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  • Overview
  • Obesity prevalence
  • Trends over time
  • Population breakdowns
  • Drivers
  • Comorbidities
  • Health systems
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Obesity prevalence

Women, 2017

Survey type:Measured
Age:15-49
Sample size:1182
Area covered:National
References:Pickens, C. M., Flores-Ayala, R., Addo, O. Y., Whitehead, R. D., Jr, Palmieri, M., Ramirez-Zea, M., Hong, Y., & Jefferds, M. E. (2020). Prevalence and Predictors of High Blood Pressure Among Women of Reproductive Age and Children Aged 10 to 14 Years in Guatemala. Preventing chronic disease, 17, E66. https://doi.org/10.5888/pcd17.190403
Notes:Non-pregnant women
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2014-2015

Survey type:Measured
Age:15-49
Sample size:23891
Area covered:National
References:Demographic Health Survey, Guatemala 2014-15
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2008

Survey type:Measured
Age:15-49
Sample size:15119
Area covered:National
References:Ramirez-Zea M, Kroker-Lobos MF, Close-Fernandez R, Kanter R. The double burden of malnutrition in indigenous and nonindigenous Guatemalan populations. Am J Clin Nutr. 2014 Dec;100(6):1644S-51S. doi: 10.3945/ajcn.114.083857
Notes:This study used data from ENSMI, Encuesta Nacional de Salud Materno Infantil (National Maternal and Child Health Survey)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 1998-1999

Survey type:Measured
Age:18-49
Sample size:2318
Area covered:National
References:http://www.unscn.org/layout/modules/resources/files/rwns5.pdf; MEAN BMI Data DHS Survey
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 1995

Survey type:Measured
Age:15-49
Sample size:4978
References:Martorell R, Khan LK, Hughes ML, Grummer Strawn LM. Obesity in women from developing countries. EJCN (2000) 54;247-252
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2017

Survey type:Measured
Age:10-14
Sample size:560
Area covered:National
References:Pickens, C. M., Flores-Ayala, R., Addo, O. Y., Whitehead, R. D., Jr, Palmieri, M., Ramirez-Zea, M., Hong, Y., & Jefferds, M. E. (2020). Prevalence and Predictors of High Blood Pressure Among Women of Reproductive Age and Children Aged 10 to 14 Years in Guatemala. Preventing chronic disease, 17, E66. https://doi.org/10.5888/pcd17.190403
Notes:Small sample size.
Cutoffs:WHO 2007

Children, 2015

Survey type:Self-reported
Age:13-17
Sample size:4374
Area covered:National
References:Global School-based Student Health Survey (GSHS), available at https://www.who.int/ncds/surveillance/gshs/gshs_fs_guatemala_2015.pdf (last accessed 28.09.20)
Notes:WHO cutoffs.
Cutoffs:WHO

Girls, 2014-2015

Survey type:Measured
Age:15-19
Sample size:1086
Area covered:National
References:Mazariegos M, Kroker-Lobos MF, Ramírez-Zea M. Socio-economic and ethnic disparities of malnutrition in all its forms in Guatemala. Public Health Nutr. 2020 Aug;23(S1):s68-s76. doi: 10.1017/S1368980019002738. Epub 2019 Oct 7. PMID: 31588883.
Cutoffs:WHO

Overweight/obesity by education

Women, 2014-2015

Survey type:Measured
Age:15-49
Sample size:23891
Area covered:National
References:Demographic Health Survey, Guatemala 2014-15
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Girls, 2014-2015

Survey type:Measured
Age:15-19
Sample size:1086
Area covered:National
References:Mazariegos M, Kroker-Lobos MF, Ramírez-Zea M. Socio-economic and ethnic disparities of malnutrition in all its forms in Guatemala. Public Health Nutr. 2020 Aug;23(S1):s68-s76. doi: 10.1017/S1368980019002738. Epub 2019 Oct 7. PMID: 31588883.
Cutoffs:WHO

Overweight/obesity by age

Women, 2014-2015

Survey type:Measured
Sample size:23891
Area covered:National
References:Demographic Health Survey, Guatemala 2014-15
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2015

Survey type:Self-reported
Sample size:4374
Area covered:National
References:Global School-based Student Health Survey, Guatemala ,2015 Fact Sheet https://www.who.int/ncds/surveillance/gshs/gshs_fs_guatemala_2015.pdf (last accessed 28.09.20)
Cutoffs:WHO

Overweight/obesity by region

Women, 2014-2015

Survey type:Measured
Age:15-49
Sample size:23891
Area covered:National
References:Demographic Health Survey, Guatemala 2014-15
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Boys, 2015

Survey type:Self-reported
Age:13-17
Sample size:4374
Area covered:National
References:World Health Organization. Global school-based student health survey (GSHS). Available from: https://www.who.int/ncds/surveillance/gshs/factsheets/en/. [Accessed 20 February 2019].
Notes:WHO cut-offs used and based on Self-reported data.
Cutoffs:WHO

Girls, 2015

Survey type:Self-reported
Age:13-17
Sample size:4374
Area covered:National
References:World Health Organization. Global school-based student health survey (GSHS). Available from: https://www.who.int/ncds/surveillance/gshs/factsheets/en/. [Accessed 20 February 2019].
Notes:WHO cut-offs used and based on Self-reported data.
Cutoffs:WHO

Overweight/obesity by socio-economic group

Women, 2014-2015

Survey type:Measured
Age:15-49
Sample size:23891
Area covered:National
References:Demographic Health Survey, Guatemala 2014-15
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Insufficient physical activity

Adults, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Men, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Women, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Children, 2010

Age:11-17
References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)

Boys, 2010

Age:11-17
References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)

Girls, 2010

Age:11-17
References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)

Average daily frequency of carbonated soft drink consumption

Children, 2009-2015

Survey type:Measured
Age:12-17
References:Beal et al. (2019). Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-food consumption: A meta-analysis of global school-based student health surveys. Food and Nutrition Bulletin. https://doi.org/10.1177/0379572119848287 sourced from Food Systems Dashboard http://www.foodsystemsdashboard.org/food-system

Estimated per-capita fruit intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita fruit intake (g/day)

Prevalence of less-than-daily fruit consumption

Children, 2009-2015

Survey type:Measured
Age:12-17
References:Global School-based Student Health Surveys. Beal et al (2019). Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-food consumption: A meta-analysis of global school-based student health surveys. Food and Nutrition Bulletin. https://doi.org/10.1177/0379572119848287. Sourced from Food Systems Dashboard http://www.foodsystemsdashboard.org/food-system
Definitions:Prevalence of less-than-daily fruit consumption (% less-than-daily fruit consumption)

Prevalence of less-than-daily vegetable consumption

Children, 2009-2015

Survey type:Measured
Age:12-17
References:Beal et al. (2019). Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-food consumption: A meta-analysis of global school-based student health surveys. Food and Nutrition Bulletin. https://doi.org/10.1177/0379572119848287 sourced from Food Systems Dashboard http://www.foodsystemsdashboard.org/food-system
Definitions:Prevalence of less-than-daily vegetable consumption (% less-than-daily vegetable consumption)

Average weekly frequency of fast food consumption

Children, 2009-2015

Age:12-17
References:Beal et al. (2019). Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-food consumption: A meta-analysis of global school-based student health surveys. Food and Nutrition Bulletin. https://doi.org/10.1177/0379572119848287 sourced from Food Systems Dashboard http://www.foodsystemsdashboard.org/food-system

Estimated per-capita processed meat intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita processed meat intake (g per day)

Estimated per-capita whole grains intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita whole grains intake (g/day)

Mental health - depression disorders

Adults, 2015

References:Prevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
Definitions:% of population with depression disorders

Mental health - anxiety disorders

Adults, 2015

References:Prevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
Definitions:% of population with anxiety disorders

Oesophageal cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20+. ASR (World) per 100,000

Breast cancer

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, breast, females, ages 20+. ASR (World) per 100,000

Colorectal cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20+. ASR (World) per 100,000

Pancreatic cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20+. ASR (World) per 100,000

Gallbladder cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20+. ASR (World) per 100,000

Kidney cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20+. ASR (World) per 100,000

Cancer of the uterus

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, cervix uteri, females, ages 20+. ASR (World) per 100,000

Raised blood pressure

Adults, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Men, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Women, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Raised cholesterol

Adults, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Men, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Women, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Raised fasting blood glucose

Men, 2014-2019

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A869?lang=en
Definitions:Age Standardised % raised fasting blood glucose (>= 7.0 mmol/L or on medication).

Women, 2014-2019

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A869?lang=en
Definitions:Age Standardised % raised fasting blood glucose (>= 7.0 mmol/L or on medication).

Diabetes prevalence

Adults, 2017

References:Reproduced with kind permission of IDF, International Diabetes Federation. IDF Diabetes Atlas, 8th edition. Brussels, Belgium: International Diabetes Federation, 2017. http://www.diabetesatlas.org
Definitions:Diabetes age-adjusted comparative prevalence (%).

Health systems

Economic classification: Upper Middle Income

Health systems summary

Access to healthcare in Guatemala is guaranteed under the Guatemalan constitution. Care is provided free at point of service in the public sector, but it is widely recognised that there are numerous barriers to care in practice, particularly for the indigenous Mayan population and those in rural areas. Care is increasingly being outsourced to private companies, meaning that some services are only available privately and at cost to individuals. It appears that much of these challenges can be attributed to limited funding for the public system, with healthcare spending (as a share of GDP) one of the lowest in Central America. Out of pocket expenditure currently constitutes 50% of healthcare expenditure and there are low levels of private insurance coverage. The Guatemalan Institute for Social Security provides insurance for formal sector workers.

Guatemala’s health system currently spends much of its resources on treatment rather than prevention. Major health challenges in Guatemala include high rates of malnutrition and maternal and infant mortality.

Indicators

Where is the country’s government in the journey towards defining ‘Obesity as a disease’?No
Where is the country’s healthcare provider in the journey towards defining ‘Obesity as a disease’?No
Is there specialist training available dedicated to the training of health professionals to prevent, diagnose, treat and manage obesity?No
Have any taxes or subsidies been put in place to protect/assist/inform the population around obesity?No
Are there adequate numbers of trained health professionals in specialties relevant to obesity in urban areas?Some progress
Are there adequate numbers of trained health professionals in specialties relevant to obesity in rural areas?No
Are there any obesity-specific recommendations or guidelines published for adults?Not known
Are there any obesity-specific recommendations or guidelines published for children?Not known
In practice, how is obesity treatment largely funded?Out of pocket

Perceived barriers to treatment

  • Lack of political will, interest and action
  • Food cost and availability
  • Poor health literacy and behaviour
  • Lack of training
  • Influence of food industry
  • Social determinants of health
  • Cultural norms/traditions

Summary of stakeholder feedback

Malnutrition remains a major challenge in Guatemala. While obesity is a form of malnutrition, in Guatemala, undernutrition rather than overnutrition is perceived to be the greater and more important challenge. As a result, stakeholders reported that obesity is not yet considered to be a disease or a priority, and so there are limited to no policies and resources in place concerning it. Obesity in Guatemala is generally only present in the urban areas, while undernutrition is the main challenge in rural areas.

Most stakeholders felt that healthcare providers and professionals considered and treated obesity as a risk factor rather than a disease. Similarly, it was reported that insurers felt that obesity treatment (particularly seeing a nutritionist and bariatric surgery) was a cosmetic concern rather than a medical one. Due to this lack of prioritisation of obesity, obesity treatment is typically only given in the presence of comorbidities and is limited in the public sector. Most obesity care is Guatemala is thus delivered privately, at great expense to the individual.

There appears to be no specialist obesity training available in Guatemala that allows health professionals to become an obesity specialist. There is, however, some limited obesity training available to nutritionists and endocrinologists.

Based on interviews/survey returns from 6 stakeholders

Last updated: June 2020

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