Obesity is a mounting public health challenge that has grown into worldwide epidemics.

It is estimated that almost one-third of the adults worldwide will be overweight and more than one billion will be obese by 2025.

In Malaysia, based on the National Health and Morbidity Survey 2019, one in every two adults is overweight or obese.

The Economist Intelligence Unit reported in 2017 that Malaysia suffers the highest overall cost for obesity among other ASEAN countries, reaching an alarming 10 to 20 per cent of the country’s healthcare expenditure.

These overall costs include treatment, loss of economic output and the loss of years of productive life due to obesity-related mortality.

Evidences show that obesity is a risk factor for many non-communicable diseases and now a major risk factor in COVID-19 complications and mortality.

From the preliminary results of our study among 3,221 working female adults, half of them were overweight (31.7 per cent) and obese (18.5 per cent).

 The five most important risk factors for overweight/obesity are inadequate fruits and vegetable intake (90.4%), anxiety (51.4%), physically inactivity (30.3%), depression (26.6%) and stress (18.3%).

About one-third of them have three or more risk factors (34.7 per cent), followed by one (32.6 per cent) and two risk factors (28.7 per cent).

The total number of risk factors was significantly associated with the risk of being overweight and obese.

Because of the complexities in the obesity root causes, its prevention and intervention efforts should no longer be simplistic, nor only target at individual actions and center on the ‘eat less, move more’ mantra.

Concerted efforts should be targeted at wider societal and governmental determinants.

Align with the World Obesity Day’s theme “Everybody needs to act” which will be celebrated on March 4, 2022, it is now the time to declare the obesity fight as everybody’s fight.

Everybody has his part to play. The following recommendations involving a top-down collaboration from the government, policymakers, employers, municipals and individuals in the interpersonal and intrapersonal levels are suggested: 

1. Government and policymakers: Reaffirm their commitment to addressing obesity as a matter of urgency through the implementation of comprehensive national strategies that tackle the structural roots of obesity.

Effective healthy lifestyle promotion should be disseminated thoroughly via all available media platforms. Public health policies and preventive intervention programs especially on the modifiable health-related behaviors should be made multi-domain, not only targeting one aspect but incorporating overall socio-behavioral aspects.

The preventive approaches should also be made population-based and multilevel, focus on environmental and policy change, and require participation from actors in multiple sectors.

Provisions must be made to ensure all interventions including health services, supportive environment as well as communities are easily accessible to the population.

2. Employers and municipals in the neighborhood: Employers are encouraged to provide a healthy working environment for employees to reduce the risk and impacts of obesity.

Municipals should improve the availability and accessibility of parks, greens, walking / jogging / cycling tracks etc that encourage healthier life practices among residents.

3. Interpersonal: Social support from family members, colleagues and neighbors in the form of encouraging each other to practice healthy lifestyles is very crucial. They should avoid stigmatization on people living with obesity.

This weight stigma and bias can lead to avoidance of seeking medical care which creates barriers to obesity prevention and treatment.

Improving awareness about obesity among the public and challenging the assumption that obesity is purely an issue of personal responsibility is paramount to successfully reducing stigma.

4. Intrapersonal: At the individual level, practicing a healthier lifestyle is the most effective way to combat overweight and obesity. Remember HELPS!

Halt smoking and alcohol consumption with expert guidance and assistance. Most Public Health Clinics provide Quit Smoking program. You can also register yourself through the Ministry of Health’s JomQuit program.

Eating a healthy diet as frequently as you can. Make sure your diet consists of a variety of fruits and vegetables, whole grains, low-fat dairy products, lean poultry and fish, nuts and legumes, and vegetable oils. There are several mobile diet apps that are available to help you keep track of your daily diet taken.

Love your mind as you love your soul. Practicing mindfulness, deep breathing, as well as relaxation exercises and therapies could provide a peaceful mind thus preventing unhealthy behaviors that can lead to weight gain. Feel free to seek help and treatment if you need so.

Physical exercise should be made at least 150 to 300 minutes of moderate-intensity aerobic activity throughout the week. Examples include brisk walking, cycling at moderate speeds, swimming, gardening or walking. Finding an activity that you enjoy most will motivate you to continue adhering to it.

Social connectivity may provide more sustainable lifestyle changes. Improve your connections in the community to build a supportive society and conducive environment to keep you motivated for healthier choices.

The only way we can make real progress in obesity prevention is by realizing that this is an issue for everybody. Together, we can give everybody the best chance to live happier, healthier and longer lives. 

(Dr Zakiah Othman, Professor Dr Moy Foong Ming and Datuk Professor Dr Awang Bulgiba Awang Mahmud, Centre for Epidemiology and Evidence-Based Practice Department of Social and Preventive Medicine Faculty of Medicine, Universiti Malaya.)