MALAYSIA has long been labelled the “fattest nation” in Asia. The share of overweight and obese adults rose from 44.5% in 2011 to 54.4% in 2023, an almost 10% jump in a decade. The 2023 National Health Screening Initiative recorded a similar figure, with 53.5% of Malaysians screened as overweight or obese.
The crisis is not confined to adults; it has been found that childhood obesity doubled over 26 years while Malaysia now has the second-highest child obesity rate in Asean, with 7.1% of children under five overweight.
The 2023 National Health and Morbidity Survey (NHMS) showed that 95.1% of Malaysian adults eat too little fruit and vegetables while 84% are inactive in sports, leisure or fitness – patterns reinforced by Malaysia’s car-centric culture, where the lack of sidewalks, crossings and bike lanes discourages walking, cycling and public transport.
Ultra-processed foods and sugar-sweetened beverages (SSB) have become cheaper, more convenient and heavily marketed, keeping consumption high despite stagnant incomes and rising living costs.
Sugar intake remains dangerously high. It has been observed that 53.6% of surveyed Malaysians consume SSB daily. Among university students, the average daily sugar intake is 12 teaspoons – double the WHO’s recommended six.
At the same time, the 2023 BMJ (British Medical Journal) umbrella review of more than 8,000 studies found high sugar intake linked to 83 harmful health outcomes, most reliably body weight gain, childhood obesity, coronary heart disease, ectopic fat and depression. Notably, it was empirically derived that SSB intake should be limited to less than one serving per week – far below Malaysia’s daily habits.
Obesity is closely tied to non-communicable diseases (NCD). Globally, NCD already account for 75% of non-pandemic-related deaths, 73% of them in low and middle-income countries. In Malaysia, the NCD fatality rate reached 19.4% in 2021 and is expected to climb, driven by deaths from diabetes, cancer and cardiovascular disease.
Obesity is not only a public health crisis but also an economic one. It already consumes 10% to 20% of Malaysia’s healthcare budget.
Obese individuals may also lose up to 12 productive years through absenteeism, presenteeism, early retirement or premature death. The total economic burden was estimated at US$5.68 billion (RM23.88 billion) (1.6% of GDP) in 2019 and is projected to soar to US$104.55 billion (4% of GDP) by 2060.
To curb sugar intake, the government introduced an SSB tax in 2019 at 40 sen per litre, raised it to 50 sen in 2024 and further to 90 sen per litre in 2025. The Health Ministry also launched the healthier choice logo in 2019, limiting sugar content in sweetened beverages to less than 5g per 100ml. Yet, the SSB tax has had a limited impact.
An unpublished Health Ministry study (2022) found that at least 242 beverages were reformulated to sit just below taxable thresholds, keeping price increases at only 2.24% instead of the expected 8.83%.
For consumers, these numbers mean little: most cannot interpret nutrition labels. A simple rule of thumb: take the total carbohydrates and divide by four to get teaspoons of sugar. By that measure, a 355ml can of “reformulated” soft drink still delivers more than four teaspoons while a 500ml flavoured milk contains over seven – enough to exceed or nearly max out the WHO’s daily limit of six teaspoons in one serving, all while staying under the tax radar.
In a country where diets are already heavy with rice, noodles and sweetened kopi or teh, Malaysians are surpassing safe sugar levels long before the day is done. This is a public health disaster in slow motion, masked by reformulation and weak labelling. Without clearer education, the mentality that one or two drinks a day is harmless goes unchallenged.
Awareness remains another challenge. Another study found that 57% of Malaysians with obesity misclassified themselves as overweight or normal, partly because Malaysia sets obesity at BMI above 27.5, instead of 25, as in the wider Asia-Pacific. Worryingly, this higher cut-off not only feeds misperception but also means official surveys may be significantly understated.
The NHMS 2023 showed widespread underdiagnosis: two in five adults with diabetes, half with hypercholesterolemia and nearly 12% with hypertension were unaware of their condition. Such gaps can lead to complications, including kidney failure, stroke and heart disease.
The same study found that 48% of obese individuals felt negative emotions after weight-loss discussions with healthcare providers, potentially deterring follow-up care, yet only 67% of providers had formal obesity training, highlighting the need for greater professionalism.
Tinkering with isolated policies is no longer enough. Malaysia needs a whole-of-society strategy that hits at every level – from classrooms and clinics to supermarkets and city streets:
Obesity education and awareness: Scale up school-based education and nationwide campaigns that make sugar risks tangible (for example, teaching the “carbs ÷ 4 = teaspoons” rule). Link with Kospen to expand community-based screenings and early NCD interventions.
Professionalisation of healthcare providers: Make obesity training a core part of medical curricula and continuing education. Equip providers to design personalised weight-loss plans while mandating sensitivity training to reduce stigma and encourage patient follow-ups.
Multidisciplinary care models: Establish integrated clinics that tailor treatment to age, goals and motivation – combining exercise, diet, psychological support, BMI monitoring, medication and bariatric surgery where necessary. Prioritise long-term monitoring to sustain lifestyle changes.
Tax reform and revenue recycling: Lower the sugar thresholds that trigger taxation, raise the SSB tax rate to at least RM1 per litre and extend coverage to high-sugar foods. This dual approach would limit the industry’s ability to reformulate without meaningful change. Once products are forced either to become less sweet or more expensive, consumption will fall, as seen in the UK and Mexico. Redirect revenues into nutrition programmes such as Rancangan Makanan Tambahan and Super Sarapan, which provide free meals to low-income students.
Nudges and incentives for healthy lifestyles: Use clearer labels, reminders and strategic product placement to shift consumer behaviour. Partner with supermarkets and fintech platforms to reward healthy purchases and verified exercise milestones.
Digital engagement: Develop a national health app modelled after Singapore’s Healthy 365, with challenges, resources and activity tracking. Reward users for choosing HCL-certified products and exercising with redeemable points or e-vouchers.
Health-based urban planning: Redesign neighbourhoods to prioritise people over cars. Invest in safe sidewalks, bike lanes and green spaces while ensuring walkable access to public transport. As argued in Emir Research’s earlier commentary on road diets and car-centric urban design, shifting focus from moving cars to moving people can cut congestion and pollution while also combatting sedentary lifestyles.
Malaysia is running out of time. If obesity continues unchecked, the nation will face a double blow of collapsing public health and crippling economic losses – undermining productivity, prosperity and social stability.
Dr Margarita Peredaryenko and Avyce Heng are part of the research team at Emir Research, an independent think-tank focused on strategic policy recommendations based on rigorous research. Comments: letters@thesundaily.com
