because traditional culture regards body fullness as a sign of wealth and power," said a WHO report on the subject ten years ago.

"Food brings status. When it comes to eating, social contacts are cultivated and economic and political alliances are formed - food has a place in society and gives cultural identity," said Jimaima Schultz, nutrition specialist from the Fiji Islands, at a workshop on obesity in Samoa. "Fat people think of 'fat' as being healthy, well-groomed, rich, competitive, while in Western thinking 'fat' means low status, poor education, greed, and a lack of self-control."

"Our society has many layers, the higher you go, the more big dinners there are and the less you move - you have other people for that," says Nina von Reiche, who with her fitness studio in Apia is particularly interested in overweight people turns. "All celebrations from weddings to funerals are all about food."

Rich is Samoan, one of her ancestors came to the country during the German colonial times at the beginning of the last century. "Being fat is still a status symbol," she says. "The attitude hasn't changed, it's just getting worse."

Then she starts a sweaty fitness class on the stepper. "Come on girls, let's move the pounds!" She calls out to groovy music. Vermeulen (72), formerly director of Samoa's health ministry, has been running the sleep clinic for 13 years.

The problem with sleep apnea is growing. If too much fat collects around the neck, the trachea easily closes when lying down, the doctor explains. Breathing starts again after an interruption, but the oxygen content in the blood drops and people are exhausted during the day. Vermeulen then fits the patient with a device with a face mask, which creates a slight overpressure in the airways and thus prevents the windpipe from closing. "We only treat the symptoms first," he says. "But these patients are at the bottom of the line. We tell them, of course, that they need to lose weight."

Gardening as a slimming stitch

With his aid organization Metis, Vermeulen has started courses in the villages and promotes fitness and healthy cooking. Tasalaotele Sapolu (51) does the same. The energetic pilot is back in Samoa after a career abroad. Her father was a healer, she continues the tradition now. "We are blessed here in Samoa, we have everything we need for a healthy life," she says.

On the one hand, she is currently setting up her wellness shop for traditional Samoan body care, with massage, detoxification and weight loss programs. Everything she offers is made from 100 percent local organic ingredients. On the other hand, she wants to get Samoa going.

On this Saturday, she and employees plow the flower beds in front of the office building of a communications company. "We'll turn it into a kitchen garden," says a woman from the HR department proudly. Under Sapulus' guidance, they first plant lemongrass. "I'll be there in the office next week and show you how to make delicious tea with it - better than any lemonade," she says. Further cooking courses will follow. Cucumbers, tomatoes, papaya and pineapples will soon be planted in the garden. "Each department maintains its own piece of garden," says the HR manager. "That brings movement, promotes team spirit and you can also harvest later."

© dpa / Christiane Oelrich / odg / cag