With a landmass of about 21 square kilometers, Nauru, located in the South Pacific close to the equator, is one of the smallest nations in the world, lying third after the Vatican and Monaco.
Though tiny, when it comes to obesity, this island is a giant, ranking as the world's number one, with an average body weight among residents that appears to be about 100 kilograms.
On a drive around Nauru, one will pass by a succession of huge gentlemen, their motorbikes straining under their immense loads. As daytime temperatures soar to around 40 degrees Celsius, humongous ladies lie under the shade of the trees. The very act of movement seems a Herculean task for these women.
I walked around town to ask the locals if they were aware of Nauru's unenviable status as the world's most obese country.
"Surely people from Tonga are fatter?" asks Paul a 46-year-old postal worker, his 150-kg frame rolling with laughter. According to a World Health Organization (WHO) study, Tonga, another South Pacific island, ranks number 3 in the corpulent stakes with an obesity rate of 59.6 percent, way behind Nauru's 71.1 percent.
Why is everyone so fat?
Paul has a straightforward answer. "I eat four meals a day," he says, adding, "after finishing a meal and lying in front of the TV for an hour, you soon get hungry again." One portion of rice for Paul is the equivalent of two large bowls.
To understand why this has happened, one has to journey back to the beginning of the 20th century, when Nauru's fate was transformed after a U.K. company began mining phosphates there.
After achieving independence in 1968, Nauru enjoyed an economic boom during the 1970s and 1980s, with state coffers swollen by profits from mining rights. These profits were distributed to Nauru's citizens, who now owned the island's land. As a result, per-capita GDP became one of the highest in the world, and the people didn't need to work anymore.
"The island's eating habits changed completely," says Briar, 65.
In the days before independence, when Nauru still retained its traditional food culture, the picture was quite different. Black-and-white photos from this era depict an island of powerfully built men and slim women. Before the mining began, a Nauru diet was based on fish caught from the sea, for example, or mangoes and other fruits picked from the forests.
"The traditional culture of fishing and garden plots changed significantly due to the import of Western foodstuffs," claims a study by the Nauru government and the WHO. "Western influences have led to a deterioration in eating habits and exercise patterns over the last 30 years, giving rise to the worst health conditions in the Pacific region."
Nauru teetered on the edge of bankruptcy in the 1990s as phosphate reserves virtually dried up, while government investments in overseas real estate also suffered huge losses. As of 2005, GDP per capita had dropped to around $2,600 (about 206,000 yen).
However, the island does have one legacy remaining from the boom times--obesity. After growing accustomed to a lack of exercise and a diet based on imported foodstuffs, the population has struggled to change its lifestyle, despite the return to normal circumstances. As a result, Nauru faces a growing obesity-related health crisis.
A national survey has estimated that out of a population of roughly 10,000 people, around 2,000 have diabetes. The prevalence of the disease remains at record highs, with more than 20 percent of all adults between the ages of 25 and 64 suffering from the illness. According to a 2007 study, the average life expectancy stood at only 49 years for men and 55 for women.
"We need to change the mentality that the only choice is between dining out or eating processed foods," says Valdon Dowiyogo, Nauru's health minister.
Brene, 52, an air traffic control worker weighing 100 kg, was diagnosed with diabetes four years ago. "I used to eat anything that was put in front of me. I used to pile up beef or chicken onto bowls of rice and wash it down with fizzy drinks," he says. Bulan has now shifted his diet to one based on fish. He has since lost 10 kg, but says it is hard to undo the damage done by many years of unhealthy living.
Eva, 41, is a diabetes care manager at a public health center.
"I have seen so many funerals for such a small island," she says, adding, "so many people are dying at an early age because of diabetes."
* * *
Memo: World obesity rankings
1. Nauru: 71.7%
2. Cook Islands: 64.1%
3. Tonga: 59.6%
24. USA: 31.8%
47. U.K./Russia: 24.9%
83. Germany: 21.3%
108. Italy: 17.2%
120. France: 15.6%
141. South Korea: 7.3%
166. Japan: 4.5%
182. India: 1.9%
189. Bangladesh: 1.1%
Percentage of the adult population with a BMI of 30 or over. World Health Organization (WHO), 2008.
BMI stands for Body Mass Index, the international standard for measuring obesity. The WHO defines a BMI over 25 as "Overweight" and a BMI over 30 as "Obese."
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