OPEN MY: Recognize obesity as disease, not lifestyle disorder

Obesity must be treated as a chronic disease, not just a self-inflicted lifestyle disorder, to effectively tackle the rising burden thereof, says an international advocacy group.

“While the WHO has classified obesity as a chronic condition and considers it an epidemic, many people still do not consider it as a disease and many more do not take it seriously,” said representatives from the Obesity Policy Engagement Network in Malaysia (MY OPEN).

In a statement released in conjunction with World Obesity Day 2022—themed “Everybody Needs to Act”—MY OPEN urged for greater action and engagements between all levels of society for the monumental effort required to “tackle rising rates of obesity, reduce the stigma faced by people living with obesity, and improve the systems that contribute to obesity around the world.”

Malaysia has the highest rate of obesity among Southeast Asian countries, with an estimated 19.7 percent of the general population being obese, according to data from the 2019 National Health and Morbidity Survey (NHMS). The same report also found that childhood obesity affects 14.8 percent of Malaysian children aged 5 to 17 years. [Available at: https://iku.gov.my/images/IKU/Document/REPORT/NHMS2019/Report_NHMS2019-NCD_v2.pdf]

MY OPEN acknowledged positive steps taken in obesity prevention through national policy in recent years, such as the 2019 sugar tax introduction, and the 2021 National Nutrition Policy 2.0. However, they claimed that shortfalls remain in the care and management for people with obesity, and healthcare delivery issues remain to be addressed.

Professor Dr Rohana Abdul Ghani, MY OPEN chairperson, commented that current clinical management practices in the country are insufficient to tackle obesity’s multifaceted nature.

“When people with obesity take the necessary steps to access care, they are offered a four-step cycle of therapy, which includes diet and exercise, medication, non-invasive treatment and surgery,” said Rohana. “However, there is a limited number of public hospitals that offer such obesity-related services, and as a result, patients in many communities lack the integrated care needed to manage obesity and must access different touchpoints, prolonging their access to effective care.”

Rohana, who is also a professor of medicine and consultant endocrinologist at Universiti Teknologi Mara (UiTM), added that healthcare professionals in primary care often do not treat obesity itself, but associated chronic conditions (eg, diabetes, hypertension); often not from a lack of knowledge regarding obesity, but from the lack of its prioritisation as a disease in and of itself, inadequate training, and/or time or resource limitations.

“Obesity requires urgent action and the time to act is now. MY OPEN is calling for widespread recognition of obesity as a chronic disease at the government, clinical, and public levels [to] help ensure the responsibility of managing obesity moves from the individual to a collective one,” said Rohana. “We believe that a systemic and sustained approach is needed to address the complex burden of obesity.”

MY OPEN is part of OPEN, a global platform for various stakeholders and collaborators in obesity care that aims to identify key actions to improve obesity prevention and care within health systems and societies.