Lifestyle diseases must be tackled holistically to reverse the trend of rising obesity in Southeast Asia, writes Krishna Reddy.

The rising tide of obesity in both adults and children across Southeast Asia is not just a public health crisis – it’s a ticking time bomb.

It is closely linked to an escalating burden of other interconnected and life-limiting conditions such as cardiovascular, renal and metabolic (CRM) diseases in the region.

The World Health Organization (WHO) recently sounded the alarm on the rapid increase of obesity in Southeast Asia, where one out of every five adults is overweight or obese.

The growing problem is not only contributing to an increase in chronic diseases, but it puts immense strain on healthcare systems, economies and individuals.

For the countries in the region to tackle this issue head-on, they need to recognise the interconnected nature of obesity with other serious health conditions and adopt a more holistic approach to care.

The WHO defines overweight and obesity as excessive fat accumulation that can impair health. A body mass index of 25 or more is considered overweight, while 30 or more is obese.

Obesity is a major risk factor for some of the most life-threatening and debilitating diseases, including cardiovascular disease, diabetes and chronic kidney disease.

Worryingly, rates of overweight and obesity are growing in both adults and children, globally and in Southeast Asia. The region bears nearly one-third of the global cardiovascular disease burden and nearly a fifth of people with diabetes worldwide.

Countries like Malaysia are already facing the consequences, with cardiovascular disease responsible for a third of all deaths in 2022. Chronic kidney disease and diabetes are similarly widespread, with kidney disease affecting about 17 per cent of adults in Thailand in 2020 and diabetes affecting 7.5 per cent of adults in the Philippines in 2021.

Financial strain

This interconnected nature of obesity and CRM diseases has profound implications for the region’s healthcare systems. Each disease individually places a heavy burden on resources. But when they occur together, the financial cost multiplies.

In Southeast Asia, Malaysia and Indonesia, face the highest costs of obesity relative to healthcare spending. In Malaysia, obesity costs account for up to 19 per cent of national healthcare expenditure, while in Indonesia, it can reach up to 16 per cent. These costs are unsustainable, especially given the region’s rapidly ageing population and already limited healthcare infrastructure.

We also need to factor in lost productivity and economic strain. For many Southeast Asian countries, the growing incidence of CRM diseases linked to obesity is draining national healthcare resources.

Healthcare systems are already overwhelmed by the increasing number of people in need of long-term care, often for conditions that could have been prevented with earlier intervention and proper management.

Additionally, as many people suffer from multiple chronic conditions, the complexity of care intensifies. This places a heavy burden on healthcare workers and institutions, which are not equipped to handle the intertwined nature of these diseases.

Meanwhile, the financial burden on individuals and families can be tremendous, with many facing high out-of-pocket costs for medications, treatments and hospitalisations.

Globally, the total economic cost of CRM diseases combined is estimated to be around US$2 trillion a year.

Care coordination

So, there is an urgent need to rethink how we approach obesity and related diseases to alter the growth curve.

Too often, healthcare systems treat each disease in isolation, resulting in a fragmented approach and delayed diagnosis and treatment.

What is needed is a more integrated, patient-centric approach that views the individual holistically and acknowledges the interconnectedness of obesity and CRM diseases. How can this be achieved?

Firstly, countries must adopt multi-disciplinary care pathways, where a team of specialists from various fields work together to manage patients’ overall health.

This approach should prioritise early screening for all interconnected diseases. This is key to preventing further complications, improving patient outcomes and quality of life, and reducing the long-term financial burden.

There is a need to establish national initiatives to prioritise obesity and implement standards of care in obesity management.

Secondly, models of care continuum must be redesigned for CRM diseases. Standards-based integrated national health information systems should be leveraged to achieve the needed care coordination and monitor growth rates and premature deaths.

Thirdly, a “health in all policies” approach that implements strong, interconnected multi-sectoral policy changes is required to maximise policy impact.

Policies aimed at innovating financing and value-based purchasing solutions are needed to ensure equitable access to innovations addressing obesity and related conditions, which are yielding new, proven therapeutic solutions.

Greater public education is also needed across Southeast Asia, where patients are often unaware of the profound impact obesity can have on their health and how diet and lifestyle changes can transform outcomes.

Awareness campaigns and health promotion activities, paired with proactive screening for at-risk populations, can go a long way in preventing the progression of obesity and associated conditions.

Wake-up call

The growing obesity epidemic in Southeast Asia has far-reaching implications for public health, healthcare systems, and economies. It is the root cause of a range of deadly and costly diseases and because these conditions do not exist in isolation, neither should their treatment.The WHO’s call for action should serve as a wake-up call for governments, healthcare providers, and individuals alike. The cost of inaction is too great, both in terms of lives lost and economic damage.

Tackling obesity, and its broader health consequences, requires systemic changes, greater awareness, and a unified approach to healthcare. The time to act is now, before the burden becomes even more unmanageable.

Krishna Reddy is a board-certified cardiologist with over 35 years of experience in healthcare and the chief executive officer of ACCESS Health International, a non-profit think tank.

This piece was produced by SciDev.Net’s Asia & Pacific desk.