Big is not better

WHILE the World Health Organisation has classified obesity as a chronic condition and considers it an epidemic, many people still do not take it seriously.

Obesity is one of the biggest public health challenges in Malaysia, which has the highest rates of adult obesity in Southeast Asia. As reported in the 2019 National Health and Morbidity Survey, 50.1 per cent of the adult population in Malaysia is overweight (30.4 per cent ) or obese (19.7 per cent).

Obesity is linked to more than 200 chronic diseases, including cardiovascular diseases, diabetes, musculoskeletal disorders and cancers and increases the risk of type 2 diabetes by sevenfold in men and 12-fold in women..

The Covid-19 pandemic has also highlighted that people with obesity have an increased risk of developing severe illness.

Obesity not only impacts the health of individuals and communities but also has far-reaching complications for healthcare systems and the economy.

As well as rising rates of adult obesity, the prevalence of childhood obesity is also alarming in Malaysia, with 29.8 per cent of children aged 5 to 17 years being overweight (15.0 per cent) or obese (14.8 per cent).

This has far-reaching health and economic consequences for children, their communities, as well as health systems at large, due to the higher likelihood of developing chronic conditions, such as cardiovascular disease and diabetes in childhood and also in later life.

Additionally, there are negative social and developmental impacts for children living with obesity, such as poorer school performance and lower self-esteem due to bullying.

The current clinical management of obesity in Malaysia is insufficient to tackle the multifaceted nature of obesity, explains Universiti Teknologi Mara professor of medicine and consultant endocrinologist, Dr Rohana Abdul Ghani.

Dr Rohana , who is also the chairperson of the Obesity Policy Engagement Network in Malaysia (MY OPEN), says when people with obesity take the necessary steps to access care, they are offered a four-step cycle of therapy, which includes diet and exercise, medication, non-invasive treatment and surgery.

However, there are a limited number of public hospitals that offer such obesity-related services, and as a result, patients in many communities lack the integrated care needed to manage obesity and must access different touchpoints, prolonging their access to effective care.

Addressing obesity is a delicate and daunting task. It is a topic that almost everyone knows of and recognises, but many are more comfortable either denying or ignoring it.

At the policy level, numerous important and necessary steps have been developed to acknowledge the shared responsibility needed to address nutrition.

This includes the introduction of the sugar tax in 2019 and developing the National Nutrition Policy 2.0 in 2021 to proactively combat the future rise in malnutrition and obesity, as well as non-communicable diseases linked to nutrition, such as diabetes and high blood pressure from a young age.


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