• Reduces productive (working) life by four to nine years
• Healthcare systems in Southeast Asia under threat as people get fatter faster
Incidence of obesity and overweight is increasing rapidly in Southeast Asia1. Today, with between 20 to 35 per cent of adults overweight, obesity is reducing productive (working) life by an average of four to nine years, while the total (direct and indirect) costs of obesity can amount to as much as US$10billion in Southeast Asia, according to a report released by the Economist Intelligence Unit.
Commissioned by the Asia Roundtable on Food Innovation for Improved Nutrition (ARoFIIN) – a public-private initiative convened in January 2015 by the Health Promotion Board (HPB), Agency for Science, Technology and Research (A*STAR), Singapore Institute for Clinical Sciences (SICS) and Food Industry Asia (FIA) to tackle obesity and chronic diseases and produced by The Economist Intelligence Unit (EIU), the report is the first to carry out a detailed analysis on the economic impact of obesity in ASEAN. Titled “Tackling obesity in ASEAN – Prevalence, impact, and guidance on interventions”, the report calls for more concerted efforts by health authorities to tackle the problem of obesity so as to avoid strains on healthcare systems.
Impact and economic cost of obesity
Direct and indirect costs associated with obesity can amount to as much as US$10billion in the six countries covered in the report. This is due to a spike in related non-communicable diseases like type 2 diabetes, cancer, cardiovascular diseases and stroke, as well as loss of productivity arising from illness and poor health.
Among the six countries, Malaysia and Indonesia are experiencing the highest overall costs of obesity in 2016, equivalent to between 10 per cent and 19 per cent, and 8 per cent and 16 per cent of national healthcare spending, or US$1-2billion and US$2-4billion respectively. Singapore incurs the third highest costs (direct and indirect costs arising from obesity) equivalent to between 3 per cent and 10 per cent of national healthcare spending, or US$0.4-1billion.
The report also reveals that problems associated with obesity are resulting in the loss of four to nine years of productive (working) life on average, due to absenteeism/presenteeism-related productivity losses and early death or early retirement ahead of the legal retirement age.
“Data on obesity prevalence in the region is uneven and often absent across the ASEAN region. This constrains policy-making, which can in turn lead to certain untargeted programmes or 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 EIU’s Global Chief Economist, Dr Simon Baptist, who led the report.
The report shows that obesity rates vary widely, depending on ethnic, genetic, regional and economic differences, and underscores the need for carefully tailored obesity prevention strategies, rather than a one-size-fits-all approach. Dr Baptist added, “Taking time to identify at-risk communities can enable the development of smarter policies and more targeted interventions.”
Understanding the overweight prevalence
In Singapore, the proportion of people who are overweight – at 32.8 per cent according to World Health Organization (WHO) data – is the second-highest in ASEAN after Malaysia (38.5 per cent). This is despite proactive measures taken by the respective health authorities to stem the problem. Singapore men are more likely to have a weight problem compared to ladies, unlike in the rest of the region where more women need to trim down.
As for the proportion that is seriously overweight or obese, Singapore comes in third among the ASEAN countries surveyed with 6.2 per cent2, behind Malaysia (13.3 per cent) and Thailand (8.5 per cent).
Higher income levels in Singapore and Malaysia are believed to have a knock-on effect on obesity as increased incomes result in greater food consumption. As for Thailand, a key obesity driver is the increased availability of calorie-dense, nutrient-poor food, as well as the tendency to overfeed children.
Among the more effective interventions highlighted in the report, low glycaemic index3, low-calorie, low-fat and low-carbohydrate diets, as well as regular exercise, have shown to be the most promising in reducing obesity at both the individual and population levels. The study also points to evidence that an intervention which targets both food and exercise is even more effective than individual interventions. These interventions can be further strengthened via greater collaboration between industry and government in areas such as in food product innovation.
In Singapore for example, the government has set aside funds from its S$4.5billion Industry Transformation Programme to help the food industry. One key area explored by the research is to help businesses develop safer, higher quality food products that are lower in obesogenic ingredients like sugar and saturated fats4.
Outside of Singapore, some firms in Vietnam, Indonesia and the Philippines have collaborated with the local governments to raise awareness and promote behavioural changes towards healthy lifestyles. The programmes have led to stronger demand for wiser food choices, fostering a stronger partnership between the public healthcare and private sectors in developing healthier products.
As for the lack of exercise, the report suggested that local governments should identify specific problem areas where they can step in with initiatives to increase the level of physical activity. For example, Thailand’s Department of Health recently announced plans to extend its physical health campaign to thousands of schools nationwide to combat the rising obesity rate among schoolchildren, which has increased from 12.5 per cent to 13.1 per cent in the last year, according to the Policy and Strategy Bureau of the Ministry of Public Health5. Indonesia introduced bike lanes in some provinces, while Singapore has rolled out a series of population-based physical activity challenges to tackle this issue.
The way forward
Dr Baptist noted that ASEAN policymakers often have a “blind spot” toward obesity, as some are still battling what they regard as more pressing issues like malnutrition and food shortages. As a result, some countries are not prioritising obesity as a public health issue. Meanwhile, the average person has little awareness about the associated dangers, including the long-term cost of obesity and its connection to diseases like cancer.
“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. Tackling obesity can help to free up resources in national healthcare systems and channel them to other areas that deserve attention,” added Dr Baptist.
1 Covers six Southeast Asia countries, namely Singapore, Malaysia, Indonesia, Thailand, the Philippines and Vietnam.
2 Update National Health Survey 2010 has found this prevalence to be higher at 10.8%
3 The Glycaemic Index (GI) is a ranking of food based on the ability to raise blood glucose level when 50 g of carbohydrate from that food is eaten. They are ranked low, moderate or high GI food based on the results. Low GI food raises blood glucose level slower than high GI food. However low GI does not mean that the particular food is nutritious.
4 Lin, M. (2016, May 2). Nutrition centre gives SMEs food for thought. The Straits Times. Retrieved from http://www.straitstimes.com/singapore/nutrition-centre-gives-smes-food-for-thought
5 Thailand’s department of health to extend physical health campaign to school children (2017, February 2). Chiangrai Times. Retrieved from http://www.chiangraitimes.com/thailands-department-of-health-to-extend-physical-health-campaign-to-school-children.html