Report Card: Thailand - World Obesity Federation

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Report cardThailandContentsPageObesity prevalence2Trend: % Adults living with obesity, 1997-20144Trend: % Adults living with overweight or obesity, 2003-20146Overweight/obesity by education8Overweight/obesity by age10Overweight/obesity by region12Insufficient physical activity16Average daily frequency of carbonated soft drink consumption22Estimated per capita fruit intake23Prevalence of less than daily fruit consumption24Prevalence of less than daily vegetable consumption25Average weekly frequency of fast food consumption26Estimated per-capita processed meat intake27Estimated per capita whole grains intake28Mental health - depression disorders29Mental health - anxiety disorders30% Infants exclusively breastfed 0-5 months31Oesophageal cancer32Breast cancer34Colorectal cancer35Pancreatic cancer37Gallbladder cancer39Kidney cancer41Cancer of the uterus43Raised blood pressure44Raised cholesterol47Raised fasting blood glucose50Diabetes prevalence52Health systems531

Obesity prevalenceAdults, ey type:MeasuredAge:15 Sample size:627Area covered:References:RegionalSakboonyarat, B., Pornpongsawad, C., Sangkool, T. et al. Trends, prevalence and associated factors of obesity amongadults in a rural community in Thailand: serial cross-sectional surveys, 2012 and 2018. BMC Public Health 20, 850(2020). https://doi.org/10.1186/s12889-020-09004-wNotes:NB Small regional survey NOT NATIONALUnless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².2

Children, urvey type:GirlsMeasuredAge:6-18Sample size:1749Area covered:References:RegionalNonboonyawat T, Pusanasuwannasri W, Chanrat N, Wongthanavimok N, Tubngern D, Panutrakul P, Mungthin M,Nivesvivat T, Hatthachote P, Rangsin R, Piyaraj P. (2019) 'Prevalence and associates of obesity and overweight amongschool-age children in a rural community of Thailand.' Korean J Pediatr. doi: 10.3345/kjp.2018.06499.Notes:WHO cut-offs used.Cutoffs:WHO3

% Adults living with obesity, 1997-2014MenObesity7% Adults living with obesity65432101998200020022004Survey type:20062008MeasuredReferences:For full details of references visit https://data.worldobesity.org/Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².Different methodologies may have been used to collect this data and so data from different surveys may not be strictly comparable. Pleasecheck with original data sources for methodologies used.4

WomenObesity12% Adults living with obesity10864201998200020022004Survey type:20062008MeasuredReferences:For full details of references visit https://data.worldobesity.org/Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².Different methodologies may have been used to collect this data and so data from different surveys may not be strictly comparable. Pleasecheck with original data sources for methodologies used.5

% Adults living with overweight or obesity, 2003-2014MenOverweight or obesity% Adults living with overweight or obesity3025201510502003200420052006Survey type:200720082009MeasuredReferences:For full details of references visit https://data.worldobesity.org/Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².Different methodologies may have been used to collect this data and so data from different surveys may not be strictly comparable. Pleasecheck with original data sources for methodologies used.6

WomenOverweight or obesity% Adults living with overweight or obesity40353025201510502003200420052006Survey type:200720082009MeasuredReferences:For full details of references visit https://data.worldobesity.org/Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².Different methodologies may have been used to collect this data and so data from different surveys may not be strictly comparable. Pleasecheck with original data sources for methodologies used.7

Overweight/obesity by educationMen, 2009ObesityOverweight454035%302520151050Less than primaryPrimarySecondarySurvey type:MeasuredAge:20 Sample size:19,181Area covered:References:UniversityNational - URBANWichai Aekplakorn, Rungkarn Inthawong, Pattapong Kessomboon, et al.,  Prevalence and Trends of Obesity andAssociation with Socioeconomic Status in Thai Adults: National Health Examination Surveys, 1991–2009, Journal ofObesity, vol. 2014, Article ID 410259, 8 pages, 2014. doi:10.1155/2014/410259Notes:Prevalence of Overweight & Obesity by Education in Urban Areas In this graph, overweight refers to BMI 25– 30, andobesity as BMI 30 kg/m2Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².8

Women, 2009ObesityOverweight5040%3020100Less than primaryPrimarySecondarySurvey type:MeasuredAge:20 Sample size:19,181Area covered:References:UniversityNational - URBANWichai Aekplakorn, Rungkarn Inthawong, Pattapong Kessomboon, et al.,  Prevalence and Trends of Obesity andAssociation with Socioeconomic Status in Thai Adults: National Health Examination Surveys, 1991–2009, Journal ofObesity, vol. 2014, Article ID 410259, 8 pages, 2014. doi:10.1155/2014/410259Notes:Prevalence of Overweight & Obesity by Education in Urban Areas In this graph, overweight refers to BMI 25– 30, andobesity as BMI 30 kg/m2Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².9

Overweight/obesity by ageAdults, 2003-2005ObesityOverweight3025%20151050MenWomenAge 19-39MenWomenAge 40-59MenWomenAge 60 WomenAge 45-49Survey type:MeasuredSample size:7279Area covered:References:NationalJitnarin N, Kosulwat V, Rojroongwasinkul N et al. Prevalence of overweight and obesity in Thai population: Results ofthe National Thai Food Consumption Survey. 2011;16:e242-e249Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².10

Children, 2003-2005ObesityOverweight76%543210BoysGirlsAge 3-5BoysGirlsAge 6-11BoysGirlsAge 12-18Survey type:MeasuredSample size:9287Area covered:References:NationalJitnarin N, Kosulwat V, Rojroongwasinkul N et al. Prevalence of overweight and obesity in Thai population: Results ofthe National Thai Food Consumption Survey. 2011;16:e242-e249Cutoffs:IOTF11

Overweight/obesity by regionMen, rvey type:MeasuredAge:20 Sample size:19,181Area covered:NationalReferences:Wichai Aekplakorn, Rungkarn Inthawong, Pattapong Kessomboon, et al.,  Prevalence and Trends of Obesity andAssociation with Socioeconomic Status in Thai Adults: National Health Examination Surveys, 1991–2009, Journal ofObesity, vol. 2014, Article ID 410259, 8 pages, 2014. doi:10.1155/2014/410259Notes:In this graph, overweight refers to BMI 25– 30, and obesity as BMI 30 kg/m2Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².12

Women, Survey type:MeasuredAge:20 Sample size:19,181Area covered:NationalReferences:Wichai Aekplakorn, Rungkarn Inthawong, Pattapong Kessomboon, et al.,  Prevalence and Trends of Obesity andAssociation with Socioeconomic Status in Thai Adults: National Health Examination Surveys, 1991–2009, Journal ofObesity, vol. 2014, Article ID 410259, 8 pages, 2014. doi:10.1155/2014/410259Notes:In this graph, overweight refers to BMI 25– 30, and obesity as BMI 30 kg/m2Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².13

Boys, gkokCentralNorthSurvey type:NortheastSouthMeasuredAge:3-18Sample size:9287Area covered:References:NationalJitnarin N, Kosulwat V, Rojroongwasinkul N et al. Prevalence of overweight and obesity in Thai population: Results ofthe National Thai Food Consumption Survey. 2011;16:e242-e249Cutoffs:IOTF14

Girls, kCentralNorthSurvey type:NortheastSouthMeasuredAge:3-18Sample size:9287Area covered:References:NationalJitnarin N, Kosulwat V, Rojroongwasinkul N et al. Prevalence of overweight and obesity in Thai population: Results ofthe National Thai Food Consumption Survey. 2011;16:e242-e249Cutoffs:IOTF15

Insufficient physical activityAdults, 201635% insufficient physical esteIndonesiaBhutanThailandBangladeshSri LankaMaldivesIndiaGuthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooledanalysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214109X(18)30357-716

Men, 2016% insufficient physical alBangladeshBhutanSri LankaThailandIndonesiaIndiaMaldivesGuthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooledanalysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214109X(18)30357-717

Women, 20164540% insufficient physical esiaTimor-LesteThailandBhutanMaldivesSri LankaBangladeshIndiaGuthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooledanalysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214109X(18)30357-718

Children, 20169080% insufficient physical ivesNepalSurvey type:Sri eferences:Bhutan11-17Global Health Observatory data repository, World Health in.A893ADO?lang en (last accessed 16.03.21)Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing lessthan 60 minutes of moderate- to vigorous-intensity physical activity daily.Definitions:% Adolescents insufficiently active (age standardised estimate)19

Boys, 20169080% insufficient physical ivesSri LankaSurvey dAge:References:Nepal11-17Global Health Observatory data repository, World Health in.A893ADO?lang en (last accessed 16.03.21)Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing lessthan 60 minutes of moderate- to vigorous-intensity physical activity daily.Definitions:% Adolescents insufficiently active (age standardised estimate)20

Girls, 201690% insufficient physical palBhutanSurvey type:IndonesiaSri :Maldives11-17Global Health Observatory data repository, World Health in.A893ADO?lang en (last accessed 16.03.21)Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing lessthan 60 minutes of moderate- to vigorous-intensity physical activity daily.Definitions:% Adolescents insufficiently active (age standardised estimate)21

Average daily frequency of carbonated soft drink consumptionChildren, 2014-20151.41.2Times per y 7Beal et al. (2019). Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-food consumption: Ameta-analysis of global school-based student health surveys. Food and Nutrition Bulletin.https://doi.org/10.1177/0379572119848287 sourced from Food Systems system22

Estimated per capita fruit intakeAdults, 2017140120g/day100806040200Timor-Leste BangladeshSri LankaMyanmarNorth KoreaBhutanSurvey e:25 References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/Definitions:Estimated per-capita fruit intake (g/day)23

Prevalence of less than daily fruit consumptionChildren, 2008-201560% daily consumption50403020100ThailandSri LankaIndonesiaBangladeshSurvey 17Global School-based Student Health Surveys. Beal et al (2019). Global Patterns of Adolescent Fruit, Vegetable,Carbonated Soft Drink, and Fast-food consumption: A meta-analysis of global school-based student health surveys. Foodand Nutrition Bulletin. https://doi.org/10.1177/0379572119848287. Sourced from Food Systems systemDefinitions:Prevalence of less-than-daily fruit consumption (% less-than-daily fruit consumption)24

Prevalence of less than daily vegetable consumptionChildren, 2008-201560% daily consumption50403020100ThailandSri LankaIndonesiaBangladeshSurvey 17Beal et al. (2019). Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-food consumption: Ameta-analysis of global school-based student health surveys. Food and Nutrition Bulletin.https://doi.org/10.1177/0379572119848287 sourced from Food Systems systemDefinitions:Prevalence of less-than-daily vegetable consumption (% less-than-daily vegetable consumption)25

Average weekly frequency of fast food consumptionChildren, 2014-20153Times per ferences:BangladeshThailand12-17Beal et al. (2019). Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-food consumption: Ameta-analysis of global school-based student health surveys. Food and Nutrition Bulletin.https://doi.org/10.1177/0379572119848287 sourced from Food Systems system26

Estimated per-capita processed meat intakeAdults, te North KoreaMyanmarThailandSri LankaSurvey :25 References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/Definitions:Estimated per-capita processed meat intake (g per day)27

Estimated per capita whole grains intakeAdults, 20176050g/day403020100MaldivesIndiaNorth KoreaSri LankaBhutanNepalSurvey MeasuredAge:25 References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/Definitions:Estimated per-capita whole grains intake (g/day)28

Mental health - depression disordersAdults, 20154.54% of palIndonesiaMaldivesMyanmarNorth Korea BangladeshSri LankaBhutanThailandIndiaPrevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression andOther Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BYNC-SA 3.0 IGO.Definitions:% of population with depression disorders29

Mental health - anxiety disordersAdults, 20154.543.5% of IndonesiaMaldivesMyanmarSri LankaThailandNepalBhutanNorth Korea BangladeshPrevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression andOther Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BYNC-SA 3.0 IGO.Definitions:% of population with anxiety disorders30

% Infants exclusively breastfed 0-5 monthsChildren, rBhutanIndiaArea steSri LankaNationalThailand Multiple Indicator Cluster Survey 2019, Survey Findings Report. Bangkok, Thailand: National Statistical Office ofThailand.Notes:See UNICEF website for further survey information. Available at : oungchild-feeding/ (last accessed 28.9.21) Citation: United Nations Children’s Fund, Division of Data, Analysis, Planning andMonitoring (2021). Global UNICEF Global Databases: Infant and Young Child Feeding: Exclusive breastfeeding, New York,September 2021.Definitions:% exclusively breastfed 0-5 months31

Oesophageal cancerMen, 201830Incidence per IndiaSri LankaAge:ThailandBhutanNorth KoreaMyanmarBangladesh20 References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)Definitions:Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20 . ASR (World) per100,00032

Women, 20181816Incidence per landNorth KoreaNepalAge:MyanmarIndiaSri LankaBhutanBangladesh20 References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)Definitions:Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20 . ASR (World) per100,00033

Breast cancerWomen, 201870Incidence per i LankaIndiaAge:Timor-Leste North KoreaThailandMaldivesIndonesia20 References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)Definitions:Estimated age-standardized incidence rates (World) in 2018, breast, females, ages 20 . ASR (World) per100,00034

Colorectal cancerMen, 201835Incidence per 100,000302520151050BangladeshNepalSri nesiaThailandNorth Korea20 References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)Definitions:Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20 . ASR (World) per100,00035

Women, 201825Incidence per 100,00020151050BhutanIndiaBangladeshSri hailandNorth Korea20 References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)Definitions:Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20 . ASR (World) per100,00036

Pancreatic cancerMen, 201898Incidence per 100,00076543210Sri LankaIndiaBangladesh ndonesiaNorth Korea20 References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)Definitions:Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20 . ASR (World) per100,00037

Women, 201887Incidence per 100,0006543210MaldivesSri mor-LesteNepalNorth KoreaBhutan20 References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)Definitions:Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20 . ASR (World) per100,00038

Gallbladder cancerMen, 201814Incidence per 100,000121086420MaldivesTimor-LesteIndonesiaSri LankaMyanmarIndiaAge:BhutanBangladesh North KoreaNepalThailand20 References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)Definitions:Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20 . ASR (World) per100,00039

Women, 201812Incidence per 100,0001086420MaldivesTimor-LesteIndonesiaSri LankaMyanmarBhutanAge:IndiaNorth KoreaThailandBangladeshNepal20 References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)Definitions:Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20 . ASR (World) per100,00040

Kidney cancerMen, 20186Incidence per 100,000543210BhutanMaldivesTimor-LesteIndonesiaSri LankaBangladeshAge:MyanmarIndiaThailandNepalNorth Korea20 References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)Definitions:Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20 . ASR (World) per 100,00041

Women, 20183Incidence per 100,0002.521.510.50MaldivesTimor-LesteIndonesiaSri North Korea20 References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)Definitions:Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20 . ASR (World) per 100,00042

Cancer of the uterusWomen, 20184035Incidence per 100,000302520151050Sri LankaBangladesh North Korea ivesIndonesia20 References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)Definitions:Estimated age-standardized incidence rates (World) in 2018, cervix uteri, females, ages 20 . ASR (World) per100,00043

Raised blood pressureAdults, 201530% raised blood pressure2520151050North KoreaReferences:ThailandSri NepalGlobal Health Observatory data repository, World Health n.A875?lang enDefinitions:Age Standardised estimated % Raised blood pressure 2015 (SBP 140 OR DBP 90).44

Men, 201530% raised blood pressure2520151050North KoreaReferences:Sri esBhutanNepalGlobal Health Observatory data repository, World Health n.A875?lang enDefinitions:Age Standardised estimated % Raised blood pressure 2015 (SBP 140 OR DBP 90).45

Women, 201530% raised blood pressure2520151050North KoreaReferences:ThailandSri NepalGlobal Health Observatory data repository, World Health n.A875?lang enDefinitions:Age Standardised estimated % Raised blood pressure 2015 (SBP 140 OR DBP 90).46

Raised cholesterolAdults, 200850% raised h KoreaIndiaMyanmarBhutanIndonesiaSri LankaMaldivesThailandGlobal Health Observatory data repository, World Health n.A885Definitions:% Raised total cholesterol ( 5.0 mmol/L) (age-standardized estimate).47

Men, 200850% raised cholesterol403020100NepalReferences:North KoreaBangladeshIndiaMyanmarBhutanSri LankaIndonesiaMaldivesThailandGlobal Health Observatory data repository, World Health n.A885Definitions:% Raised total cholesterol ( 5.0 mmol/L) (age-standardized estimate).48

Women, 200850% raised h KoreaIndiaBhutanMyanmarIndonesiaSri LankaMaldivesThailandGlobal Health Observatory data repository, World Health n.A885Definitions:% Raised total cholesterol ( 5.0 mmol/L) (age-standardized estimate).49

Raised fasting blood glucoseMen, 201412% raised fasting blood glucose1086420North KoreaReferences:Sri aldivesBhutanGlobal Health Observatory data repository, World Health n.A869?lang enDefinitions:Age Standardised % raised fasting blood glucose ( 7.0 mmol/L or on medication).50

Women, 201412% raised fasting blood glucose1086420North KoreaReferences:MyanmarSri BhutanGlobal Health Observatory data repository, World Health n.A869?lang enDefinitions:Age Standardised % raised fasting blood glucose ( 7.0 mmol/L or on medication).51

Diabetes prevalenceAdults, 202114% diabetes aldivesAge:NepalSri LankaThailandTimor-Leste20-79Area covered:References:MyanmarNationalReproduced with kind permission International Diabetes Federation. IDF Diabetes Atlas, 10th edn. Brussels,Belgium:International Diabetes Federation, 2021. ed comparative prevalence of diabetes, %52

Health systemsEconomic classification: Upper Middle IncomeHealth systems summaryThailand has a pluralistic health system that involves both public and private providers and financing bodies(although most care is delivered by the public system). By law, all Thai citizens must be a member of a socialhealth protection scheme and so universal health coverage was reached by 2002. There are three healthinsurance schemes, membership of which is typically dependent on type of employment. The Servant MedicalBenefit Scheme covers central government employees and the Social Security Scheme covers private employees.Most people, however, are covered by the Universal Coverage Scheme that covers those that work in the informalsector. The latter scheme is financed by general taxation, does not rely on contributions from members and coversapproximately 72% of the population. Over the past two decades, public expenditure on health has increasedsignificantly and out of pocket payments as a percentage of total health spending has fallen to 12.4%. There hasalso been a reduction in catastrophic health spending and medical impoverishment.Current challenges include the continued financing of the primarily tax-financed health system. As a largeproportion of the population live in poverty and contribute little, there is widespread concern that the status quo isnot sustainable.IndicatorsWhere is the country’s government in the journey towards defining ‘Obesity as a disease’?Where is the country’s healthcare provider in the journey towards defining ‘Obesity as aDefined as diseaseSome progressdisease’?Is there specialist training available dedicated to the training of health professionals toNot knownprevent, diagnose, treat and manage obesity?Have any taxes or subsidies been put in place to protect/assist/inform the population aroundYesobesity?Are there adequate numbers of trained health professionals in specialties relevant to obesityYesin urban areas?Are there adequate numbers of trained health professionals in specialties relevant to obesitySome progressin rural areas?Are there any obesity-specific recommendations or guidelines published for adults?Are there any obesity-specific recommendations or guidelines published for children?53NoYes

In practice, how is obesity treatment largely funded?Out of pocketPerceived barriers to treatmentHigh cost of out ofpocket paymentsPoor availability ofObesity considered anpharmaceuticalaesthetic issuetreatmentsSummary of stakeholder feedbackObesity is high on the government’s agenda in Thailand and is increasingly being prioritised. There has beenseveral healthy lifestyle campaigns and public awareness drives alongside clear policies ambitions from theMinistry of Health. Preventative action on obesity includes both the introduction of a sugar tax and mandatoryfood labelling.While it is felt that most healthcare professionals believe obesity to be a disease, this appears not to extend to theinsurers as there is limited to no reimbursement for obesity treatment. It appears that only lifestyle andbehavioural treatment is covered by public insurance and so most obesity treatment received is paid for out ofpocket.Stakeholders reported that there is a sufficient number of obesity treatment professionals in urban areas, but lessso in rural areas. Stakeholders noted, however, that there are no guidelines in place for these professionals tofollow. A literature search found 2014 obesity guidelines for children by the Royal College of Paediatricians but itappears that there are not well-versed with the public as the stakeholders were not aware of it.Based on interviews/survey returns from 3 stakeholdersLast updated: June 2020PDF created on December 31, 202154

Notes: Prevalence of Overweight & Obesity by Education in Urban Areas In this graph, overweight refers to BMI 25– 30, and obesity as BMI 30 kg/m2 Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m²,

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