Collective Action Needed To Tackle Childhood Obesity

Barnama

a day ago

T
his is the final instalment of a four-part series exploring the growing prevalence of overweight and obesity among children in Malaysia.
Addressing childhood obesity is not merely a matter of making changes to diets and lifestyles but requires a comprehensive, cross-sectoral approach, ranging from public health policies to community-level enforcement and awareness.
According to the National Health and Morbidity Survey (NHMS), the obesity rate among children under 18 has shown an alarming upward trend – from 11.9 percent in 2015 to 14.8 percent in 2019. It remained high at 14.3 percent in 2022.
The latest NHMS 2024 statistics also reveal that obesity among children and adolescents aged five to 19 remains significantly high at 13.6 percent, proving that this issue has yet to be fully addressed.
As the country's lead agency in health-related matters, the Ministry of Health Malaysia (MOH) bears a major responsibility in tackling obesity. However, the issue also calls for the commitment of various parties to share the responsibility and implement coordinated solutions.
SET REGULAR MEALTIMES
Head of the Dietetics Department at Universiti Malaya Medical Centre (UMMC) Dr Rokiah Ismail emphasised a balanced, nutrient-rich diet to ensure children grow up healthy, active and with optimal energy, adding that children need food that supports growth and brain development and keeps the immune system strong.
Admitting that limiting the intake of sugary, oily and other unhealthy food is a big challenge, especially with such food heavily promoted on social media and TV, she said it can, however, be done through several strategies. These include educating children early about the harmful effects of unhealthy food.
'When watching TV with children, parents can explain the pros and cons of (consuming) the advertised foods.
'Set specific mealtimes every day. This helps prevent children from becoming too hungry or reaching for unhealthy snacks between meals,' she said, adding that involving children in meal preparations can make them appreciate healthier home-cooked food.
She also said physical activities and exercise play a key role in helping obese children lose weight and achieve a healthy weight. Exercise also improves fitness, muscle strength, heart health and mental well-being. Suitable physical activities for obese children include brisk walking, jogging, cycling, swimming, football, netball, basketball, strength training, outdoor obstacle courses and yoga or pilates.
Acknowledging that it is not easy to encourage obese children to participate in sports and lead a healthy lifestyle, Rokiah said it is a process that requires patience and urged parents and schools to create a supportive environment, such as organising various fun-filled activities consistently.
'… focus on participation (satisfaction) rather than outcomes (winning) and set a good example for the children,' she told Bernama.
ACTION TAKEN BY LOCAL COUNCILS
Meanwhile, responding to the issue of vendors selling unhealthy snacks and beverages outside the gates of schools, Seremban City Council (MBS) mayor Datuk Masri Razali said the authority has been monitoring the areas concerned and conducting enforcement actions, in accordance with Section 80 of the Local Government Act 1976, Section 46 of the Street, Drainage and Building Act 1974, and the Hawkers By-Laws 1980.
He said enforcement is carried out in response to public nuisance complaints, obstruction of public spaces and unlicensed hawking activities. Actions taken include issuing relocation notices and offence notices, imposing compounds, and seizing goods when necessary.
(In the third instalment of its four-part feature on childhood obesity titled 'Obesity's Toll On Children's Mental, Emotional Health', Bernama reported that its survey at several primary schools in Kuala Lumpur and Negeri Sembilan had shown that besides sweets and snacks, fast food like sausages, nuggets and ice cream, and a variety of brightly coloured carbonated drinks were also being sold by vendors outside school gates.)
Masri said all business activities within MBS administrative areas, whether on public or private property, must first obtain permission from the local authority. Business licences or permits issued come with conditions, such as only operating in designated zones where hawking is permitted.
He added that MBS also acknowledges the Guidelines on the Prohibition of Sale of Unhealthy Food and Beverages issued by the Ministry of Education Malaysia (MOE) and MOH. However, these guidelines have not yet been formally adopted by MBS.
'At present, enforcement against vendors operating outside school premises is carried out solely under the Hawkers By-Laws 1980 and other applicable legal provisions,' he pointed out.
PUBLIC COMPLAINTS
Masri also said MBS is currently trying to balance law enforcement with the rights of local citizens who earn a living through street vending.
For Malaysian citizens engaged in illegal hawking activities, enforcement action begins with a relocation notice, requiring them to move to designated hawker sites provided by MBS.
'However, if their operations pose a risk to public health or safety, we will escalate our enforcement by issuing them a formal notice of offence, and a compound. Seizure (of goods) will be carried out if necessary.
'For non-citizen hawkers, MBS adopts a zero-tolerance approach and will immediately confiscate goods without prior notice, in line with existing enforcement policies and high-risk control requirements,' he said.
On the sale of junk food in front of schools, Masri said MBS has received complaints on this matter from the public.
To address the issue comprehensively and enhance the effectiveness of their enforcement activities, MBS is collaborating with the Parent-Teacher Associations (PTA) of the schools concerned, he said.
'Previous enforcement actions, such as issuing notices and fines, proved ineffective in stopping illegal vending in these areas. As a result, banners have been put up prohibiting hawking at school gates. This measure serves as a final warning to vendors to trade only in authorised areas, and that strict action will be taken for non-compliance.
'The banners also serve to remind parents and students to follow the rules and raise awareness on the importance of safety and respect for local laws,' he said, adding that complaints, inquiries or suggestions can be submitted to the MBS Public Complaint Management System (SISPAA) at mbseremban.spab.gov.my; the Respon Rakyat mobile app (available for free download); or by calling 06-7654444.
A visit last week to one of the primary schools in Negeri Sembilan that Bernama had surveyed earlier found no more hawkers outside the school gate. MBS has also put up a banner there prohibiting the sale of food and drinks in the area.
INITIATIVES IMPLEMENTED BY MOH
Expert advice, community engagement and enforcement measures can help curb unhealthy food environments, but long-term solutions require comprehensive interventions driven by national public health policy.
In this context, MOH plays a key leadership role in developing a holistic obesity management ecosystem, starting from prevention to clinical treatment.
The ministry said it has developed and implemented the 'Guidelines for the Enforcement of the Ban on the Sale of Food and Beverages Outside School Gates', which came into effect on July 13, 2012.
'The implementation of these guidelines banning the sale of unhealthy food outside school areas is an important environmental intervention to support the government's efforts to reduce obesity rates among children in Malaysia.
'These guidelines aim to control students' access to unhealthy food sold outside school premises, which has been identified as one of the contributing factors to the rising problem of childhood obesity,' the ministry said, adding that the implementation is carried out in collaboration with local authorities and monitored by the Ministry of Housing and Local Government.
MOH said it has also developed a national obesity management ecosystem, encompassing strategies for obesity prevention and management across the general population, high-risk groups and clinically obese population, aligned with the World Health Organization (WHO) Acceleration Plan to Stop Obesity.
'This approach includes interventions at all levels, from primordial, primary and secondary to tertiary prevention, aimed at fostering healthy environments, preventing new obesity cases, and offering structured treatment and support for those in need.
'At the primordial and primary prevention levels, the focus is on shaping environments that minimise exposure to obesity risk factors,' said the ministry.
Key policies and interventions include the implementation of a sugar-sweetened beverage tax in 2019, covering ready-to-drink and pre-mixed drinks.
Other efforts include the introduction of the 'Healthier Choice Logo' (in 2017) and the launch of the 'War on Sugar' campaign on June 29 last year by Health Minister Datuk Seri Dr Dzulkefly Ahmad.
NATIONAL AGENDA FOR A HEALTHY MALAYSIA
The promotion of healthy living was further strengthened through the National Agenda for a Healthy Malaysia (ANMS), launched in 2020. ANMS is a national movement that aims to cultivate healthy lifestyles through communication campaigns and community engagement, and by providing supportive environments.
'Under the second pillar of ANMS, the delivery of health well-being services has been expanded through the establishment of Wellness Hubs. Weight management interventions are among the key services offered across 33 Wellness Hubs nationwide.' MOH said.
It reported that from 2020–2024, a total of 14,671 individuals participated in weight management intervention programmes at the Wellness Hubs, with 77 percent (9,075) successfully losing more than one kilogramme, and 16 percent reducing at least 10 percent of their initial weight by the end of the intervention.
High-risk individuals are referred to healthcare and community facilities for further management, including lifestyle interventions, weight management and health risk monitoring.
The ministry also said that as of 2025, KOSPEN (its Healthy Community, Nation Builders Programme) is being conducted in 793 localities nationwide, with the help of 7,662 volunteers acting as community health agents.
'The programme emphasises early detection of non-communicable diseases (NCDs), and promotes healthy diets and physical activity. Involving the adult community in the programme helps create homes that support healthy habits, which will benefit children as well,' it said.
These intervention programmes are essential as recent reports have confirmed that Malaysia continues to rank among the countries with the highest diabetes prevalence in Southeast Asia, with one in six Malaysians having the condition. This is not surprising, given the rising obesity rates, one of the major contributing factors to diabetes.
The 2023 NHMS showed a worrying increase in the prevalence of overweight and obesity among Malaysians, from 50.1 percent in 2019 to 54.5 percent in 2023.
INTERVENTIONS FOR CHILDHOOD OBESITY
Meanwhile, to specifically address childhood obesity, MOH has rolled out targeted programmes within educational institutions.
In 2018, the ministry implemented the Health Promotion in Learning Institutions (HePiLI) programme to promote health from preschool to higher education levels.
'The scope of this programme covers healthy eating, physical activity and lifestyle practices to promote a health-oriented culture among students.
'A key component (of the programme) is the Young Doctors Club, established in both primary and secondary schools, where students are trained as peer educators to promote messages on nutrition and physical activity,' MOH said.
HePiLI has been implemented in 6,076 kindergartens/preschools through the 'Tunas Doktor Muda' programme; and in 3,530 primary schools and 900 secondary schools nationwide.
MOH has also formed a dedicated taskforce committee to address obesity in Malaysia and implemented the 'National Strategic Plan to Combat the Double Burden of Malnutrition among Children (2023–2030)', which involves various parties.
Through this plan, the ministry has set a target to reduce the rate of overweight children under the age of five to three percent by the year 2030, compared to the current rate of six percent recorded in NHMS 2022.
Meanwhile, for children aged five to 17, the National Plan of Action for Nutrition Malaysia III (2016-2025) has set a target to maintain obesity and overweight rates at the base rates recorded in 2015, with no further increase.
The base rates are: for children aged five to nine (obesity 14.8 percent and overweight 12.0 percent); children aged 10 to 14 (obesity 14.4 percent, overweight 16.0 percent); and children aged 15 to 17 (obesity 9.6 percent and overweight 14.4 percent).
MOH's key initiatives are being carried out through its 'Policy Options to Combat Obesity in Malaysia' starting in 2016. The initiatives were improved under its 'Reviewed Policy Options to Combat Obesity in Malaysia (2021-2025)', with 60 percent of initiatives targeting child-centric settings such as schools and kindergartens.
'One such initiative is the Healthy Meals in Schools (HiTS) programme, which ensures students are provided only with nutritious meals during recess. Full implementation of HiTS (without the sale of other food items at canteens) helps reduce the risk of overeating and address the sale of unhealthy food in schools,' the ministry added.
FIRST 1,000 DAYS OF LIFE
MOH has also implemented the 'First 1,000 Days of Life' initiative, which targets pregnant mothers and children up to two years old. It focuses on nutritional care and health as a preventive measure against childhood obesity.
'This period is considered a golden phase in children's development, where optimal nutrition and healthcare can have a long-term impact on their health,' it said.
Another initiative is the 'Healthy Eating Responsibility for Women' (HER), which focuses on preventing obesity and anaemia among women in the reproductive age (15–49), ensuring future generations are born healthy.
MOH has also appointed lead coaches from among PTA members under its 'Your Best Lifestyle' (C-HAT) programme to promote nutrition and healthy activities in schools. This is complemented by the widespread dissemination of healthy eating information for children, particularly by MOH nutritionists via social media platforms.
MOH also conducts school health screenings, including weight monitoring. Children identified as obese are referred to health clinics for treatment and further intervention.
RAISE SUGAR TAX
MOH said it has also been monitoring food and beverages sold in school canteens since 2012, using MOE's list of prohibited food and beverages as its guide.
'Out of 905 schools inspected by MOH in 2024, 678 (74.9 percent) complied with the ruling. MOE will issue reminders to district education offices and schools found violating the ruling,' MOH said.
Meanwhile, the sugar-sweetened beverage (SSB) tax introduced in 2019 has proven to be effective, with consumption of such beverages among teenagers dropping from 36.9 percent (NHMS 2017 findings) to 16.4 percent (2022 Impact Assessment Study on SSB Taxation).
The NHMS: Adolescent Health Survey 2022, meanwhile, showed a decline in the prevalence of daily carbonated drink consumption (at least once a day), from 36.9 percent in 2017 to 32.4 percent in 2022.
MOH said the current SSB tax of RM0.90 per litre should be raised to further reduce sugary drink consumption, particularly to combat childhood obesity.
While current taxation focuses on beverages, MOH has not ruled out the possibility of studying and considering imposing taxes on food in the future if the food industry fails to reformulate their products to contain less sugar, salt and fat, and include more nutrients.
According to WHO, health taxes are levied on products that have a negative public health impact, for example, tobacco, alcohol and sugar-sweetened beverages (SSBs).
These taxes are considered 'win-win-win' policies because they save lives and prevent disease while advancing health equity and mobilising revenue for the general budget.
The aim of health tax policy is to reduce the consumption of products deemed risk factors for noncommunicable diseases by making them less affordable through higher prices. This is achieved with regular tax increases large enough to result in real price increases greater than economic growth.
Excise taxes are the most effective tax measures for promoting health because they change the prices of harmful products relative to other goods and can be easily increased over time.
ADVERTISING GUIDELINES
In October 2024, Health Parliamentary Select Committee chairman Suhaizan Kaiat announced the drafting of a Malaysian Nutrition Act to regulate food nutrition, especially among children.
On May 24, Bernama reported that MOH is drafting a Nutrition Bill following Cabinet approval of its proposal on the matter. However, the Bill would not be tabled in Parliament this year.
On the issue of fast food advertisements targeting children, MOH said the 'Guidelines for Advertising and Labelling Nutritional Information for Fast Food', introduced in 2008, should serve as a guide to fast food companies, advertising agencies and broadcasters.
'The guidelines prohibit fast food advertisements during children's TV programmes and prevent sponsorship of such programmes by fast food companies. These rules are aimed at raising public awareness and shifting behaviour toward healthier dietary habits.
'MOH is also considering making it mandatory to restrict the advertisement of food and beverages high in fat, salt and sugar on all local and international media platforms, including digital media,' the ministry said.
In terms of treatments for obesity, MOH said it has improved clinical obesity management by providing pharmacotherapy and non-pharmacotherapy options, supported by early detection, multidisciplinary interventions and digital tools.
'On the whole, MOH adopts a whole-of-government and whole-of-society approach in addressing obesity,' it added.
Ultimately, the fight against childhood obesity is not solely the responsibility of the government, local authorities, parents, schools, teachers or healthcare professionals. It is a collective responsibility, with industry players, in particular, playing an important role in fostering an environment that promotes the health and well-being of the next generation.
According to WHO, NCD management interventions are essential for achieving the Sustainable Development Goals (SDGs) target on NCDs
The final instalment of this four-part series concludes with a call to action that the future of our children must not be clouded by obesity statistics. Now is the time for all parties to take greater, more serious, and more effective action to tackle childhood obesity in Malaysia.
(This story was produced under the 'Communicating Noncommunicable Diseases' Media Fellowship by Probe Media Foundation Inc [PMFI], Reporting ASEAN [RA] and World Health Organization [WHO]. The views and opinions expressed in this piece are not necessarily those of PMFI, RA and WHO.)