Prague, 29 May 2004 (RFE/RL) -- In the gymnasium of a Prague basic school, around 20 chunky women sweat through an aerobics class before being weighed to check on their weight-loss progress.
30-year-old Michal Macek is here with his wife. Together they have a combined weight of nearly 250 kilograms.
"I've been obese since childhood. I've made many attempts to lose weight, and that part has never really been a problem. The problem was always keeping the weight off. Within a year I always put it back on again. So we decided that we needed to do something more radical. This [course] should help. It's not just about slimming, it's about changing our lifestyle. It uses a psychological approach and teaches you that healthy food is tasty food and that you don't need to eat fried pork cutlets and fatty meat," Macek said.
Vojtech Hainer wishes more central Europeans were, like the Maceks, taking action about their weight.
The Czech obesity specialist is president-elect of the European Association for the Study of Obesity, which is wrapping up a four-day congress in Prague today.
Yesterday he chaired a special session on central and eastern Europe -- a region he says has the worst weight problem on the continent.
"[Obesity is] one of the most important health risks in this region, [as] in western Europe it's the second [biggest health risk] after smoking. The hazard of obesity will be increasing permanently if we don't try to introduce some steps to stop this epidemic," Hainer said.
Data is patchy, but in many of those countries more than half the population is overweight or obese. Typically, older people who live in rural areas are most likely to be too fat.
The Czech Republic, Romania, and the countries of the former Yugoslavia all scored high in recent obesity surveys.
Philip James heads the International Obesity Task Force. "It's because the whole of the agriculture, food policies for the last 50 years were geared to ideas which we introduced as scientists to the governments in the 1950s. [The idea was to] produce as much meat and fat and sugar as possible because we're all starving, [and] to allow the poor people to buy food that's cheap.... People have been stuffed with food for a very long time," James said.
"I've been obese since childhood. I've made many attempts to lose weight, and that part has never really been a problem. The problem was always keeping the weight off."
But the changes since the fall of communism have had an impact, too.
Hainer says people have got fatter in the wealthier countries, but also in the ones that have seen rising poverty.
"[There is the] social economic level, price rises in Russia, for example, where high-fat items are usually cheaper. But in this country it's combining the traditional Czech menu with new items like Mcdonalds and Coca Cola, so it's a combination of the effects of all these new products with our traditional products," Hainer said.
He says some people in the region are also getting fatter because they are traveling more by car and enjoying more sedentary lifestyles -- just like their counterparts in the west.
Other speakers -- from Macedonia to Russia to Lithuania -- also noted that their countries have less money to spend on obesity health care and fewer obesity specialists than in the west.
But they warned that overweight people are storing up problems for the future.
That's because they face increased risks of heart diseases, diabetes and some cancers -- and also risk dying earlier than slimmer people.
Gabriela Roman is a Romanian obesity specialist. "If now we have a problem with diabetes we will have more problems, 2.5-fold problems in a few years if we [do] not [do] anything," Roman said.
Obesity is measured by a mathematical formula -- based on height and weight -- known as the Body Mass Index.
Anyone with a Body Mass Index of over 25 is considered overweight -- over 30, obese.
There are now at least 300 million obese people in the world, as rates rise globally.
Last week the UN's World Health Organization (WHO), adopted an action plan to tackle the problem. The global strategy on diet, physical activity, and health calls on people to exercise more and cut down on fats, sugar, and salt, and urges governments to make it easier for people to eat more healthily.
Speakers at the Central and Eastern Europe session said concerned groups in the region should use the WHO meeting to press governments to put more money into obesity prevention and treatment.
And they also called for better cooperation between their countries and for proper, comparable data.