Obesity is a complex disease, not just a cosmetic concern about physical appearance.
Call for action plans to reduce rates of obesity and its associated complications
EVERYBODY Needs to Act – this is the theme of World Obesity Day (WOD) 2022 as concerned parties come together to call for change.
Among WOD’s missions are to increase awareness that obesity is not just a cosmetic concern about physical appearance but a complex disease that increases the risk of other health issues such as heart disease, type 2 diabetes and high blood pressure and specific cancers.
Obesity is one of the biggest public health challenges that the world faces today. In Malaysia, 50.1% of our adult population were reported to be overweight (30.4%) or obese (19.7%), according to the 2019 National Health and Morbidity Survey (2019 NHMS), while the prevalence of overweight and obesity among adolescents was 15% and 14.8% respectively.
“The numbers are alarming, with half of our Malaysian population being overweight and obese and one third of our children facing the same issue,” said Prof Dr Rohana Abdul Ghani, Consultant Endocrinologist of Faculty of Medicine at Universiti Teknologi Mara.
“To make change a reality, we need action. That said, it should not involve just the patients but society as a whole, including the family, community, policy makers and healthcare professionals to work together and address this chronic disease and educate people about the causes of obesity.”
During a virtual discussion session on WOD, Dr Rohana pointed out that obesity is not a new issue and there are many on-going initiatives.
“However, most of the initiatives are not yet structured and not guided to be patient-centric.
“Many initiatives are lecture-centric by just focusing on prevention – like what to eat and what exercise to do – but not guiding patients on how to overcome the challenges. For example, how to overcome cravings, poor eating habits, and if a patient has bilateral knee pain, he or she needs another form of exercise than the common jogging
“Another example is how patients misunderstand that fats come from fat, which led to cutting down fried food but eating more rice as a solution. That is totally wrong,” she added.
Joining the discussion was Assoc Prof Dr Barakatun Nisak, deputy dean of the Faculty of Medicine and Health Sciences, Universiti Putra Malaysia. She shared that the main cause of obesity observed, aside from non-modifiable factors like genetics, is lifestyle factor.
“The 2019 NHMS reported that 95% of Malaysian adults do not eat the recommended daily amount of fruits and vegetables despite this being important in weight management and disease prevention.
“According to the same report, 53.2% Malaysians use sugar daily in self-prepared drinks, followed by 4.2% in carbonated and non-carbonated drinks, and 6.7% in premixed drinks, with an average of 12 teaspoons of sugar intake daily in total, excluding hidden sugar from food intake.
“Also, one in four Malaysian adults are physically not active. The combination of inactivity, a diet rich in sugar as well as insufficient fruits and vegetables intake contributes hugely to weight gain in the country.
“The same survey indicated that only 24% of the population is aware and can describe the Suku-Suku Separuh plate portioning method correctly. Among the 24%, only a handful or 14% practise it daily. This proves that initiatives are being rolled out but the take up by people is not there yet,” added Dr Nisak.
While healthcare professionals play a crucial role in effective treatment and prevention of obesity, there are no structured programmes to equip these significant personnel with the knowledge and skills needed to support patients with obesity, stressed Dr Rohana.
“For instance, some diabetes medication can cause weight gain. Healthcare professionals should take this into consideration when prescribing to patients.
“With half the population being overweight and obese, it is seriously time to focus on managing the disease with a structured approach,” Dr Rohana said.
To this end, the Malaysia Obesity Policy Engagement Network (MY OPEN) was formed.
OPEN is a global platform for national public health, policy, patient representatives and other thought leaders in the field of obesity to come together to improve obesity care. MY OPEN is the local chapter of the network and is a long-term initiative to engage local stakeholders to come together to gain diverse perspectives on a common challenge.
Newly formed in 2022, MY OPEN aims to identify how healthcare providers, policy makers, patients, and those involved in health systems can collaborate to drive national action that enable health systems and society to put in place interventions which will effectively reduce rates of obesity and its associated complications through target action plans together.
MY OPEN has three focus areas – advocating the recognition of obesity as a disease; increasing awareness of obesity as a disease among healthcare providers and the public; and establishing local research and networks to connect with other OPEN initiative groups in the South-East Asian region.
“We look forward to working with relevant agencies and policy makers to make this change for a healthier nation.
“To the patients out there, it is your own initiative to start from within as you are the one putting food into your mouth. But do know that you are not alone as we are here to guide you.
“There are weight management centres in UPM, UiTM, UKM and Hospital Putrajaya, among others, and there are relevant weight reduction medications.
“But one thing to bear in mind; weight loss is not an easy process but we are here to make it as easy as possible with the correct guidance and structured programmes,” said Dr Rohana who is MY OPEN chairperson.
