Brunei's Obesity Rate Highest In The Region
By Za'im Zaini

Bandar Seri Begawan - Brunei Darussalam's obesity rate is the highest among Asean member countries.

The recent World Health Organisation (WHO) Global Database on Body Mass Index has placed Brunei at 37th and 43rd positions for adult women and men respectively for body mass index of 30 and more.

"This represents about 20 per cent from the Ministry of Health's total budget expenditure. The top 10 drugs are for the treatment of chronic diseases such as cardiovascular disease, approximately over $20M, cancer $6M, diabetes $3.7M, asthma $1.8M and gastro-intestinal $1.7M," he said. -

Drugs are dispensed free of charge in Brunei, and as the global price of drugs continues to go up, the burden is mostly borne by the government.

"In 2007, the hospitals alone gave out 580,459 prescriptions involving 1,747,284 drugs of all kinds, an increase from the 2006 figure of 557,292 prescriptions and 1,621,635 drugs.

"The health centres, in 2007, gave out 585,498 prescriptions and as many as 1,684,309 items of drags compared to 558,481 prescriptions and 1.5M items of drugs in 2006.

"On average, each cardiovascular patient is prescribed with seven types of drugs, for one month's supply at a total value of $307.50.

"Each cancer patient spends on average between $8,000 and $10,000 on drugs per year. Diabetes patients spend between $42 and $276 for a month's supply of drugs.

"On minor illnesses — such as common cold, cough, muscle pain, stomach upset, cuts and bruises — we are spending approximately $750,000," he said.

"All these are fine, if all the drugs we get from the pharmacies are actually used by us as prescribed by doctors. As is often the case, many of the drugs especially those that are given for common illnesses, are not being consumed according to prescriptions. This does not only mean outright wastage but this also affects the patient's recovery and often results in the patient's repeated visits to hospitals and health centres.

"For disease management to be truly effective, we have to look beyond the prescription of drugs. Effective care is all about effective self-care. Healthcare providers have traditionally treated their patients by prescribing medications. Emphasis on diet and exercise has been less important," the minister added.

Citing an example, the minister said, "In a study done in US, patients who have chronic diseases routinely see their doctors for management of their conditions. Many of these patients may require or desire exercise guidelines. Unfortunately only 10 per cent of visits to the doctors involve any mention of exercise prescriptions.

"We all know that inactivity results in chronic diseases such as cardiovascular and pulmonary diseases and diabetes and therefore disease management must include a regime of exercises. A study by a journal ofAmerican medical association in 1996 reported that less fit men and women are approximately twice likely to die during the eight-year follow up compared to their counterparts.

"In a study made by the Centre for Disease Control and Prevention (CDC), adults should accumulate 30 minutes or more of moderate-intensity physical activity, most if not all days of the week," the minister said.

Obesity, Pehin Awg Hj Suyoi said, is a chronic condition that requires life long management strategy, which includes weight reduction and maintenance. But most reduction trials are limited by a short follow up duration of six months or less. In most cases, weight regain is typically observed after an initial six to 12 months period of weight loss.

"It is not easy for doctors to change a patient's lifestyle. But doctors can motivate the patients to change with a system of support and encouragement until the patients become convinced that it is for their own good. By just telling the patients to exercise without a support system, 50 per cent of patients will stop exercising within six months to one year.

"Doctors and patients also do not think the same way when it comes to illnesses. While doctors are more concerned with finding what's wrong with a patient and how to treat him, patients only understand illness when there is pain, suffering, and disruption to their lives. It is this gap between the doctors and the patients that separates what doctors actually order from what the patients do.

"Therefore a need for a dedicated approach to disease management, and effective self-care requires that the patients have knowledge of the disease and the treatment; take action to promote one's own health, as well as making changes to one's lifestyle; monitoring and setting goals, as well as emotional and social support."  -- Courtesy of Borneo Bulletin

Related News: Brunei Tops Asean In Obesity | Minister Concerned Over Overweight Civil Servants

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