Obesity is on the rise in Singapore, with recent studies revealing a worrying trend.

The 2021/2022 National Population Health Survey by the Ministry of Health showed that the prevalence of obesity among adults aged 18 to 74  in Singapore had increased from 2020 to 2022.

The World Obesity Federation has also reported that our nation now ranks third among Asian countries in terms of adult obesity percentage. 

According to the National University Health System (NUHS), obesity is a chronic disease caused by having too much body fat, and can increase the risk of several other medical conditions. 

An article by Harvard Health in 2019 explained that there are several factors that can contribute to a person becoming overweight — from genetic factors to diet, lifestyle and stress.

Speaking to AsiaOne, Wong Hui Mei, principal dietitian at Gleneagles Hospital, shared that one of the biggest dietary contributors to the rising obesity rates in Singapore is the increased convenience and affordability of ultra-processed food such as fast food, ready-to-eat meals and sugary beverages. 

"These foods are high in calories, high in fat and sugar, low in nutrients, and may lack balanced nutrition. They're also more affordable than healthier alternatives. This makes it harder for individuals to make nutritious choices," she stated. 

Her statement is echoed by Dr Koh Huilin, a consultant in Endocrinology at Woodlands Health, who told AsiaOne: "We have an obesogenic (tending to cause obesity) environment where local delights tend to be high calorie-density food with high carbohydrates and high fat, as well as ultra-processed foods that are available 24/7 and rather inexpensive." 

And other than diet and lifestyle, are there any other factors that could affect a person's weight?

How Singapore's physical and cultural environment plays a part

According to Dr Koh, there are several factors that come into play, including things like physical and cultural environment — especially in the context of Singapore. 

"Our humid weather makes it unattractive to exercise outdoors despite the many green spaces and park connectors being developed. Our stressful work culture with long hours take time away from self-care amidst other familial roles such as caregiving. It can also lead to poor quality sleep or insomnia. Poor sleep with inadequate hours or poor quality can lead to increased hunger, cravings and reduced metabolism," she explained. 

The impact of medical conditions on obesity

In addition to these external factors, Dr Anuradha Negi, specialist in Endocrinology and senior consultant at Raffles Diabetes and Endocrine Centre, shares that there are also several medical conditions that contribute to obesity. 

"Several endocrine disorders such as hyperthyroidism, polycystic ovarian syndrome (PCOS), Cushing's syndrome and growth hormone deficiencies can lead to weight gain or make weight loss harder," she told AsiaOne. 

Mental health's part in obesity

On top of that, mental health also plays a part, as explained by Hui Mei, who said that many often turn to overeating as a way to cope with high levels of stress — which often results in consuming excessive calories. 

This is also backed by Dr Precelia Lam, general practitioner at Raffles Medical, who shared with AsiaOne: "Stress, anxiety and depression can lead to emotional eating, binge-eating or poor food choices. Some people turn to food for comfort, especially high-sugar or high-fat options for the 'dopamine hit'." 

The role of prescribed medications

The idea that certain medications can cause weight gain isn't just a myth, either. 

According to Dr Koh, some prescribed medications used to treat psychiatric and chronic conditions such as diabetes, autoimmune conditions or acute asthma attacks (steroids) may lead to weight gain, and chronic use of anti-histamines can also "make one susceptible for weight gain". 

She also noted that certain medications used to treat diabetes like insulin, sulphonylrea and thiazolidinediones can result in weight gain, but more as a "physiologic response rather than an abnormal weight gain". 

Dr Koh also added that conversely, some medications used in chronic disease management can help with weight loss. 

"That said, medications are selected and tailored by one's doctor to best treat the underlying condition, hence they should not be stopped without consultation with your doctor," the endocrinologist said. 

Genetic and ethnic factors

At times, we might observe that some people tend to lose or gain weight easily while for others, it might be tougher — even when they seemingly consume the same amount of food. 

According to Dr Negi, this is because genetics also affect whether a person is more prone to obesity. 

"Genetics play a role in how the body regulates appetite, converts food into calories, and how your body burns calories during exercise," she explained. 

She also added that ethnicity also has a hand in it all, with certain ethnic groups such as South Asians and East Asians having a tendency to have higher visceral fat at a lower BMI. 

Dr Abel Soh, endocrinologist at Mount Elizabeth Hospital, also seconded that genetics and ethnicity are contributing factors to obesity. 

"At least 15 genes have been found that can contribute to a person becoming obese. In Singapore, ethnic groups like Malays and Indians have higher rates of obesity compared to the Chinese, likely due to a combination of genetic and lifestyle factors," he stated. 

Health implications of obesity 

Regardless of the cause — obesity often comes with health implications which can significantly increase the risk of serious and chronic conditions. 

Speaking to AsiaOne, Dr Tham Kwang Wei, senior consultant in Endocrinology at Woodlands Health, said that obesity is currently associated with 265 medical conditions and diseases, which reflects "the degree to which excess body fat can cause havoc to one's body". 

And while it affects everyone differently to a certain extent because of how fat is distributed, how the body reacts to excess fat and different lifestyles, it doesn't mean that the risks that come with obesity are any less significant.

"If one does not have any medical issues at present related to obesity, that person still remains at risk," she warned. 

According to Dr Lam, some chronic health problems associated with obesity include: 

• High blood pressure 
• High cholesterol 
• Type 2 diabetes 
• Cardiovascular disease 
• Stroke 

But that's not all. 

"One growing concern is sleep apnoea, which causes trouble breathing and poor overall health. Joint and mobility problems [also] arise from extra weight being put on joints, causing osteoarthritis and lower back pain. Obesity is also linked to higher risk of certain cancers like breast, colon and liver cancer," the GP warned. 

Additionally, Dr Wong shared that fatty liver is also one of the health conditions associated with obesity. 

Experts' advice on tackling obesity 

For those struggling with obesity, it's not only important to get to a healthy weight — but to lose the weight healthily and in a safe manner to reduce the health risks.

Hui Mei suggests calorie counting to lose weight — explaining that it's an important factor even when consuming nutritious foods as it's still possible to take in more calories than the body needs when doing so — which would ultimately hinder weight loss. 

"It's also crucial to focus on sustainability and practicality. The best approach is one that you can maintain in the long term without feeling overwhelmed. Extreme calorie restriction or over-exercising can be difficult to sustain and might lead to burnout," she added. 

She also explained that if you continue to struggle with losing weight despite that, "it's a good idea to consult a healthcare professional" as "they can help identify any underlying health conditions" and "offer personalised advice and support" in order to help reach your weight loss goals safely and effectively. 

To those who are struggling to lose weight, Dr Lam also advises that it's important to recognise that "weight loss is often non-linear". 

She stated that plateaus happen when trying to lose weight, and it's okay — because "the goal is not perfection, but progress and persistence." 

"You're not alone, and you're not a failure. Obesity is a complex, chronic condition, and treating it requires support, compassion and realistic strategies. You don't have to run marathons. Dancing, walking, swimming or even gardening counts. Movement should feel energising, not punishing. Consistency beats intensity," she encouraged. 

The GP also warned against buying into fad diets and pseudoscience online. 

"If something sounds to good to be true, for example, losing 10kg in a week, it probably is," she said. 

For those who aren't sure where to start, Loh Win Nie, vice president of the Singapore Nutrition and Dietetics Association, also shared simple tips that may "make a difference in managing weight and building healthier habits without needing a total lifestyle overhaul", including: 

• Asking for more vegetables when eating out (make at least half your plate plant-based) 
• Choosing plain drinks more often (go for plain or sparkling water, or ordering less-sugar versions of your favourite drinks) 
• Eating slower to feel fuller as it takes time for our brains to register fullness 
• Not waiting until you're starving to eat as it's more likely to lead to overeating or unhealthy fast fixes 
• Watching portions, not just food choices as even healthy food can lead to weight gain in excess 
• Moving in short bursts throughout the day (take the stairs, brisk 10-minute walks after meals or stretch between meetings) 

Finally, she expressed that it's also crucial not to be too hard on yourself on your weight loss journey. 

"Last but not least, be kind to yourself. Change takes time. It is okay to enjoy your favourite food once in a while. The goal is not to restrict, but to find a healthier rhythm that works for you in the long run. Small, consistent changes make the biggest impact. It's not about dieting; it is about learning what works for your lifestyle and taking steps that are realistic and sustainable," she concluded. 

As for those who are struggling to lose weight on top of certain medical conditions and medications, Dr Koh advised that it's a good idea to consult a doctor or healthcare professional.

"Best to seek help from medical professionals for guidance as one's overall health condition, along with the obesity, needs to be managed comprehensively and holistically. For example, some medications may not be suitable for people on certain medications or [with] certain conditions," she stated.

carol.ong@asiaone.com

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