Former Asia health fellow details new approach to understanding obesity in Cambodia

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The number of obese and overweight people continues to rise in developing countries – Cambodia is no exception. Obesity and being overweight are in turn associated with a higher risk of chronic non-communicable diseases like diabetes. However, the relationship between body weight and disease risk may not be the same in different countries. If Asian populations show an elevated risk of disease at a lower body weight than in the west, policy recommendations based on western body mass index (BMI) standards may not be appropriate.

How should healthcare providers counsel patients and policymakers design policies to reduce risk and create prevention strategies in Cambodia, as well as elsewhere across the Asia-Pacific?

Former Developing Asia Heath Policy Fellow Siyan Yi, joined by other global health experts, considered these questions and recently published his findings in “Appropriate Body Mass Index and Waist Circumference Cutoff for Overweight and Central Obesity among Adults in Cambodia” in PLOSOne, Vol. 8, Issue 10, (October 2013).

Using cross-sectional data from a national survey conducted by the World Health Organization and Ministry of Health in Cambodia, the study aimed to identify the appropriate BMI and waist circumference (WC) cutoff to understand which individuals are considered overweight and thus have an elevated risk of disease.

For both men and women, significant associations were found between individuals who had diabetes, hypertension, and high cholesterol and a WC of greater than/equal to 80.0 cm and a BMI of greater than/equal to 23.0 kg/m2. Therefore, the study suggests that relevant cutoff to determine obesity designation is a WC 80.0 cm and a BMI 23.0 kg/m2, which is lower than the standard cut-off in the west.

The article findings may be particularly helpful to health policymakers in Cambodia. It is the first study of its kind – using nationwide data to suggest specific WC and BMI cutoff among Cambodian adults. The cutoff can act as a benchmark for health care providers to administer proper diagnosis. Furthermore, national public health programs could be developed to better target this population for health improvement.

Yi is now the Research Director of Population Health & Development at Khmer HIV/AIDS NGO Alliance (KHANA), an NGO in Cambodia that provides integrative HIV/AIDS prevention and support services.