Heavyweight challenges ahead as obesity rises in Asean

Consumers across Southeast Asia should think twice before gulping down their meals as experts are warning that the growing rate of obesity in regional economies could push up the costs of healthcare for everyone.

According to a report by The Economist Intelligence Unit (EIU), Malaysia had the highest increase in obese adults in the region in 2014, while Vietnam ranked first in the number of obese people between 2010 and 2014. Commissioned by the Asia Roundtable on Food Innovation for Improved Nutrition (ARoFIIN) and produced by the EIU, the report is the first to carry out a detailed analysis of the economic impact of obesity in Asean.

Entitled “Tackling Obesity in Asean — Prevalence, Impact and Guidance on Interventions”, the report calls for more concerted efforts by health authorities to deal with obesity in order to avoid strains on healthcare systems.

Among the six Asean countries — Indonesia, Malaysia, the Philippines, Singapore, Thailand and Vietnam — studied in the report, Malaysia had the highest percentage of obese adults at 13.3%, up from 10.5% four years earlier, based on World Health Organization (WHO) estimates. The increase in the number of obese Malaysians was 27% between 2010 and 2014.

“Some of Malaysia’s obesity drivers are common to many nations passing through a period of rapid economic change,” said the report, exemplifying how a rise in gross domestic product per capita from US$7,101 in 1980 to $23,267 in 2015 fuelled increased food consumption.

“Cultural factors are also pertinent. For instance, popular Malaysian foods include deep-fried snacks, dishes heavy in coconut oil and fatty foods.”

Thailand and Singapore ranked second and third for percentage of obese adults, at 8.5% and 6.2%, respectively. They were followed by Indonesia (5.7%), the Philippines (5.1%) and Vietnam (3.6%).

Body mass index (BMI) measures weight and height and is used to classify underweight, overweight and obesity in adults. But the report said this method is not an optimal measure for Asian populations because Asians have a more centralised body fat distribution compared with Europeans. Asians also experience associated morbidity and mortality at a lower BMI than Caucasians, it added.

Despite registering the lowest percentage of obese adults in 2014, Vietnam recorded the highest increase in the number of obese people at 38% between 2010 and 2014. This was followed by Indonesia (33%), Thailand (27%), Malaysia (27%), the Philippines (24%) and Singapore (24%).

“A study of adolescents in Vietnam’s largest city, Ho Chi Minh, revealed that boys were also more likely to be overweight or obese than girls, with those from the wealthiest households most likely to be affected,” said the report.

Total costs, both direct and indirect, of obesity are the highest in Malaysia, where it is estimated they are equivalent between 10% and 19% of national healthcare spending. Indonesia’s obesity costs are nearly as high, ranging from 8% to 16% of healthcare spending. Obesity costs are lowest in Vietnam (1-3%) and Thailand (3-6%).

“Changing diet and lifestyles are the key to tackling obesity,” said Bruno Kistner, the secretary of ARoFIIN. “We need to increase public awareness of dietary guidelines and the importance of exercise.”

Among the more effective interventions highlighted in the report, low-glycaemic index, low-calorie, low-fat, and low-carbohydrate diets, together with regular exercise, have shown the potential to combat obesity at both the individual and population levels.

“There is no magic formula to solving the growing obesity epidemic in Asia. Governments in the region need to realise that obesity will be one of the major healthcare challenges we could face over the next two to three decades,” said Mr Kistner.

“Every sector has a role to play. There must be proper undertakings among industry, government and civil society — real progress can only be made by constructive, transparent and accountable engagement with all stakeholders.”

Taxation could potentially make a difference, with examples from multiple countries outside Asean pointing toward decreasing consumption as a result of taxes, said the report.

But education campaigns should not be dismissed. There are widespread misconceptions about obesity among Asean populations, including a lack of understanding of its origins and consequences, said the report. There are also cultural challenges, including the presence of unhealthy ingredients in national dishes and social norms that consider fat a sign of health in children.

“Simple educational campaigns and more effective food labelling can help to tackle complacency and promote healthier choices,” the report said.

EIU chief economist Simon Baptist noted that data on obesity prevalence was uneven and often absent across Asean. This constrains policymaking, which can in turn lead to certain untargeted programmes or uninformed interventions.

“This study is the first time such a detailed analysis on the impact of obesity has been carried out. We hope it will help deepen the understanding of Southeast Asia’s obesity threat,” said Dr Baptist.

“This report aims to be a guide for policymakers, health organisations and the industry as they tackle the rising threat of obesity in the region together.

“Taking time to identify at-risk communities can enable the development of informed policies and more targeted interventions, and tackling obesity can help free up resources in national healthcare systems and channel them to other areas that deserve attention.”

“There is no magic formula to solving the growing obesity epidemic in Asia. Governments in the region need to realise that obesity will be one of the major healthcare challenges we could face over the next two to three decades” BRUNO KISTNER Asia Roundtable on Food Innovation for Improved Nutrition