WORLD Obesity Day was marked on March 4. It is a day that is dedicated to addressing the global obesity epidemic, raising awareness of the fact that obesity is a disease, and encouraging advocacy.
Malaysia has the highest prevalence of obesity among adults in South-East Asia. In the 2019 National Health and Morbidity Survey, 50.1% of our adult population was reported to be overweight (30.4%) or obese (19.7%).
Obesity is a risk factor for noncommunicable diseases (NCDs) like type 2 diabetes, cardiovascular disease and cancers such as breast, large intestine, pancreas and kidney cancers. Compared with individuals of normal weight, obesity increases the risk of getting type 2 diabetes sevenfold in men and 12-fold in women.
An obese individual has an 81% higher risk of developing heart disease and 64% higher risk of getting a stroke. In addition, Asian populations are predisposed to type 2 diabetes and cardiovascular diseases at lower than usual body mass index.
Besides that, the economic costs of these diseases are enormous. The conservative estimate of diabetes and cardiovascular disease was RM70.1bill in 2017, equivalent to 5.1% of Malaysia’s gross domestic product that year.
A local study found that 30% of Malaysians with type 2 diabetes are clinically obese. Diabetes patients need to achieve as many ABC treatment goals as possible to prevent complications like cardiovascular disease, kidney disease, and foot complications. (A for A1C that reflects blood sugar control over three months, B for blood pressure, and C for low levels of LDL-cholesterol, or bad cholesterol).
Diabetes patients who are obese are 1.5 times less likely to achieve ABC goals than non-obese patients. Weight reduction is a great strategy for overweight and obese patients to improve blood sugar levels and blood pressure and cholesterol control. That’s killing three birds with one stone.
Worldwide evidence shows that diabetes is happening at younger ages, ie, below 40 years old. One of the main causes of this is rising obesity. Youth-onset diabetes is associated with a more aggressive form of the disease and higher risks of complications.
What is equally worrying is that a considerable number of female diabetes patients are still in reproductive ages. Poor blood sugar control during pregnancy is related to adverse outcomes for both mothers and babies. Moreover, the children born to these mothers are at higher risks of childhood obesity and youth-onset diabetes later on in life. This will perpetuate the high diabetes prevalence in Malaysia.
The rising prevalence of obesity, coupled with the substantial economic costs of its associated diseases means that the situation will worsen if the obesity epidemic is not urgently tackled.
What can we do to optimise our weight?
> Have a healthy plate according to the “suku-suku-separuh” concept, or “quarter-quarter-half”. That is, a quarter plate of grains or grain products, preferably whole grains; a quarter plate fish, poultry, meat, or egg; and half a plate of fruits and vegetables.
> Exercise regularly. Adults should aim to have 150 minutes of moderate-intensity physical activity a week, such as brisk walking, cycling with light effort and recreational badminton.
> Remember, obesity is not just about physical appearance. It is a disease that could give rise to other NCDs.
PROF DR MOY FOONG MING, PROF DR NORAN NAQIAH HAIRI & DR WAN KIM SUI
Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya