Mexico
- Overview
- Obesity prevalence
- Trends over time
- Population breakdowns
- Drivers
- Comorbidities
- Health systems
- Policies
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National obesity risk *8/10This is a composite ‘obesity risk’ score (out of 10, the highest risk) based on obesity prevalence, rate of increase, likelihood of meeting the 2025 target, treatment indicator and childhood stunting levels.Childhood obesity risk *7/11This is a ‘risk score’ for each country’s likelihood of having or acquiring a major childhood obesity problem during the 2020s, taking account of current prevalence levels and risk for future obesity (based on stunting among infants, maternal obesity, maternal smoking, and breastfeeding rates).
* Based on estimated data. For more information see Publications
Obesity prevalence
Trends over time
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The report card collates all the most-recent graphics for this country. If you would like to produce a custom report based on selected graphics, just tap the Add to custom PDF button below the graphics you would like to use.Population breakdowns
Drivers
Comorbidities
Health systems
Obesity prevalence
Adults, 2018-2019
| Survey type: | Measured |
| Age: | 20+ |
| Sample size: | 16257 |
| Area covered: | National |
| References: | Encuesta Nacional de Salud y Nutrición 2018. https://ensanut.insp.mx/encuestas/ensanut2018/informes.php (Accessed 15.12.20) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Adults, 2016
| Survey type: | Measured |
| Age: | 20+ |
| Sample size: | 8412 |
| Area covered: | National |
| References: | Encuesta Nacional de Salud y Nutrición de Medio Camino 2016 |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Adults, 2012
| Survey type: | Measured |
| Age: | 20+ |
| Sample size: | 38620 |
| Area covered: | National |
| References: | ENSANUT 2012 http://ensanut.insp.mx/informes/ENSANUT2012ResultadosNacionales.pdf accessed 25th June 2014 |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Adults, 2006
| Survey type: | Measured |
| Age: | 20+ |
| Sample size: | 33624 |
| Area covered: | National |
| References: | Olaiz-Fernández G, Rivera-Dommarco J, Shamah-Levy T, Rojas R, Villalpando-Hernández S, Hernández-Avila M, Sepúlveda-Amor J. Encuesta Nacional de Salud y Nutrición 2006. Cuernavaca, México: Instituto Nacional de Salud Pública, 2006. (National Health and Nutrition Survey 2006). |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Adults, 2000
| Survey type: | Measured |
| Age: | 20-69 |
| Sample size: | 41188 |
| References: | Personal Communication from Dr C Sanchez Castillio, Body Mass Index cutoff points for Type 2 Diabetes Melliuts and Hypertension in the Mexican National Health Survey 2000. |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Adults, 1992-1993
| Survey type: | Measured |
| Age: | 20+ |
| Sample size: | 14392 |
| References: | Arroyo et al. Prevalence of Pre-Obesity and Obesity in Urban Adult Mexicans in Comparison with other Large Surveys. Obesity Research. 2000;8:179-185 |
| Notes: | Urban |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Women, 1988
| Survey type: | Measured |
| Age: | 18-49 |
| Sample size: | 12138 |
| References: | Rivera JA, BarqueraS, Campirano F, Campos I, Safdie M, Tovar V. Epidemiological and nutritional transition in Mexico:rapid increase of non-communicable chronic diseases and obesity. Public Health Nutrition 2002. 5(1A), 113-122 |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Children, 2018-2019
| Survey type: | Measured |
| Age: | 12-19 |
| Sample size: | 5671 |
| Area covered: | National |
| References: | Encuesta Nacional de Salud y Nutrición 2018. https://ensanut.insp.mx/encuestas/ensanut2018/informes.php (Accessed 15.12.20) |
| Cutoffs: | WHO |
Children, 2016
| Survey type: | Measured |
| Age: | 12-19 |
| Sample size: | 2581 |
| Area covered: | National |
| References: | Shamah-Levy T, Cuevas-Nasu L, Gaona-Pineda EB,Gómez-Acosta LM, Morales-Ruán MC,Hernández-Ávila M, Rivera-Dommarco JA. Overweight and obesity in children and adolescents,2016 Halfway National Health and Nutrition Survey update. Salud Publica Mex 2018;60:244-253. |
| Notes: | WHO Growth Ref Standard NB. Combined child data estimated. These estimates were calculated by weighting male and female survey results. Weighting based on World Bank Population % total female 2019 (https://data.worldbank.org/indicator/SP.POP.TOTL.FE.ZS - accessed 21.10.20)' |
| Cutoffs: | WHO |
Children, 2012
| Survey type: | Measured |
| Age: | 12-19 |
| Sample size: | 13992 |
| Area covered: | National |
| References: | ENSANUT 2012, https://ensanut.insp.mx/encuestas/ensanut2012/doctos/informes/ENSANUT2012ResultadosNacionales.pdf (Accessed 15.12.20) |
| Cutoffs: | WHO |
Children, 2012
| Survey type: | Measured |
| Age: | 5-11 |
| Sample size: | 16351 |
| Area covered: | National |
| References: | ENSANUT 2012 http://ensanut.insp.mx/informes/ENSANUT2012ResultadosNacionales.pdf accessed 25th June 2014 |
| Notes: | WHO Cut off NOT: International IOTF Cut off |
| Cutoffs: | WHO |
Children, 2006
| Survey type: | Measured |
| Age: | 5-17 |
| Sample size: | 17158 |
| Area covered: | National |
| References: | Encuesta nacional de salud y nutricion 2006 |
| Notes: | IOTF Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3. |
| Cutoffs: | IOTF |
Children, 2000
| Survey type: | Measured |
| Age: | 10-17 |
| References: | del Rio-Navarro B, Velazquez-Monroy O, Sanchez-Castillo CP et al. The High Prevalence of Overweight and Obesity in Mexican Children. Obesity Research 2004;12:215-223 |
| Notes: | IOTF Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3. |
| Cutoffs: | IOTF |
Children, 1995
| Survey type: | Measured |
| Age: | 5-17 |
| Sample size: | 2853 |
| References: | Personal Communication - Sanchez Castillo C, National Institute of Nutrition, Mexico. Data from Encuesta Urbana de Alimentación y Nutrición en la Zona Metropolitana de la Ciudad de México, 1995. |
| Notes: | IOTF Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3. |
| Cutoffs: | IOTF |
% 12-19 year old children living with overweight or obesity in Mexico 2012-2018
Girls
| Survey type: | Measured |
| References: | 2012: ENSANUT 2012, https://ensanut.insp.mx/encuestas/ensanut2012/doctos/informes/ENSANUT2012ResultadosNacionales.pdf (Accessed 15.12.20) 2016: Shamah-Levy T, Cuevas-Nasu L, Gaona-Pineda EB,Gómez-Acosta LM, Morales-Ruán MC,Hernández-Ávila M, Rivera-Dommarco JA. Overweight and obesity in children and adolescents,2016 Halfway National Health and Nutrition Survey update. Salud Publica Mex 2018;60:244-253. 2018: Encuesta Nacional de Salud y Nutrición 2018. https://ensanut.insp.mx/encuestas/ensanut2018/informes.php (Accessed 15.12.20) |
| Different methodologies may have been used to collect this data and so data from different surveys may not be strictly comparable. Please check with original data sources for methodologies used. | |
Boys
| Survey type: | Measured |
| References: | 2012: ENSANUT 2012, https://ensanut.insp.mx/encuestas/ensanut2012/doctos/informes/ENSANUT2012ResultadosNacionales.pdf (Accessed 15.12.20) 2016: Shamah-Levy T, Cuevas-Nasu L, Gaona-Pineda EB,Gómez-Acosta LM, Morales-Ruán MC,Hernández-Ávila M, Rivera-Dommarco JA. Overweight and obesity in children and adolescents,2016 Halfway National Health and Nutrition Survey update. Salud Publica Mex 2018;60:244-253. 2018: Encuesta Nacional de Salud y Nutrición 2018. https://ensanut.insp.mx/encuestas/ensanut2018/informes.php (Accessed 15.12.20) |
| Different methodologies may have been used to collect this data and so data from different surveys may not be strictly comparable. Please check with original data sources for methodologies used. | |
Boys and girls
| Survey type: | Measured |
| References: | 2012: ENSANUT 2012, https://ensanut.insp.mx/encuestas/ensanut2012/doctos/informes/ENSANUT2012ResultadosNacionales.pdf (Accessed 15.12.20) 2016: Shamah-Levy T, Cuevas-Nasu L, Gaona-Pineda EB,Gómez-Acosta LM, Morales-Ruán MC,Hernández-Ávila M, Rivera-Dommarco JA. Overweight and obesity in children and adolescents,2016 Halfway National Health and Nutrition Survey update. Salud Publica Mex 2018;60:244-253. 2018: Encuesta Nacional de Salud y Nutrición 2018. https://ensanut.insp.mx/encuestas/ensanut2018/informes.php (Accessed 15.12.20) |
| Different methodologies may have been used to collect this data and so data from different surveys may not be strictly comparable. Please check with original data sources for methodologies used. | |
% Adults living with obesity in Mexico 1992-2018
Men
| Survey type: | Measured |
| References: | 1992: Arroyo et al. Prevalence of Pre-Obesity and Obesity in Urban Adult Mexicans in Comparison with other Large Surveys. Obesity Research. 2000;8:179-185 2000: Personal Communication from Dr C Sanchez Castillio, Body Mass Index cutoff points for Type 2 Diabetes Melliuts and Hypertension in the Mexican National Health Survey 2000. 2006: Olaiz-Fernández G, Rivera-Dommarco J, Shamah-Levy T, Rojas R, Villalpando-Hernández S, Hernández-Avila M, Sepúlveda-Amor J. Encuesta Nacional de Salud y Nutrición 2006. Cuernavaca, México: Instituto Nacional de Salud Pública, 2006. (National Health and Nutrition Survey 2006). 2012: ENSANUT 2012 http://ensanut.insp.mx/informes/ENSANUT2012ResultadosNacionales.pdf accessed 25th June 2014 2016: Encuesta Nacional de Salud y Nutrición de Medio Camino 2016 2018: Encuesta Nacional de Salud y Nutrición 2018. https://ensanut.insp.mx/encuestas/ensanut2018/informes.php (Accessed 15.12.20) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
| Different methodologies may have been used to collect this data and so data from different surveys may not be strictly comparable. Please check with original data sources for methodologies used. | |
Women
| Survey type: | Measured |
| References: | 1992: Arroyo et al. Prevalence of Pre-Obesity and Obesity in Urban Adult Mexicans in Comparison with other Large Surveys. Obesity Research. 2000;8:179-185 2000: Personal Communication from Dr C Sanchez Castillio, Body Mass Index cutoff points for Type 2 Diabetes Melliuts and Hypertension in the Mexican National Health Survey 2000. 2006: Olaiz-Fernández G, Rivera-Dommarco J, Shamah-Levy T, Rojas R, Villalpando-Hernández S, Hernández-Avila M, Sepúlveda-Amor J. Encuesta Nacional de Salud y Nutrición 2006. Cuernavaca, México: Instituto Nacional de Salud Pública, 2006. (National Health and Nutrition Survey 2006). 2012: ENSANUT 2012 http://ensanut.insp.mx/informes/ENSANUT2012ResultadosNacionales.pdf accessed 25th June 2014 2016: Encuesta Nacional de Salud y Nutrición de Medio Camino 2016 2018: Encuesta Nacional de Salud y Nutrición 2018. https://ensanut.insp.mx/encuestas/ensanut2018/informes.php (Accessed 15.12.20) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
| Different methodologies may have been used to collect this data and so data from different surveys may not be strictly comparable. Please check with original data sources for methodologies used. | |
% Adults living with overweight or obesity in Mexico 1992-2018
Men
| Survey type: | Measured |
| References: | 1992: Arroyo et al. Prevalence of Pre-Obesity and Obesity in Urban Adult Mexicans in Comparison with other Large Surveys. Obesity Research. 2000;8:179-185 2000: Personal Communication from Dr C Sanchez Castillio, Body Mass Index cutoff points for Type 2 Diabetes Melliuts and Hypertension in the Mexican National Health Survey 2000. 2006: Olaiz-Fernández G, Rivera-Dommarco J, Shamah-Levy T, Rojas R, Villalpando-Hernández S, Hernández-Avila M, Sepúlveda-Amor J. Encuesta Nacional de Salud y Nutrición 2006. Cuernavaca, México: Instituto Nacional de Salud Pública, 2006. (National Health and Nutrition Survey 2006). 2012: ENSANUT 2012 http://ensanut.insp.mx/informes/ENSANUT2012ResultadosNacionales.pdf accessed 25th June 2014 2016: Encuesta Nacional de Salud y Nutrición de Medio Camino 2016 2018: Encuesta Nacional de Salud y Nutrición 2018. https://ensanut.insp.mx/encuestas/ensanut2018/informes.php (Accessed 15.12.20) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
| Different methodologies may have been used to collect this data and so data from different surveys may not be strictly comparable. Please check with original data sources for methodologies used. | |
Women
| Survey type: | Measured |
| References: | 1992: Arroyo et al. Prevalence of Pre-Obesity and Obesity in Urban Adult Mexicans in Comparison with other Large Surveys. Obesity Research. 2000;8:179-185 2000: Personal Communication from Dr C Sanchez Castillio, Body Mass Index cutoff points for Type 2 Diabetes Melliuts and Hypertension in the Mexican National Health Survey 2000. 2006: Olaiz-Fernández G, Rivera-Dommarco J, Shamah-Levy T, Rojas R, Villalpando-Hernández S, Hernández-Avila M, Sepúlveda-Amor J. Encuesta Nacional de Salud y Nutrición 2006. Cuernavaca, México: Instituto Nacional de Salud Pública, 2006. (National Health and Nutrition Survey 2006). 2012: ENSANUT 2012 http://ensanut.insp.mx/informes/ENSANUT2012ResultadosNacionales.pdf accessed 25th June 2014 2016: Encuesta Nacional de Salud y Nutrición de Medio Camino 2016 2018: Encuesta Nacional de Salud y Nutrición 2018. https://ensanut.insp.mx/encuestas/ensanut2018/informes.php (Accessed 15.12.20) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
| Different methodologies may have been used to collect this data and so data from different surveys may not be strictly comparable. Please check with original data sources for methodologies used. | |
% Adults living with obesity in selected countries in the Americas Region 1960-2018
Men
| References: | 1960, 1971, 1973, 1976, 1991: Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960-1994. International Journal of Obesity (1998);22:39-47 1975: Monteiro CA, Conde WL, Popking BM. Is obesity replacing or adding to undernutrition? Evidence from different social classes in Brazil. 2002. Public Health Nutrition:51(1A), 105-112 1988: Berrios X, Jadue I, Zenteno J, Ross MI, Rodriguez H. Prevalencia de factores de riesgo para enfermedades cronicas. Estudio de la poblacion general de la region Metropolitana, 1986-1987. Rev. Med. Chile. 1990;118:597-604 1992, 1994, 1995: Martorell R, Khan LK, Hughes ML, Grummer Strawn LM. Obesity in women from developing countries. EJCN (2000) 54;247-252 1997: Filozof C, Gonzales C, Sereday M, Mazza C, Braguinsky J. Obesity prevalence and trends in Latin American countries. Obesity Reviews, 2001;2:99-196 1998: http://www.unscn.org/layout/modules/resources/files/rwns5.pdf; MEAN BMI Data DHS Survey 1999: Centres for Disease Control and Prevention. http://www.cdc.gov/ 2000: Demographic Health Survey, Peru 2000 2001: Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of Overweight and Obesity in the United States, 1999-2004. JAMA 2006;295(13):1549-1555 2002: Monteiro CA, Conde WL and Popkin BA. (2007). Income-specific trends in obesity in Brazil: 1975 - 2003. American Journal of Public Health, 97 (10): 1808 - 1812. 2003: 2003 ENS Report. Final results on the National Health Survey. Http://epi.minsal.cl/epi/html/invest/ENS/informeFinalENS.pdf. 2005: Demographic Health Survey 2006. 2006: Olaiz-Fernández G, Rivera-Dommarco J, Shamah-Levy T, Rojas R, Villalpando-Hernández S, Hernández-Avila M, Sepúlveda-Amor J. Encuesta Nacional de Salud y Nutrición 2006. Cuernavaca, México: Instituto Nacional de Salud Pública, 2006. (National Health and Nutrition Survey 2006). 2007: DHS 2007 - 2008 2008: 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 2009, 2018: 1-4th Argentinian National Survey of Risk Factors (Encuesta Nacional de Factores de Riesgo). 4th (2018) Survey 2010: Demographic Health Survey 2010 2011: Ruopeng An, “Prevalence and Trends of Adult Obesity in the US, 1999–2012”, ISRN Obesity, vol. 2014, Article ID 185132, 6 pages, 2014. doi:10.1155/2014/185132 2012: Demographic Health Survey Haiti 2012 2013: DHS Peru 2013 2014: Demographic Health Survey, Guatemala 2014-15 2015: NHANES 2015/16. Analysis conducted by the World Obesity Federation, Caroline Litts, Fiona Montague & R Jackson-Leach 2017 2016: Encuesta Nacional de Salud. Chile. 2016-2017 https://www.minsal.cl/wp-content/uploads/2017/11/ENS-2016-17_PRIMEROS-RESULTADOS.pdf (Last accessed 04.08.20) 2017: 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 2019: Bahamas STEPS Survey (Preliminary results) https://www.bahamas.gov.bs/wps/wcm/connect/891fac39-ad7d-4aa8-ac54-39912a1afcea/Preliminary+Factsheet+v7+%28med+resl%27n%29.pdf?MOD=AJPERES (Accessed 03.11.2020) |
| Different methodologies may have been used to collect this data and so data from different surveys may not be strictly comparable. Please check with original data sources for methodologies used. | |
Women
| References: | 1960, 1971, 1973, 1976, 1991: Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960-1994. International Journal of Obesity (1998);22:39-47 1975: Monteiro CA, Conde WL, Popking BM. Is obesity replacing or adding to undernutrition? Evidence from different social classes in Brazil. 2002. Public Health Nutrition:51(1A), 105-112 1988: Berrios X, Jadue I, Zenteno J, Ross MI, Rodriguez H. Prevalencia de factores de riesgo para enfermedades cronicas. Estudio de la poblacion general de la region Metropolitana, 1986-1987. Rev. Med. Chile. 1990;118:597-604 1992, 1994, 1995: Martorell R, Khan LK, Hughes ML, Grummer Strawn LM. Obesity in women from developing countries. EJCN (2000) 54;247-252 1997: Filozof C, Gonzales C, Sereday M, Mazza C, Braguinsky J. Obesity prevalence and trends in Latin American countries. Obesity Reviews, 2001;2:99-196 1998: http://www.unscn.org/layout/modules/resources/files/rwns5.pdf; MEAN BMI Data DHS Survey 1999: Centres for Disease Control and Prevention. http://www.cdc.gov/ 2000: Demographic Health Survey, Peru 2000 2001: Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of Overweight and Obesity in the United States, 1999-2004. JAMA 2006;295(13):1549-1555 2002: Monteiro CA, Conde WL and Popkin BA. (2007). Income-specific trends in obesity in Brazil: 1975 - 2003. American Journal of Public Health, 97 (10): 1808 - 1812. 2003: 2003 ENS Report. Final results on the National Health Survey. Http://epi.minsal.cl/epi/html/invest/ENS/informeFinalENS.pdf. 2005: Demographic Health Survey 2006. 2006: Olaiz-Fernández G, Rivera-Dommarco J, Shamah-Levy T, Rojas R, Villalpando-Hernández S, Hernández-Avila M, Sepúlveda-Amor J. Encuesta Nacional de Salud y Nutrición 2006. Cuernavaca, México: Instituto Nacional de Salud Pública, 2006. (National Health and Nutrition Survey 2006). 2007: DHS 2007 - 2008 2008: 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 2009, 2018: 1-4th Argentinian National Survey of Risk Factors (Encuesta Nacional de Factores de Riesgo). 4th (2018) Survey 2010: Demographic Health Survey 2010 2011: Ruopeng An, “Prevalence and Trends of Adult Obesity in the US, 1999–2012”, ISRN Obesity, vol. 2014, Article ID 185132, 6 pages, 2014. doi:10.1155/2014/185132 2012: Demographic Health Survey Haiti 2012 2013: DHS Peru 2013 2014: Demographic Health Survey, Guatemala 2014-15 2015: NHANES 2015/16. Analysis conducted by the World Obesity Federation, Caroline Litts, Fiona Montague & R Jackson-Leach 2017 2016: Encuesta Nacional de Salud. Chile. 2016-2017 https://www.minsal.cl/wp-content/uploads/2017/11/ENS-2016-17_PRIMEROS-RESULTADOS.pdf (Last accessed 04.08.20) 2017: 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 2019: Bahamas STEPS Survey (Preliminary results) https://www.bahamas.gov.bs/wps/wcm/connect/891fac39-ad7d-4aa8-ac54-39912a1afcea/Preliminary+Factsheet+v7+%28med+resl%27n%29.pdf?MOD=AJPERES (Accessed 03.11.2020) |
| Different methodologies may have been used to collect this data and so data from different surveys may not be strictly comparable. Please check with original data sources for methodologies used. | |
Overweight/obesity by education
Women, 2012
| Survey type: | Measured |
| Age: | 20-49 |
| Sample size: | 4943 |
| Area covered: | National |
| References: | Perez Ferrer C, McMunn A, Rivera Dommarco JA, Brunner EJ. Educational Inequalities in Obesity among Mexican Women: Time-Trends from 1988 to 2012. Miranda JJ, ed. PLoS |
| Notes: | Obesity Prevalence based on Education level in Rural areas |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Women, 2012
| Survey type: | Measured |
| Age: | 20-49 |
| Sample size: | 9588 |
| Area covered: | National |
| References: | Perez Ferrer C, McMunn A, Rivera Dommarco JA, Brunner EJ. Educational Inequalities in Obesity among Mexican Women: Time-Trends from 1988 to 2012. Miranda JJ, ed. PLoS |
| Notes: | Obesity Prevalence based on Education level in Urban areas. |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Adults, 2009-2010
| Survey type: | Measured |
| Age: | 50+ |
| Sample size: | 2032 |
| Area covered: | National |
| References: | Rivas-Marino, G., Negin, J., Salinas-Rodríguez, A., Manrique-Espinoza, B., Sterner, K. N., Snodgrass, J. and Kowal, P. (2015), Prevalence of overweight and obesity in older Mexican adults and its association with physical activity and related factors: An analysis of the study on global ageing and adult health. Am. J. Hum. Biol., 27: 326–333. doi: 10.1002/ajhb.22642 |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Overweight/obesity by age
Adults, 2018-2019
| Survey type: | Measured |
| Sample size: | 16257 |
| Area covered: | National |
| References: | Encuesta Nacional de Salud y Nutrición 2018. https://ensanut.insp.mx/encuestas/ensanut2018/informes.php (Accessed 15.12.20) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Children, 2018-2019
| Survey type: | Measured |
| Sample size: | 11937 |
| Area covered: | National |
| References: | Encuesta Nacional de Salud y Nutrición 2018. https://ensanut.insp.mx/encuestas/ensanut2018/informes.php (Accessed 15.12.20) |
| Cutoffs: | WHO |
Children, 2016
| Survey type: | Measured |
| Sample size: | 5765 |
| Area covered: | National |
| References: | Shamah-Levy T, Cuevas-Nasu L, Gaona-Pineda EB,Gómez-Acosta LM, Morales-Ruán MC,Hernández-Ávila M, Rivera-Dommarco JA. Overweight and obesity in children and adolescents,2016 Halfway National Health and Nutrition Survey update. Salud Publica Mex 2018;60:244-253. |
| Cutoffs: | WHO |
Children, 2012
| Survey type: | Measured |
| Sample size: | Large National Survey |
| Area covered: | National |
| References: | La Encuesta Nacional de Salud y Nutrición 2012 (ENSANUT2012) http://ensanut.insp.mx/ (last accessed 4 April 2016) |
| Notes: | WHO Cut-Off |
| Cutoffs: | WHO |
Overweight/obesity by region
Adults, 2018-2019
| Survey type: | Measured |
| Age: | 20+ |
| Sample size: | 16257 |
| Area covered: | National |
| References: | Encuesta Nacional de Salud y Nutrición 2018. https://ensanut.insp.mx/encuestas/ensanut2018/informes.php (Accessed 15.12.20) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Women, 2012
| Survey type: | Measured |
| Age: | 20-49 |
| Sample size: | 14531 |
| Area covered: | National |
| References: | Perez Ferrer C, McMunn A, Rivera Dommarco JA, Brunner EJ. Educational Inequalities in Obesity among Mexican Women: Time-Trends from 1988 to 2012. Miranda JJ, ed. PLoS |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Adults, 2012
| Survey type: | Measured |
| Age: | 20+ |
| Area covered: | National |
| References: | Encuesta Nacional de Salud y Nutricion, Resultados Nacionales 2012 |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Adults, 2009-2010
| Survey type: | Measured |
| Age: | 50+ |
| Sample size: | 2032 |
| Area covered: | National |
| References: | Rivas-Marino, G., Negin, J., Salinas-Rodríguez, A., Manrique-Espinoza, B., Sterner, K. N., Snodgrass, J. and Kowal, P. (2015), Prevalence of overweight and obesity in older Mexican adults and its association with physical activity and related factors: An analysis of the study on global ageing and adult health. Am. J. Hum. Biol., 27: 326–333. doi: 10.1002/ajhb.22642 |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Children, 2018-2019
| Survey type: | Measured |
| Age: | 12-19 |
| Sample size: | 5671 |
| Area covered: | National |
| References: | Encuesta Nacional de Salud y Nutrición 2018. https://ensanut.insp.mx/encuestas/ensanut2018/informes.php (Accessed 15.12.20) |
| Cutoffs: | WHO |
Boys, 2018-2019
| Survey type: | Measured |
| Age: | 12-19 |
| Sample size: | 5671 |
| Area covered: | National |
| References: | Encuesta Nacional de Salud y Nutrición 2018. https://ensanut.insp.mx/encuestas/ensanut2018/informes.php (Accessed 15.12.20) |
| Cutoffs: | WHO |
Girls, 2018-2019
| Survey type: | Measured |
| Age: | 12-19 |
| Sample size: | 5671 |
| Area covered: | National |
| References: | Encuesta Nacional de Salud y Nutrición 2018. https://ensanut.insp.mx/encuestas/ensanut2018/informes.php (Accessed 15.12.20) |
| Cutoffs: | WHO |
Children, 2006
| Survey type: | Measured |
| Age: | 5-11 |
| Sample size: | Children aged 5-11yr: n=15111 |
| Area covered: | National: Mexican National Health and Nutrition Survey 2006 (ENSANUT 2006) |
| References: | Bonvecchio A, Safdie M, Monterrubio EA, Gust T, Villalpando S, Rivera JA. Overweight and obesity trends in Mexican children 2 to 18 years of age from 1988 to 2006. Salud Publica Mex 2009;51 suppl 4:S586-S594. |
| Notes: | Overweight and obesity were classified according to IOTF criteria, based on BMI measurements, with cutoff points for BMI based on an international reference population drafted from seven countries, specific for age and sex. Said cutoff points are a projection of the criteria proposed by WHO for diagnosing overweight (BMI of 25-29.9) and obesity (BMI of 30 or more) in adults. |
| Cutoffs: | IOTF |
Children, 2006
| Survey type: | Measured |
| Age: | 5-11 |
| Sample size: | Children aged 5-11yr: n=15111 |
| Area covered: | National: Mexican National Health and Nutrition Survey 2006 (ENSANUT 2006) |
| References: | Bonvecchio A, Safdie M, Monterrubio EA, Gust T, Villalpando S, Rivera JA. Overweight and obesity trends in Mexican children 2 to 18 years of age from 1988 to 2006. Salud Publica Mex 2009;51 suppl 4:S586-S594. |
| Notes: | Overweight and obesity were classified according to IOTF criteria, based on BMI measurements, with cutoff points for BMI based on an international reference population drafted from seven countries, specific for age and sex. Said cutoff points are a projection of the criteria proposed by WHO for diagnosing overweight (BMI of 25-29.9) and obesity (BMI of 30 or more) in adults. |
| Cutoffs: | IOTF |
Boys, 2000
| Survey type: | Measured |
| Age: | 10-17 |
| Sample size: | 7862 Girls, 8947 Boys |
| Area covered: | National |
| References: | del Rio-Navarro BE, Velaquez-Monroy O, Sanchez-Castillo CP et al. The High Prevalence of Overweight and Obesity in Mexican Children. Obesity Research 2004;12:215-223 |
| Cutoffs: | IOTF |
Girls, 2000
| Survey type: | Measured |
| Age: | 10-17 |
| Sample size: | 7862 Girls, 8947 Boys |
| Area covered: | National |
| References: | del Rio-Navarro BE, Velaquez-Monroy O, Sanchez-Castillo CP et al. The High Prevalence of Overweight and Obesity in Mexican Children. Obesity Research 2004;12:215-223 |
| Cutoffs: | IOTF |
Overweight/obesity by socio-economic group
Adults, 2009-2010
| Survey type: | Measured |
| Age: | 50+ |
| Sample size: | 2032 |
| Area covered: | National |
| References: | Rivas-Marino, G., Negin, J., Salinas-Rodríguez, A., Manrique-Espinoza, B., Sterner, K. N., Snodgrass, J. and Kowal, P. (2015), Prevalence of overweight and obesity in older Mexican adults and its association with physical activity and related factors: An analysis of the study on global ageing and adult health. Am. J. Hum. Biol., 27: 326–333. doi: 10.1002/ajhb.22642 |
| Notes: | Prevalence of obesity in older Mexican adults (50+) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Children, 2006
| Survey type: | Measured |
| Age: | 5-11 |
| Sample size: | Children aged 5-11yr: n=15111 |
| Area covered: | National: Mexican National Health and Nutrition Survey 2006 (ENSANUT 2006) |
| References: | Bonvecchio A, Safdie M, Monterrubio EA, Gust T, Villalpando S, Rivera JA. Overweight and obesity trends in Mexican children 2 to 18 years of age from 1988 to 2006. Salud Publica Mex 2009;51 suppl 4:S586-S594. |
| Notes: | Prevalence of overweight and obesity by Socioeconomic Level. Overweight and obesity were classified according to IOTF criteria, based on BMI measurements, with cutoff points for BMI based on an international reference population drafted from seven countries, specific for age and sex. Said cutoff points are a projection of the criteria proposed by WHO for diagnosing overweight (BMI of 25-29.9) and obesity (BMI of 30 or more) in adults. |
| Cutoffs: | IOTF |
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, 2016
| Survey type: | Self-reported |
| Age: | 11-17 |
| References: | Global Health Observatory data repository, World Health Organisation, https://apps.who.int/gho/data/node.main.A893ADO?lang=en (last accessed 16.03.21) |
| 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, 2016
| Survey type: | Self-reported |
| Age: | 11-17 |
| References: | Global Health Observatory data repository, World Health Organisation, https://apps.who.int/gho/data/node.main.A893ADO?lang=en (last accessed 16.03.21) |
| 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, 2016
| Survey type: | Self-reported |
| Age: | 11-17 |
| References: | Global Health Observatory data repository, World Health Organisation, https://apps.who.int/gho/data/node.main.A893ADO?lang=en (last accessed 16.03.21) |
| 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) |
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) |
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
| 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
| 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
The Mexican Health System is complex; made up of public healthcare and employer-funded insurance schemes as well as private health insurance schemes that involve out of pocket payment. Employees of the state are provided for by the Institute for Social Security and Services, while non-state employees are provided for through the Mexican Institute of Social Security. Employees of the navy, armed forces and oil industry all have their own arrangements. For those that are unemployed or are in poverty, healthcare is provided for through Sistema de Protección Social en Salud (Seguro Popular). Serguro Popular was introduced as a step towards ensuring Universal Health Coverage in Mexico and currently covers approximately 42.2% of the population. Those covered receive selected healthcare treatments free at the point of service. The poorest Mexicans do not have to contribute to the scheme while those with an income pay a small fee based on earnings. Still, however, out of pocket payments remain high at 41% of total health expenditure.
One of the main drawbacks to the Mexican health system is the lack of continuity of care. If you are in one system you usually cannot use the facilities of another (with some exceptions). This means that if employment status changes during treatment individuals often must switch facilities.
Indicators
| Where is the country’s government in the journey towards defining ‘Obesity as a disease’? | Some progress |
| Where is the country’s healthcare provider in the journey towards defining ‘Obesity as a disease’? | Some progress |
| 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? | Yes |
| 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? | Yes |
| Are there any obesity-specific recommendations or guidelines published for children? | Yes |
| In practice, how is obesity treatment largely funded? | Out of pocket |
Summary of stakeholder feedback
In Mexico, obesity is said to be increasingly prioritised by the government, with slow shifts towards recognising it as a disease. This is partly due to the high and increasing prevalence and the impact this is having on the health system. Many healthcare professionals are said to consider obesity only as a risk factor for other diseases, with many considering it to be a problem of the individual. As a result, people living with obesity are routinely stigmatised within the health system.
Stakeholders reported that the typical cut off used for initiating treatment is BMI ≥ 30 Kg/m² but government funding tends to not be given for obesity itself but rather obesity-related co-morbidities. Treatment within the public system is therefore limited, with long waiting times between appointments, a lack of personalised treatment and low success rates. In the private system on the other hand, there tends to be more successful weight loss and more treatment options (e.g. psychological and behavioural treatments). Unfortunately, this treatment in the private system is usually paid for out of pocket because of the lack of insurance coverage for obesity treatment. Obesity treatment in Mexico is therefore inaccessible for many and only those that have comorbidities enter the system in the first place.
It was noted that although Mexico has clinical guidelines and a national obesity strategy, both are not fully implemented. Stakeholders felt that the obesity strategy does not go far enough and so despite the prevention campaigns and the introduction of taxes, obesity rates are still rising, particularly in rural areas and among children.
Stakeholders also agreed that appropriate specialist obesity training is limited in Mexico. As a result, there are limited obesity specialists in urban areas, with virtually none in rural areas. This situation is worsened by private hospitals promoting ‘bariatric tourism’ that results in qualified bariatric surgeons focussing on treating overseas visitors.
Innovative technologies to connect rural populations to primary health care centres have been trialled in Mexico but success has been limited by lack of internet access in these areas. Other applications are said to have limited uptake.l
Based on interviews/survey returns from 20 stakeholders
Last updated: June 2020
