Speech by A/Prof Benjamin Ong Director of Medical Services, Ministry of Health, at the Obesity, Bariatric, Endocrine Societies Symposium, 20 October 2017

Dr Asim Shabbir, President of Obesity and Metabolic Surgery Society of Singapore

Distinguished guests

Good afternoon.

1    I am pleased to join you today at this multidisciplinary symposium to address the issue of ‘Diabesity’, a term used to describe diabetes and obesity, which has become a global health priority.

‘Diabesity’– A growing concern

2    Worldwide obesity has nearly tripled since 1975 with an estimated nearly two billion adults overweight in 2016, of which more than half a billion were obese.^[1] Globally, there were more than 400 million adults with diabetes in 2015 and this is expected to increase to above 640 million by 2040.^[2]  The high disease burden is seen in Singapore, with one in three Singaporeans at risk of developing diabetes in their lifetime. Obesity, itself was the leading modifiable risk factor associated with our local burden of disease.^[3]

‘Diabesity’ can be prevented and its complications minimised

3    Prevention is better than cure. Being overweight is a well-established risk factor for chronic conditions such as Type 2 diabetes as part of the metabolic syndrome. Hence, one of the key measures to decrease the rising rate of diabetes prevalence is to tackle obesity. Leading a healthier lifestyle such as adopting healthier eating habits, exercising regularly and having appropriate health screening at regular intervals are steps we can take to prevent the onset of ‘diabesity’.

4    While the government continues its efforts to create a supportive environment for people in Singapore to better prevent or manage ‘diabesity’, the decision to adopt healthier living habits ultimately lies with each of us. For example, we can choose healthier dining options and opt for water instead of sweetened drinks. We can also take part in enjoyable physical activities with family members and friends while spending quality time together.

5    Early detection and timely treatment will help to delay disease progression and the development of related complications. As healthcare professionals, we should motivate our patients, their caregivers and families to adopt and maintain a healthy lifestyle, as well as to go for regular screening and the necessary follow-ups based on risk profile.  

Metabolic surgery

6    While lifestyle modification is the main treatment strategy for weight management, metabolic surgery may be considered for obese patients with at least one obesity-related comorbidity, especially if they have found it difficult to control with lifestyle and pharmacological therapy.

7    A review which looked at 136 articles with over 22,000 patients^[4], indicated that effective weight loss was achieved in morbidly obese patients after undergoing bariatric surgery. A majority of patients with co-morbidities such as diabetes and hyperlipidaemia also experienced resolution or improvement of the condition. Within the multi-disciplinary treatment approach, it has emerged as a tool to provide control in both weight and blood sugar

Conclusion

8    Effectively addressing ‘diabesity’ requires a multidisciplinary and collaborative approach that involves the patient, to reduce the burden that it places on our healthcare system. This conference is a good platform for us to gain new insights on the latest developments.  I hope the discussions at this meeting will also generate ideas for research which can eventually be translated into clinical and public health practice.

9    On this note, I wish everyone a fruitful meeting. 

^[1]Source: World Health Organization. Factsheet on Obesity and overweight - updated on October 2017. 

^[2] Source: International Diabetes Federation (IDF) Diabetes Atlas – 7^th edition 2015. 

^[3] Source: Singapore Burden of Diseases Study 2010. High Body Mass accounted for 12.1% of the total burden of disease in Singapore.

^[4]Buchwald H, Avidor Y, Braunwal E, et al. Bariatric Surgery. A Systematic Review and Meta-Analysis. JAMA 2004; 292(14): 1724-1727.