The Shay Rebellion | Christopher Shay

Hong Kong’s Expanding Obesity Problem

by Christopher Shay

A note to Hong Kongers for the new year: Watch your waistlines.

Obesity rates among men and children in Hong Kong are on the rise, and researchers say it’s related to the usual suspects: lack of exercise, poor diet and stress.

A May 2010 study found that the rate of central obesity — fat around the stomach—in Hong Kong men had risen, despite little change in overall weight, to 27% in 2005 from 23% in 2001. Hong Kong kids are also putting on fat: General obesity rates among primary-school students climbed to 22.2% in 2009-2010, from 16.7% in 1996-1997, according to the latest government data available.

Although the city’s obesity problem isn’t as bad as that in the U.S., where a third of the population is classified as obese by the Centers for Disease Control and Prevention, it is a growing and costly problem.

Obesity, especially central obesity, increases the risk of other health problems such as diabetes, heart disease and hypertension. And according to a 2008 government study, the costs associated with obesity account for 10% to 20% of Hong Kong’s total public expenditure on health every year.

Hong Kong isn’t alone: Obesity is also on the rise in Taiwan, Singapore and Japan. In China, childhood-obesity rates in coastal cities grew more than 20-fold between 1985 and 2000.

“People’s tummies are getting much worse,” says Dr. Gary Ko, vice-president of the Hong Kong Association for the Study of Obesity, a professional association. A bad diet and not enough exercise are the biggest culprits, but Dr. Ko says that stress and long workdays also play a role.

But how is central obesity—and general obesity—defined? The answer varies from study to study and between gender and age groups as well. Among adults, central obesity is often measured using a waist-to-hip ratio, where the circumference of the waist is divided by the circumference of the hips.

According to some studies, the optimum waist-to-hip ratio for women is about 0.7 for women and 0.9 for men; ratios above 0.85 for women and 0.95 for men cross the line into obesity.

But in the May 2010 Hong Kong study, a waist-to-hip ratio wasn’t used at all – the study focused on waistlines: a waistline of more than 90 centimeters for men was defined as obese; 80 centimeters for women.

South Asians appear to be more susceptible to being thicker around the middle than Chinese or Caucasians, though the exact reason for this is unclear. A 2004 health survey in England showed that the Chinese Britons are less centrally obese than the average U.K. citizen and also are less obese overall. Bangladeshis and Pakistanis living in the U.K., on the other hand, have an above-average waist-to-hip ratio, according to the survey.

Obesity among children in Hong Kong is usually defined using a measure of weight against height, similar to the Body Mass Index (BMI). Kids with such a measure above the 120th percentile compared with other children of the same age and sex are considered obese in Hong Kong.

In the U.S., the standards are stricter: Kids with a BMI at or above the 95th percentile are classified as obese, according to CDC. Hong Kong parents “like the child fat,” says Dr. Christine Chan. “If the child is not fat, the parents feel guilty.”

Dr. Chan, a psychology professor at the Hong Kong Institute of Education, blames the growing child-obesity problem on culture, as well as the rise of fast-food chains and videogames. Childhood-onset obesity poses even graver health risks: A child who is obese before the age of 5, says Dr. Chan, is 12 times more likely to be obese later in life.

The government has initiated a campaign,, to teach students healthy-eating habits and ensure that local schools offer nutritious lunch and snack options. This year, 65% of Hong Kong’s primary schools participated.

Ultimately, says Dr. Ko, the HKASO vice president, the cause of obesity is simple: “You have more energy intake into your body, but less energy being released” and that causes weight gain.

Last October, in an effort to raise awareness of the issue, York Chow, the secretary of Food and Health, challenged the city’s Legislative Council to lose weight, saying, “I see some fat legislators in this council… and secretaries, too. We should lead by example for our citizens.”

So far, the challenge has gone unmet.

Category: Article, Health

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