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Adam Minter

Southeast Asia Has a Weight Problem

With obesity rates soaring, countries like Singapore and Malaysia are weighing aggressive interventions.

Enjoy responsibly.

Enjoy responsibly.

Photographer: Manjunath Kiran/AFP

Starting next year, Singapore will treat packaged sugary drinks such as Coca-Cola the way that other countries treat cigarettes. Advertisements will be banned, and a label attesting to a beverage's unhealthiness will be mandatory. The goal is to reduce the high rate of sugar consumption and associated health problems — such as diabetes and heart disease — that are now plaguing Southeast Asia.

The problem is quickly getting worse. Between 2010 and 2014, obesity surged 24% in Singapore, 27% in Malaysia and 38% in Vietnam. Left unaddressed, this epidemic could exact steep human and financial costs. Banning ads for sugary drinks won't solve the problem on its own. But if Singapore thinks a bit more ambitiously, it might provide a model for other emerging and newly developed countries needing to slim down.

It wasn't so long ago that much of Asia was associated with undernourishment. Thanks to a half-century of economic development and income growth, that’s no longer the case. Although hunger remains an issue in some areas, overall, Asians now have access to more and better food than ever — a fact reflected in rising life expectancies across the continent.

But increased access to food isn't all good news. As incomes have risen, Asia's eaters have tended to shift away from traditional starch-based diets and toward food rich in fat, protein, dairy, and sugar, much of it packaged and processed. Calories that might've once been worked off in rural fields now accumulate on the hips and bellies of Asia's middle classes as they settle in cities by the tens of millions. Meanwhile, local food cultures that posed few health risks in less affluent times turn out to be problematic in an era of cheap calories. The fried snacks emblematic of Malaysian street food pose minimal health risks in moderation. But thanks to their low-cost ubiquity, they’re now helping to make the country, in UNICEF's words, “the fattest nation in Asia.”

Then there's sugar. Even before low prices made sweets widely accessible, Southeast Asia had a sweet tooth. Now that it can be more easily indulged, consumption is skyrocketing. In Thailand, daily sugar intake has increased from 19 teaspoons a day in 1997 to 28 in 2019. Singapore is modest by comparison, with consumers averaging around 12 teaspoons a day, about half from beverages (a typical can of soda contains 10 teaspoons). But even that’s at the high end of the World Health Organization’s guidelines.

The health effects associated with this shift, combined with other unhealthy nutritional trends, have been severe. Southeast Asia now accounts for about 20% of all diabetics globally. Over the past two decades, countries in the region have seen the world’s largest increases in premature deaths related to cardiovascular disease. Already, obesity-related ailments take up as much as 15% of Indonesia’s national health-care spending and 19% of Malaysia's.

Faced with such an epidemic, Singapore's plan to ban advertising and mandate labeling certainly makes sense. But if the government really wants to reduce consumption, it’ll need to apply direct pressure on manufacturers and consumers by imposing taxes on the production and sale of sugary goods. In price-sensitive developing countries like Mexico, such taxes have proved effective in reducing consumption or changing manufacturers’ practices. In Malaysia, the mere threat of such a tax convinced F&N Beverages Marketing, one of the country's biggest drink manufacturers, to reformulate 70% of its products to avoid the price hike.

Ultimately, developing countries will have to look beyond prepackaged goods. Informal street dining remains prevalent in most of these areas, and consumers seeking sugary snacks or fried food can simply frequent a stall and eat tax-free. Promoting healthy (or healthier) eating will require long-term public-education campaigns, ideally combined with school-based nutritional programs like the one Malaysia will be launching next year.

None of this will be easy or cheap. But, as with a diet, the improved quality of life should ultimately pay for all the sacrifice.