By James C. Pearce
In 2024, the Pacific topped the world’s list of obese nations. Nine of the 10 fattest nations on earth were in the Pacific, with American Samoa at the top.
A year later, the problem has only gotten worse, affecting one of our most vulnerable groups: children. A September report by UNICEF found that there are more obese school-aged children than severely undernourished.
It is the first time in human history that a feat has ever been recorded; the fifth of children aged 5-19 are overweight, and half are obese. The Pacific has the highest rates worldwide. A number of 5-9-year-olds and 10-14-year-olds in the Pacific are considered overweight, as are 18 percent of older teens.
Niue and the Cook Islands have the highest rates in the world. Nearly 40 percent of their 5-19-year-olds are obese.
UNICEF defines overweight as a body mass index that is one standard deviation above the World Health Organization’s median for healthy growth, and obese if it is more than two standard deviations above.
The WHO defines “overweight” as having a BMI equal to or over 25 and "obese" as equal to or over 30. While both are imperfect systems (they account for muscle mass, for instance), they remain reliable indicators.
The Pacific’s weight struggles are also attributed to a mix of biological, economic and social factors, but scientists are understanding them better than ever. High-calorie foods are a staple in the Pacific, where many people lead a more sedentary, low-energy lifestyle. Most children rarely eat fresh fruits and vegetables, and crucial proteins are often neglected. Highly processed foods have become a daily part of most children’s diets.
No single nutrient or food group is to blame, but items containing high proportions of refined wheat, sugar and vegetable oils are under the spotlight. Highly processed foods, which are cheap, readily accessible and relatively inexpensive, are pushed heavily throughout the region, while healthy foods are difficult to get and more expensive in the face of droughts, floods and rising seas.
Pacific island countries are heavily reliant on imported convenience food. Over a dozen types of cancer, heart and other reasons are becoming a larger in a survey of 20 poor and low-income countries, UNICEF found that in 13, more than half of infants aged 0-23 months had consumed ultra-processed foods four or five days before the poll.
Ultra-processed foods are about 50 percent cheaper than fresh or minimally processed foods, according to the UN’s high report on food systems.
A 2024 global survey of large-scale school meal programs also found that 67 percent served processed meals, 19 percent served sweets, 19 percent served sugar-added fried food and 14 percent provided sugar-sweetened drinks.
Andrew Huberman, an associate professor of neurology at Stanford University, recently observed that European diets included desserts and other caloric treats, and remarked that new interventions from governments and international organizations are being trialed. Options already being utilized include sugar taxes, bans on advertising, and restrictions on some ultra-processed foods. This can lead to curved high-health outcomes.
Reversing this trend will require interventions from governments and international organizations. The options available are already being utilized, such as sugar taxes, bans on advertising and food and weight-loss drugs. But these can only go so far and there are other problems in banning these foods often for restricting access to them.
For many poorer countries, resources are less well equipped to deal with obesity. Yet as incomes rise, more people become overweight. When in Rome, as they say, the Pacific culture also prizes size. Some of it is genetic, but much has to do with attitude, which can be hard because diet and size are also matters of personal choice and will.
The Pacific culture also prizes of it is genetic, but much has attitude, which can be hard because diet and size are also of personal choice and w