Thailand faces rising obesity rates, experts call for systemic change

On World Obesity Day, March 4, alarming statistics reveal a global health crisis, with more than 988 million adults worldwide grappling with obesity. Projections from the World Obesity Federation forecast this figure to exceed 1.9 billion by 2035.

In Thailand, the latest National Health Examination Survey (2019-2020) conducted by the Health Systems Research Institute highlights a concerning trend: 46.4% of Thai women and 37.8% of Thai men are classified as obese, with a body mass index (BMI) of 25 or higher. 

Moreover, abdominal obesity, defined as a waist circumference exceeding 90 centimetres for men and 80cm for women, affects 27.7% of Thai men and a staggering 50.4% of Thai women. Bangkok registers the highest prevalence of abdominal obesity among women.

Obesity, characterised by excessive body-fat accumulation, triggers metabolic abnormalities such as elevated blood sugar and lipid levels, and increased inflammation. 

These factors significantly elevate the risk of non-communicable diseases (NCDs), including diabetes, heart disease, stroke, high cholesterol, hypertension and cancer.

This year's campaign, "Changing Systems, Healthier Lives", underscores the necessity for collaborative efforts across the public and private sectors to transform health systems and cultivate environments conducive to obesity prevention. 

Experts stress that obesity is not merely an individual concern but a systemic challenge demanding robust support.
 

Dr Chanesd Srisukho, of Srisukho Hospital in Phichit province and the founder of Mali Medical Clinic in Bangkok, emphasises the profound impact of obesity on national health systems and economies, leading to substantial health-care expenditures for related diseases.

"Obesity is a chronic condition requiring sustained management, akin to other chronic illnesses," Chanesd explained. "However, a significant number of individuals remain undiagnosed and untreated. US research indicates that only approximately 40% of obese individuals are diagnosed, less than 20% receive evidence-based treatment, and a mere 1.3% are prescribed obesity-specific medication."

Long-term solutions necessitate a shift in public perception. Recent medical revisions highlight the significance of "preclinical obesity", characterised by excess adiposity with normal organ function.

"Even with a normal BMI, adverse physiological changes and complications can arise," Chanesd noted. "Early intervention is crucial, even before BMI exceeds standard thresholds, with optimal BMI for Thai women averaging 24.4 and for Thai men 23.1."

Accurate diagnosis necessitates tools measuring body-fat percentage, offering insights into muscle and fat mass. Where unavailable, waist circumference and waist-to-hip ratio measurements are recommended.
 

Chanesd stressed the importance of recognising the broader health implications of obesity, including premature mortality and substantial treatment costs.

Individuals at heightened risk often exhibit behaviour such as sedentary lifestyles, poor diets, inadequate sleep, excessive screen time, stress, and the use of certain medications.

"Awareness of these risk factors is paramount," Chanesd advised. "For genetic or medical conditions, professional consultation is essential."

Dr Direk Khampaen, deputy director general of the Department of Disease Control, Ministry of Public Health, outlined government initiatives, including legislative measures for NCD prevention, sugar and sodium taxation, promotion of healthy food production, and regulation of high-fat, high-sugar, and high-sodium food marketing.

Dr Krisada Hanbunjerd, director of the Non-Communicable Diseases Division, Ministry of Public Health, emphasised the role of individual behaviour change, including balanced diets, increased physical activity, and annual health checkups.

"Ultimately, promoting overall health through balanced nutrition and regular exercise, such as running, is the most effective strategy for obesity prevention," Krisada concluded.