Written by Jolie, AA Pharmacy
Malaysia is the fattest country in Asia
With approximately half the Malaysian adult population overweight or obese, Malaysia has become the “fattest” country in Asia for over the past three decades. Not only that, our country has the second highest child obesity rate among children in ASEAN aged 5 to 19 years, with 7.1% children under the age of 5 being overweight.
What is obesity?
Obesity is defined as complex disorder involving in excessive amount of body fat that present a risk to the health. Obesity is diagnosed by using body mass index (BMI). According to World Health Organisation (WHO), a person with BMI equal to or more than 25 is considered to be overweight while 30 or above is considered obese.
What causes obesity and overweight?
Quoting Associate Prof Dr Chan Wah Kheong, UM Specialist Centre (UMSC), “Our daily energy requirement gradually increases from the time we are a child to when we become a young adult. From then onwards, our energy requirement starts to decline as we move to middle and older age, plus a more sedentary lifestyle. However, a lot of people continue to eat the same amount of food as they did when they were younger, if not more”
This complex disorder does not happen overnight. It develops gradually over time, as a result of poor diet and lifestyle choices, such as eating large amount of processed or fast food which is high in fat and sugar, eating larger portion of food than what needed, drinking a lot of sugary drinks including fruit juices, drinking too much alcohol which unknowingly high in calories, as well as comfort eating.
Another important factor is lack of physical activity. Urbanization has made life to become increasingly sedentary in nature. In this modernised world, many people have jobs that involve sitting at desk for most of the day. Also changes in mode of transportation as society are relying more on cars rather than walking or cycling, is one of the many forms of sedentary lifestyle. Being physically inactive means energy provided by the food eaten will not be use and that much energy consumed will be stored as fat in the body. This energy imbalance between calories consumed and calories expended is the fundamental cause of obesity and overweight.
What are the health risks associated with obesity?
Obesity and overweight are major risk factors for numerous chronic diseases including cardiovascular diseases, cancer, musculoskeletal disorders and diabetes.
Type 2 diabetes is a disease of above normal blood sugar level and it is the most common type of diabetes. It is reported that more than 87% diabetic adults are overweight or obese. Overweight may cause cells to alter themselves to becoming resistant to the insulin hormone.
Insulin transports sugar to the cells from the blood, where it is used for energy. Blood sugar cannot be absorbed by cells when an individual is insulin resistant, consequently resulting in high blood sugar. Moreover, insulin-producing cells must work very hard to maintain a normal blood sugar level.
Obesity and overweight are also linked to high blood pressure. Having a large body proportion increases blood pressure as the heart needs to pump harder to supply blood to the body. Other than that, excess fat may damage the kidney that regulate the blood pressure.
Hypertension of high blood pressure often does not exhibit symptom, but it may cause cardiovascular disease, kidney failure and stroke. Gaining weight as an adult increases the risk for several type of cancers. The exact reason for how being overweight increases cancer risk remains unknown.
In addition to the health problems, many people may also experience psychological problems such as low self-esteem and depression. These can affect relationship with others as well as contributed to a low quality of life.

How can I lower my risk of having health problems related to overweight and obesity?
Losing as little as 5 percent of the body weight may lower the risk for several diseases such as heart disease and type 2 diabetes. Some guidelines on physical activity recommended at least 150 minutes a week of moderate aerobic activity and more than 300 minutes per week to lose weight or to maintain a weight loss. Activities that strengthen muscles are also required at least twice a week.
The best way to achieve weight loss is to swap unhealthy and high energy food choices for a healthier choice. One of the many ways to eat healthy is to make half of the plate fruits and vegetables, replace unrefined grains (white bread, pasta, white rice) with whole-grain options (whole wheat bread, brown rice, oatmeal), enjoy lean sources of protein, such as lean meats, seafood, beans and peas, soy, nuts, and seeds. Also, check calorie information for each type of food and drink consume.
Despites all the daunting health risks associated with overweight and obese, individuals who are obese or overweight should get advice from doctor. Evidence has shown that weight loss can be more successful if other strategies alongside diet and lifestyle changes is complemented such as setting realistic loss goals and involving family and friends with the weight loss effort.

Reference:
- https://www.thesundaily.my/local/obesity-related-cancer-emerging-problem-formalaysia-lee-DF632137
- https://umsc.my/?umsc_news=malaysia-has-become-fattest-country-in-asia-in-30years
- https://www.star2.com/health/2018/08/14/fat-state-of-affairs/
- https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc20375742
- https://www.who.int/topics/obesity/en/
- https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight
- https://www.nhs.uk/conditions/obesity/treatment/
- https://www.niddk.nih.gov/health-information/weight-management/health-risksoverweight