ONE in two Malaysians is obese.
According to a 2014 report in British medical journal The Lancet, 49% of women and 44% of men in Malaysia were found to be obese.
For the 50-70 age group, the prevalence of abdominal obesity is also very high. Tah Pei Chien, a dietitian with UM Medical Centre (UMMC), informs that the obesity rate is 15% and those who are overweight make up 29%.
According to the National Health and Morbidity Survey by the Health Ministry in 2011, about 44% of people in that age group have a BMI (body mass index) of over 25. In Asia, this is the highest prevalence of obesity.
Body mass index is a way to measure how healthy you are according to your weight and height. The BMI range for people who are healthy is 18.5 to 25.
Tah informs that with the high prevalence of obesity in Malaysia has come an increase in chronic diseases like diabetes, hypertension and heart disease.
Research shows that being overweight and obese also increases the risk of cancer.
“For the elderly who is diabetic and is obese or overweight, the diabetes will not be well controlled compared to an elderly diabetic who has normal body weight,” says Tah.
A poor diet, a lack of exercise and a sedentary lifestyle are the main factors for the increase in obesity among the elderly.
Tah says that fast food and eating out where the food is high in sugar, salt and fat are to blame.
“These are the main reasons – food and lifestyle. Most of the elderly say they have no time to exercise. Actually the recommendation is to exercise at least three times a week, and 30 minutes each time.
“For the general public it is also about 100-150 minutes of exercise per week,” says Tah.
While you are not encouraged to weigh yourself daily, because of daily weight fluctuations, you are advised to do it weekly to monitor it
If you are trying to lose weight, then the weekly weight reduction should be 0.5 to 1kg a week.
Those trying to lose weight are encouraged to monitor their daily calorie intake. How many calories they need a day depends on their weight, age and activity level.
“If you are an elderly person, you don’t need that many calories daily because your physical activity is less. We want them to balance their calorie intake and physical activity,” explains Tah.
If you are overweight or obese and want to get some help at UMMC, you would need to go to the outpatient clinic where you would be assessed before being referred to a dietitian.
The dietitian would check your BMI as well as body fat mass and the level of exercise/activity.
The patient would then be advised to have a food and exercise diary and to modify their lifestyle and eating pattern.
Based on their activity level, they would be told what their daily calorie intake should be. They would also be given samples for calorie intake so that they would know how many calories a plate of nasi lemak has versus a plate of rice and steamed chicken.
“A lot of patients tell us they can’t control their diet or change their lifestyle. If they say they can’t cut out the fried chicken, for example, we will give them alternatives. We will also include the family and caregivers and inform them of the risks involved if the patient does not follow our advise. We need to tell them about the possible complications.
“If they can’t cut out fatty food, we will advise them to reduce the frequency of the intake and then slowly we will ask them to modify their diet. If we ask them to totally change their diet, it will be difficult as it is too drastic. If they are active, we will ask them to continue with the physical activities,” says Tah.
According to her, patients who are really concerned about their health will follow the advice and recommendations.
A lot of the elderly are aware of the complications but find it hard to change their lifestyle.
When the patients adhere to the recommendations and there is improvement in the blood sugar and cholesterol levels, the dietitian would show them the result improvements to motivate them.
Tah informs that UMMC also has group counselling for obese patients to give them support and encouragement and let them know the benefits of changing their diet and lifestyle.
Unfortunately, some patients do not come for their followup checkups when they feel they cannot comply with the lifestyle changes recommended.
For those with morbid obesity, with a BMI of over 30, there is the option of bariatric surgery to improve their quality of life.
This is an operation on the stomach or intestines where the size of the stomach is reduced or part of the stomach is removed, forcing the patient to eat less as they feel full faster.
While there are lots of slimming programmes and medications in the market, there are side effects to be considered. Tah says some of the slimming pills on the market may even damage the liver in the long run and cause dehydration and malnutrition.
“It is best to have a healthy diet and modify your lifestyle instead,” she adds.