Let's check your BMI, shall we? (BMI = body weight (kg)/height squared (m2)
The Thai NCDs Network Association, together with Novo Nordisk Pharma (Thailand) Co., Ltd., organized a seminar on solving "Obesity" on the topic of "OBESITY": A Public Health Crisis" at the Thai Annual Conference NCD Alliance 2023 under the theme "Fighting the Obesity pandemic" for doctors and medical personnel across the country at the convention center, True Icon Hall, Icon Siam, Bangkok. The event created an opportunity to discuss many aspects of the obesity problem, especially the cost that the government has to bear. The urgency of addressing the problem of obesity from all sectors, having a policy to prevent obesity, and pushing for clear and effective obesity treatment guidelines to solve the problem for this group of patients. At the event, it was an honor to be interviewed by Associate Professor Dr. Petch Rod-Aree Royal, President of the Thai NCDs Network Association, and Professor Wannee Nitiyanant, M.D. President of the Diabetes Association of Thailand by mentioning the main themes as follows:
Obesity is an important disease that requires immediate actions because it affects 200 other serious complications, such as diabetes, high blood pressure, excess fat, heart disease, dementia, etc. Obesity trends in Thailand continue to rise. According to the results of a survey conducted in 2020, the prevalence of obesity increased as high as 42%, with Bangkok experiencing a much higher increase of 56%. Compared to Bangkok, 50% of the populace is obese. If not properly managed, it will lead to a result of a significant public health impact. Hence, this will necessitate collaboration between the public and private sectors to expedite the search for methods to prevent and resolve the obesity crisis.
Mr. Enrico Cañal Bruland Vice President & General Manager of Novo Nordisk Pharma (Thailand) Co., Ltd. stated that: “Novo Nordisk is committed to driving change for people living with obesity in Thailand. We have invested significantly in research & development including local studies here in
Thailand, and we have accelerated access to our innovative medicines for people living with obesity. As Prof. Wannee mentioned, the cost burden of obesity is huge with tremendous financial impact on society. In Thailand this situation requires urgent action to tackle this disease and the time to act is now. The sustainability of the Thai healthcare system depends on our success in curbing this obesity crisis, otherwise the system will soon be overwhelmed by the exponential trajectory of direct and indirect cost. For Thailand the overall healthcare spend sits at 6.6% of GDP, while 1.5% of GDP is dedicated to obesity and its related complications. If we don’t act, this number alone will rise to 6.4% of GDP based on recent data. This will certainly affect everyone in our generation here in Thailand. That is why Novo Nordisk is committed to driving change for people living with obesity. We are looking forward to establishing strategic partnership and initiatives between the government and private sector to change obesity in Thailand.”
The discussion, titled "OBESITY: A Public Health Crisis," was well-received due to the multi-sectoral cooperation in caring for obese patients in Thailand:
• Professor Wannee Nitiyanant, President of the Diabetes Association of Thailand
• Associate Professor Dilok Piyayptai, M.D., Dean of Thammasat University Hospital
• Dr. Krisada Hanbunjerd, M.D. Director of Division of Non-Communicable Diseases (NCD), Ministry of Public Health
• Dr. Sathit Niramitmahapanya, M.D. Director of Institute of Medical Research and Technology Assessment Department of Medical Services (DMS), Ministry of Public Health
• Ms. Rachata Unsuk, Director of Medical Welfare Legal Group, Comptroller General's Department, Ministry of Finance
In conclusion, in the view of experts that
• According to the obesity population, Bangkok's total population is approximately 5,490,000 individuals. Around 356,000 people aged 20-69 with a BMI between 30 and 50 discovered that if they lose 10% of their weight over the next decade, they can save up to two billion baht on medical expenses.
• The government sector, such as the Centers for Disease Control has implemented obesity management in the health service system through "NCD Clinic Plus," which handles weight control in patients with underlying diseases and has a workplace policy strategy to drive policies that will make government agencies and private organizations have a good health policy for their employees. In addition, there is a push for the implementation of "NCD Clinic Plus" in the sub-district hospital for health promotion and numerous other sectors, etc.
• Obesity surgery can currently be reimbursed (the amount depends on medical treatment rights) if the patient has a BMI of 37.5 (no comorbidities) or 32.5 + 1 or more comorbidities. At present, there are no clear criteria for reimbursement of obesity drugs. If we consider obesity to have long-term effects on both patients and the economy, having clear requirements and guidelines for the treatment of obesity will result in the greatest benefit in the future reimbursement of medical expenses for obese patients by "always payment mechanism related to medical service." Therefore, clear local treatment guidelines plus studies of the health economic value (Cost-Effectiveness) in treating patients (such as behavior modification or drugs for the treatment of obesity, etc) are the key for further considerations beyond surgery.