Cost of Obesity Set to Rise with Increasing Incidence in Southeast Asia

Today, with between 20 and 35 per cent of adults in Southeast Asia 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 the region, according to a report released recently by the Economist Intelligence Unit (EIU).

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 regional health authorities to tackle the problem of obesity so as to avoid strains on healthcare systems.

Impact and economic cost of obesity

With incidence of obesity and overweight increasing rapidly in Southeast Asia – the EIU report presents evidence to show that obesity rates increased by an average of 28 per cent between 2010 and 2014 – direct and indirect costs associated with obesity can amount to as much as US$10 billion in the six countries covered in the report. This is due to a spike in related non-communicable diseases (NCDs) like type 2 diabetes, cancer, cardiovascular diseases and stroke, as well as loss of productivity arising from illness, poor health and absenteeism.

Among the six countries studied, 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$1-2 billion and US$2-4 billion 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$0.4-1 billion. The rates are lowest in Vietnam, at around 1–3 per cent, and in Thailand, 3–6 per cent of national healthcare spending.

Image credit: EIU

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.

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 women, unlike in the rest of the region where the report’s evidence shows that 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 cent, 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.

Effective interventions

“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 study. 

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.”

Among the more effective interventions highlighted in the report, low glycaemic index, 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.

As for the lack of exercise, the report suggests 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 Health. 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, such as 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.

With the main aim of this report being to act as a guide for policymakers, health organisations and the industry as they tackle the rising threat of obesity in the region, ARoFIIN is actively promoting the report in the region and meeting with industry, policymakers, academics and non-governmental and inter-governmental organisations to discuss how the report’s findings, especially the recommendations around interventions, can be applied in the region.

The EIU suggests that although developing countries in ASEAN have other challenges to overcome, the long-term economic cost of obesity and its connection to several NCDs, are signs that acting early would be prudent.

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