Let’s fight this flab club!

I HAVE joined the flab company. According to a 2020 Health Ministry study, 54.2% of Malaysian adults are estimated to be overweight or obese. I am one of them.

If that’s not bad enough, that’s a 4% increase over the findings of the National Health and Morbidity Survey (NHMS) in 2019, which showed 50.1% of Malaysian adults were too heavy. Of this, 30.4% were categorised as overweight and 19.7% as obese.

“Overweight” and “obesity” are officially defined as abnormal or excessive fat accumulation that is a risk to health. You are overweight if your body mass index (BMI) is over 25, and you are obese if it is over 30. My health screening four months ago showed my BMI was 25.15.

Data from the 2020 study, however, is considered to be “a proxy for the prevalence of obesity” because we have to wait for the proper NHMS study in 2023, said Health Minister Khairy Jamaluddin in his written answer in Parliament on Nov 23.

The NHMS 2019 stats became news again last week when an MP asked Khairy to state the level of obesity in the country and actions taken to tackle the problem.

The timing was spot-on because Friday, March 4, was World Obesity Day. The day was first marked in 2015 under the auspices of the World Obesity Federation with the aim of “promoting practical solutions to end the global obesity crisis”.

Such is our world in the 21st century. Humans have become increasingly overweight because they have too much to eat, or rather eating too much of the wrong things, and are too sedentary. An estimated 800 million people around the world are living with obesity.

The past two years have only made putting on weight even easier. We were forced to stay at home, become couch potatoes and order lots of takeaway food. We spent the most energy fiddling with our mobile phones.

When the movement control order was in full force, we couldn’t even go for walks or exercise in gyms or parks. And once you stop exercising, it’s so easy to remain lazy.

But our weighty problem didn’t start with the pandemic. In June 2014, the BBC reported a study by British medical journal The Lancet that found Malaysia to be the most obese country in Asia with almost half the population overweight. Now we are clearly over 50%.

The first NHMS was carried out by the Health Ministry in 2011, but it was the 2015 survey that caught my attention; it showed Putrajaya had the highest rate of overweight and obese citizens in the country.

In my April 6, 2016 column, titled “Supersized and overweight”, I pointed out this was extremely alarming because it’s a known fact that Putrajaya is populated overwhelmingly by government employees who are likely to have lifestyle diseases associated with obesity.

Neither the 2019 survey nor the Health Ministry’s 2020 study has updated the Putrajaya weight status. That’s unfortunate because I think we citizens, especially taxpaying ones, have the right to know.

In 2016, we already had a bloated public sector. At that time there were 1.4 million employees, the largest civil service in South-East Asia. Today, we have 1.6 million public servants.

Congress of Unions of Employees in the Public and Civil Services (Cuepacs) president (Datuk) Adnan Mat maintains that this size is still ideal and argues the actual number is only 600,000 people if we exclude the armed forces, police, education and health personnel in the definition of the public sector.

To me, that’s splitting hairs because most people in these sectors also enjoy free medical benefits post-retirement.

That’s where it becomes really concerning. This is because more than 60% of the Federal Government’s annual revenue goes towards paying emoluments, pensions and debt service charges. What we don’t know – at least I wasn’t able to find any information on it – is how much the government spends on the medical bills of civil servants and pensioners. (Can an MP please ask in Parliament?)

Let me reiterate what I said in 2016: I do not begrudge civil servants getting free medical services in government hospitals and clinics even after retirement. My late father, who was a police officer, was a beneficiary of this benefit, which is also bestowed on his widow, my mother.

Yet, I can foresee what a tremendous burden it will be in the years to come. We already have 850,000 government pensioners, a number that will continue to grow, and if many of them are unhealthy, taxpayers, present and future, will have to foot the cost of their healthcare.

Six years ago, doctors like then Malaysian Medical Association president Dr Ashok Zachariah Philip warned of a health budget that would be at an unsustainable level because, 20 years from now, if not sooner, those overweight and obese citizens will be suffering from diseases such as stroke, heart disease, kidney failure and type 2 diabetes.

Thanks to modern medicines and treatments for many of these lifestyle diseases like type 2 diabetes, they will be able to live for a very long time.

It is also well established that obese people are twice as likely to be hospitalised if they contract Covid-19.

I have always been conscious of staying healthy way before I hit retirement. But age is catching up with me. In 2016, I was medication-free. Not anymore, I am now on blood pressure and cholesterol pills. My metabolic rate has slowed, so despite eating less, I have gained weight.

Admittedly, a large part of this is because I became more sedentary, too. Still, I think I am holding up well. I have very good stamina, better than my young adult children. And I am determined not to develop type 2 diabetes, so I have reduced my carbohydrate and sugar intake despite having a sweet tooth. My favourite beverage is plain water, and I eat lots of vegetables and take supplements for bone and heart health.

I do all I can to stay healthy because I have to bear my own medical expenses. Apart from my health insurance, I have no safety net.

If a private sector retiree can do all this, then civil servants can and must do the same. They must not take for granted their generous health benefit nor consider it their right. It is a privilege and they have a responsibility to stay healthy.

That’s why I want to repeat my call to the government: Make it mandatory for civil servants to lose weight and stay healthy. This is especially so for those who have yet to develop serious illnesses like diabetes. If need be, withhold promotions and salary increases if they don’t meet this KPI.

If the government can whip its workforce into shape, it can also provide incentives for non-public sector citizens to lose weight, too. Be creative about it, like rewarding employers with tax incentives if they help their staff lose weight and maintain healthy lifestyles.

In fact, companies could also include health KPIs since they want to keep their medical insurance payouts low. If we can treat Covid-19 with such ferocity, we can do the same for obesity.

Already, one in five Malaysians has diabetes and if we do nothing, the World Obesity Federation warns that the medical consequences of obesity will cost over US$1 trillion by 2025 and childhood obesity will increase by 60% over the next decade, reaching 250 million by 2030. That’s an awfully bleak future, isn’t it?

The views expressed here are the writer’s own.