The prevalence of child obesity is increasing rapidly worldwide (WHO 1998). It is associated with several risk factors for later heart disease and other chronic diseases including hyperlipidaemia, hyperinsulinaemia, hypertension and early artherosclerosis (Berenson et al. 1998). In view of its public health importance, the trends in child obesity should be closely monitored. Trends are, however, difficult to quantify or to compare locally and internationally, as a wide variety of definitions of child obesity are in use, and no commonly accepted standard has yet emerged (Cole et al. 2000).

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Energy Balance in the Development of Obesity

Obesity can result from a minor energy imbalance, which lead to a gradual but persistent weight gain over a considerable period. Some researchers have hypothesized that energy imbalance is the result of inherited metabolic characteristics; whereas others believe it is caused by poor eating and lifestyle habits, that is “gluttony and sloth”. 

Positive energy balance occurs when energy intake is greater than energy expenditure and promotes weight gain (Figure 4). Conversely, negative energy balance promotes decrease in body fat stores and weight loss. Body weight is regulated by a series of physiological processes, which have the capacity to maintain weight within a relatively narrow range (stable weight). It is thought that the body exerts a stronger defence against under nutrition and weight loss than it does against over-consumption and weight gain. 

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This document describes recommendations to affect a combined approach to prevent overweight and obesity. It was initiated by the Malaysian Association for the Study of Obesity (MASO) in collaboration with the Ministry of Health, Malaysia.

The terms of reference are as follows:

To provide a detailed overview of the problem of obesity including its definition,causes and consequences

To provide an overview of the severity of the problem of obesity in Malaysia.

To recommend appropriate strategies for the prevention of obesity focussing on the whole population as well as specific target groups.

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