By Xavier Kong
In the previous part of the series, KiniBiz pondered the math of how obesity would affect the nation. In this part, the topic moves on to how Malaysia is handling this troubling issue.
______________________________________________________________________
Now knowing how much obesity can impact the economic growth of a country, as well as the global economy, there should be no reason to not want to resolve this issue. However, to settle an issue, one must know what settling the issue entails. In the words of Sun Tzu, “Know thy self, know thy enemy. A thousand battles, a thousand victories.”
So, what is obesity? As defined by the Malaysian Association for the Study of Obesity (MASO), obesity is a condition of abnormal or excessive fat accumulation in adipose tissues, to the extent that health may be impaired. However, obese individuals differ not only according to the degree of excess fat, which they store, but also in the regional distribution of the fat within the body. The World Health Organisation had also noted that excess abdominal fat is as great a risk factor for disease as excess body fat in general.
The report from the Mckinsey Global Institute on obesity identified the issue as a complex, systemic, multi-causal problem. This problem, according to McKinsey, is “rooted in the sedentary nature of modern post-industrial life, more widely available and more affordable food, a change in the nature and mix of diets, psychological stimuli such as stress and epigenetic triggers, and potentially even physiological disruption to the gut microbiome”.
What can be done?
As the header goes, what can be done to take on the issue of obesity, especially considering the point that the problem is multi-causal? The McKinsey Global Institute had, as a response, developed a framework that classifies interventions to tackle obesity.
“The framework draws on the most recent health-related behavioral-change theory and insights from behavioral economics. The framework comprises four types of mechanism: mechanisms that inform, enable, motivate, and influence,” said the paper.
According to the paper, the ‘inform’ segment has to do with the dissemination of information, whether it is made available, and how it is communicated to its target audience. Information availability checks on whether appropriate information is provided to relevant populations to stimulate behavioural change.
The ‘enable’ segment moves on to assess the options available to be taken, and to what extent they should be taken, with examples including giving individuals access to green spaces or a gym to facilitate exercise, or introducing healthy options in a canteen.
The ‘motivate’ segment explores the main methods for encouraging people to consciously change their behaviour, such as by setting personal goals or making commitments, which, in turn, can be aided by instruments or implements.
Other than the aspect of intrinsic motivation, there is also motivation through material incentives, including financial incentives, to lose weight or exercise more. These can either be direct, like the government of Abu Dhabi rewarding participants of a weight-loss challenge with a gram of gold for each kilogram lost, or indirect, like employers or insurers reducing healthcare premiums.
The ‘influence’ segment covers the major means for stimulating different behaviour, whether or not individuals are fully aware of the behavioural changes. Choice architecture, as the name reflects, is about the structuring of how choices are presented and usually includes the importance of standards or defaults. Examples of this include making portion sizes of unhealthy food smaller, or changing the relative pricing of different food products to influence the choice of the consumer.
Priming, on the other hand, is the exposure of a particular stimulus or cue that affects the perception, judgement, and decision-making of the consumer, such as the use of cartoon characters promoting fruit and vegetables to children, or pictures associated with health in supermarkets.
Finally, there is the effect of social norms on the consumer, where the consumer’s society or community either aids or detracts from the individual’s efforts to lose weight. Social norms are essentially the definition of what is ‘normal’ by a society, and is usually enforced through pressure from peers within society itself.
While having earned some bad reputation (the concept that sex sells, for example), there is no denying the effect this particular influencing mechanism can have. For example, the impact of social norms can be directed towards influencing people to take to a healthier diet or mode of commute to the office, and can also affect the supply and demand factor regarding unhealthy food and drinks. If a society just does not drink a lot of fizzy drinks, shop-owners in the area would be less inclined to stock them, in turn lessening the temptation towards those who would usually indulge.
Local anti-obesity action
What about in Malaysia though? What has been done here in Malaysia to help curb the rising prevalence of obesity among the nation’s citizens?
Over the years, Malaysians have seen anti-obesity campaigns come and go. Campaigns like the “Kurang Manis” campaign in 2010, which tried to make the choice for less sugar the standing order among Malaysians, had used the rise of sugar prices at that time to aid the impact of the campaign.
To address the elephant in the room, these campaigns have not worked, as Malaysia had still seen rises in the prevalence of obesity, considering a leap from the highest obesity rate in Asean and sixth in Asia in 2013, to the country with the highest rate of obesity in Asia in 2014.
However, in 2011, the health ministry had also proposed to place an anti-obesity law into action by 2020. While nothing firm has been put in place, the proposed law will most likely be modelled after the 2008 law in Japan which placed the waistlines of employees in the responsibilities of the employer.
The Japanese law has, among its provisions, measuring the waistlines of employees between the ages of 40 and 74 as part of their annual medical check-up. A company faces stiff penalties if its employees’ waistlines exceeded 33.5 inches for men and 35.4 inches for women, and employes who fail to reduce their waistline would have to undergo counseling, while the employer would have to contribute to a healthcare programme for the elderly.
Shamsuddin Bardan
This proposal met immediate resistance from the Malaysian Employers Federation, whose executive director Shamsuddin Bardan had described the proposed law as “ridiculous”, saying that obesity was a matter of individual lifestyle, and employees should take responsibility for their own health instead of passing on the burden to employers.
Economic impact of a successful action
Regardless of the means, a successful anti-obesity action, whereby success would be defined as a measurable decline in the number of obesity cases in Malaysia, would definitely improve the economy over the long term.
During her support for the proposed anti-obesity law in Malaysia, Prince Court Medical Centre dietician Tan Yen Sing had noted that employers should not shy away from it, as the law “would benefit the employers as having fit employees would mean fewer workers on sick leave and higher productivity. Tasks and assignments can also be done more efficiently”.
It all becomes a matter of numbers and logic again. Fewer obese employees would mean fewer workers likely to fall ill from obesity-related diseases, which would in turn lead towards more workers accomplishing more tasks, raising productivity for the company. As bad things can snowball out of control, so can good things snowball towards a better future. With more productivity in companies, the sector would improve its output, which in turn would raise the gross domestic product of the country.
As it stands, all that remains for Malaysia is the design and implementation of a successful plan to tackle obesity.
Tomorrow: KiniBiz looks at some of Malaysia’s neighbours, and compares local anti-obesity action against the actions these neighbours have taken.
You must be logged in to post a comment.