Obesity strains Asian healthcare systems

Obesity is rising fast in most parts of Asia, putting strain on healthcare systems and government budgets, according to a new study from Fitch Solutions Macro Research.

At the same time the United Nations is reporting that an estimated 820 million people do not have enough to eat, from 811 million last year – the third year in a row the number increased.

According to the Fitch study, Vietnam had the biggest increase in the number of obese people – those with a body mass index above 25 – in the five years through 2014, at 38%, followed by Indonesia at 33%.

However, as a proportion of the population, Vietnam still had the lowest share of the obese at 3.6%, far behind Malaysia’s 13.3% and compared with Indonesia’s 5.7%.

“The improving economic standards in the region have brought about lifestyle changes, which in turn have led to a shift to unhealthier diets,” according to the Fitch report.

The health risks of rising obesity result in mounting healthcare costs for treatment of chronic diseases including diabetes and heart disease, the Fitch analysts said.

Malaysia has the highest costs as a result of high obesity, making up as much as a 20% share of overall of healthcare spending, they estimate.

The report does not outline the steps taken since 2014 to combat obesity in South-East Asia.

Malaysia, for one, imposed an excise tax on packaged sweetened beverages, from fruit juices to soft drinks, starting July 1.

The levy excludes drinks prepared and served at restaurants as well as instant mixes.

Elsewhere in Asia, South Korea had a 38% increase in obese people in the five-year period, putting them at 5.8% of the population.

In the United States, the number of the obese rose 8% to 33.7% of the population.

The jump in obesity in many countries through 2014 caps a longer-term trend in Asia-Pacific from 1990, when 34.6% of adults were overweight or obese.

By 2013, that tally had risen to 40.9%, the data show.

The Philippines looked quite trim compared to its peers: Just 5.1% of the population was obese in 2014, with a growth rate of 6% from 2010 through 2014.

The number of obese adults in India has risen by a fourth in four years, from 24.1 million in 2012 to 32.8 million in 2016, while the country’s undernourished population has dropped by roughly the same fraction in 12 years, from 253.9 million in 2004-06 to 194.4 million in 2016-18, according to a new United Nations report.

The National Health Commission of China said 30.1% of Chinese adults were overweight in 2012, up by almost a third from 2002, and 11.9% were obese, up by just over two-thirds.

Among young people between the ages of six and 17, 9.6% were overweight, double the ratio in 2002, and 6.4% were obese, triple the ratio in 2002.

High dietary-induced obesity levels in Asia Pacific will incur significant downstream costs for healthcare systems, Fitch said.

Governments are generally expected to be increasingly involved in battling obesity, but this may vary on a country-by-country basis.

Obesity trends and expanding healthcare systems will also provide ample opportunities for generic drug makers.

A shift in lifestyle will remain responsible for rising Asia Pacific obesity levels. The improving economic standards in the region have brought about lifestyle changes, which in turn have led to a shift to unhealthier diets.

Food of low nutritional value is more easily and widely available due to its low cost and the introduction and adoption of Western dietary habits. These changes, coupled with a lack of physical exercise, have led to growing obesity levels in the region, both in children and adults. The number of obese children in Asia Pacific rose 38% between 2000 and 2016, with almost 50% of obese children under five years of age across the world living in Asia.

The percentage of overweight people in China and Bangladesh more than doubled from 1990 to 2013, from 13.2% to 27.9%, and 8.0% to 16.9%, respectively. The lowest rates are observed in South East Asia, with around 26.3% of residents being overweight.

Downstream costs from high obesity levels place strains on healthcare budgets. The association between excess weight and chronic diseases such as diabetes, cancer, hypertension and heart disease is well recognised, with risks of coronary heart disease, ischemic stroke and Type 2 diabetes increase steadily with increasing BMI.

This has resulted in growing direct and indirect costs to healthcare systems of the Asia Pacific region, which among others include medication and hospitalization costs. Malaysia has the highest costs as a result of high obesity levels, followed by Indonesia. Loss of productivity as a result of obesity has also been a growing concern, particularly in countries with less-developed economies.

The UN meanwhile said; ““The number of people who suffer from hunger has slowly increased over the past three years, with about one in every nine people globally suffering from hunger today.”

In Asia, undernourishment affects 11 percent of the population. Although southern Asia saw great progress over the last five years at almost 15 percent, it is still the sub-region with the highest prevalence of undernourishment.

This year’s edition of the report takes a broader look at the impact of food insecurity beyond hunger.

It shows that 17.2 percent of the world’s population, or 1.3 billion people, lacked regular access to “nutritious and sufficient food.”

The combination of moderate and severe levels of food insecurity brings the estimate to about two billion people, where in every continent, women are slightly more food insecure than men.

The report said overweight and obesity continue to increase throughout all regions, particularly among school-age children and adults. Economic slowdowns or downturns disproportionally undermine food security and nutrition where inequalities are greater.

“Income inequality increases the likelihood of severe food insecurity, and this effect is 20 percent higher for low-income countries compared with middle-income countries,” the report said.

– Agencies