By Yasmin Ramlan
SHAH ALAM, May 7 — Malaysia’s healthcare system is under mounting pressure, and the economy is feeling the strain from rising medical costs, absenteeism, and lost productivity — all due to a worsening obesity crisis.
Despite decades of awareness campaigns and public health messaging, obesity rates continue to climb, fuelling a surge in non-communicable diseases (NCDs) such as diabetes, hypertension, and heart conditions.
The latest data points to a troubling trend, in which millions of Malaysians now live with multiple chronic illnesses, many unaware of their condition until it is too late.
Today, Malaysia’s battle with obesity is no longer just a health concern — it is an escalating national crisis.
While individuals are often blamed for poor choices, the reality is that Malaysia’s unhealthy living environment makes it exceedingly difficult to sustain healthy habits.
The solution, according to experts? Bold policy shifts that include midnight surcharges on food, tougher food regulations, and workplace health incentives.
“More than two million people are living with three major types of NCDs, namely diabetes, hypertension, and high cholesterol. Half a million are living with four NCDs, including obesity,” said Galen Centre for Health and Social Policy chief executive officer Azrul Mohd Khalib, painting a stark picture of a nation grappling with the compounded effects of chronic illnesses.
“Malaysia now has the highest rate of diabetes in the Western Pacific region and one of the highest in the world, which is costing around RM3.1 billion annually.
“It is expected that seven million Malaysian adults aged 18 and older will be either pre-diabetic or diabetic by next year. Many of them will be undiagnosed and unaware of their status,” he told Media Selangor recently.
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The National Health and Morbidity Survey 2023 revealed a troubling rise in overweight and obesity rates among Malaysians. In 2011, 44.5 per cent of adults fell into this category, and by 2023, the figure had climbed to a staggering 54.4 per cent.
Azrul warned that awareness campaigns alone cannot undo the damage when food culture and daily routines remain unchanged.
Instead, he called for the implementation of tougher measures, such as a 10 per cent midnight food surcharge, stricter food regulations, and employer-led health incentives, before the crisis becomes irreversible.
According to data from the World Obesity Federation, in 2019, the total economic impact of overweight and obesity in Malaysia was estimated at US$5.68 billion (approximately RM26.8 billion), or 1.6 per cent of the national GDP, with the majority attributed to indirect costs such as absenteeism, reduced productivity, and premature mortality.
If left unaddressed, this figure is projected to rise dramatically to US$104.55 billion (about RM493 billion) by 2060 (4 per cent of the GDP).
Azrul said Malaysians’ nighttime eating habit, with the consumption of high calorie foods, leads to twice as much weight gain than those who limit their eating to daytime.
“When combined with sedentary lifestyles, it is not a surprise that at least half of the population are either obese or heading there.
“The costs of treating the resulting medical conditions such as cardiovascular disease is already costing billions each year. Coupled with low health literacy, an awareness campaign is simply inadequate to address these issues and for people to change their habits or behaviours,” he said.
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Obesity’s hidden costs
According to Universiti Kebangsaan Malaysia (UKM) Department of Community Health’s Prof Sharifa Ezat Wan Puteh, people living with obesity face a higher risk of developing a range of serious health conditions, including hypertension, diabetes, cardiovascular disease, stroke, cancer, and arthritis.
She explained that these illnesses often lead to frequent medical leave, hospital admissions, and long-term reliance on medication or treatment, some of which are costly.
“They put pressure on clinic waiting times, apart from potentially experiencing a reduced quality of life and premature death as body mass index (BMI) increases due to severe obesity, along with poor productivity resulting from limited mobility.
“This is especially worse for obese individuals who also engage in unhealthy behaviours, such as smoking or drug abuse,” she said.
“Some individuals with obesity also have comorbid conditions that require extended medical leave, which, even with a pay cut, can reduce overall company productivity.
Echoing similar concerns, Azrul said the private sector can do more to address obesity in the workplace by promoting healthy living through practical incentives.
These include encouraging a healthier food culture, subsidising fitness activities and fitness trackers, discouraging long working hours, and adopting work-life balance strategies.
He also suggested that factory employers provide healthier meal options that are low in fat and added sugars for workers on late-night shifts.
“Healthier employees make for smart business,” he said.
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A push for smarter policies
To address the root causes of Malaysia’s rising obesity rates, both Azrul and Sharifa Ezat agree that tackling the issue requires more than awareness — it demands workplace-level support and policy intervention.
Azrul acknowledged that while it may be unrealistic to ban 24-hour eateries or restrict personal food choices, the government can still take action through economic measures.
“The Galen Centre proposes that the government impose a 10 per cent midnight surcharge for all food and beverages sold in licensed food establishments between 12am and 6am.
“The funds collected can be channelled and earmarked for treatment of NCDs including diabetes, cardiovascular disease, kidney disease, hypertension and cancer,” he said.
He added that the funds raised could rival or even exceed the RM5 billion currently collected through sin taxes on cigarettes and alcohol, while also discouraging late-night eating habits that contribute to obesity.
Meanwhile, Sharifa Ezat highlighted the role of socioeconomic status in shaping Malaysians’ diets and activity levels.
She explained that high-income earners are generally more able to afford quality food such as fruits, vegetables, and protein, while lower- and middle-income groups often rely on cheaper options like fast food, sugary drinks, and carbohydrate-heavy meals, many of which are processed and nutrient-poor.
“Similarly, most lower-income earners do not have time to exercise as they are bogged down with work,” she said.
Sharifa stressed that health education must also be coupled with meaningful incentives, including workplace initiatives such as weight loss challenges, free medical check-ups, and monetary rewards to motivate healthier habits among employees.
She also emphasised the need for clear food labelling, increased availability of low-calorie and low-sugar options at workplaces and canteens, and pricing strategies to discourage unhealthy consumption.
Additionally, she said support systems such as stop-smoking clinics and mental health services are also essential, given the strong link between mental health issues and conditions like binge eating and obesity.
