Doctor team performs laparoscopic surgery to treat obesity at the Ninh Bình campus of Việt Đức Friendship Hospital. — Photos courtesy of the hospital

HÀ NỘI — Việt Nam is currently among the countries with the fastest-growing rates of overweight and obesity in Asia. The number of deaths attributed to obesity is now three times the combined total of deaths from breast cancer and colon cancer.

Experts said that while obesity was previously primarily found among middle-aged individuals — typically those who were affluent and frequently entertained guests — the condition is now clearly affecting a younger demographic. Many young people, some as young as 17 or 18, are already requiring treatment for severe obesity.

Experts have warned that at a scientific conference on bariatric surgery within a multidisciplinary treatment approach and the launch of the Vietnam Society for Metabolic and Bariatric Surgery (the 2026–31 term) on August 7.

Obesity is now a chronic disease

According to the 2019–20 national nutrition survey conducted by the National Institute of Nutrition, the rate of overweight and obesity among children in Việt Nam increased 2.2-fold, rising from 8.5 per cent in 2010 to 19 per cent in 2020.

It is projected that by 2030, approximately 50 per cent of adults will be overweight, with obesity rates of around 17 per cent for men and 22 per cent for women.

Speaking at the event, Dr Nguyễn Quang Bảy, Head of the Department of Endocrinology and Diabetes at Bạch Mai Hospital, said that obesity is now considered a chronic disease characterised by an increase in adipose tissue, rather than merely a state of weight gain.

Therefore, Dr. Bẩy said, treatment goals aim not only to reduce weight but also to mitigate metabolic complications, improve quality of life, and extend life expectancy.

According to the expert, obesity treatment must begin with a comprehensive assessment of the condition's severity and associated complications to determine the appropriate treatment approach.

"It is necessary to develop a personalised treatment plan for each patient and maintain long-term treatment, rather than focusing solely on short-term weight loss," said Bẩy.

Lifestyle modification is considered the cornerstone of all treatment strategies, including a balanced diet; increased physical activity; and behavioural modification therapy.

“Lifestyle changes must be maintained even when the patient undergoes medication or surgery,” he added.

Bariatric surgery is not suitable for every overweight cases

Prof. Dr. Trần Bình Giang, President of the Vietnam Surgical and Endoscopic Surgery Association, speaks at the event.

Prof. Dr. Trần Bình Giang, President of the Vietnam Association of Surgery and Endolaparosurgery, said:“Obesity is a serious medical condition that is often overlooked. The greater the degree of obesity, the lower the life expectancy due to the risk of comorbidities.” 

According to Dr. Giang, obese patients become socially marginalised due to psychological barriers and stigma. Notably, medical treatment can only stabilise the condition but cannot reverse obesity.

He emphasised that obesity reduces life expectancy and quality of life by triggering a range of silent metabolic disorders from an early stage. It is also a risk factor for type-2 diabetes, hypertension, dyslipidemia, cardiovascular disease, sleep apnea, and osteoarthritis.

According to health experts, a BMI of 20–25 is considered normal, 25–30 is overweight, and above 30 is obese. For Asians, however, the risk of disease increases significantly at a BMI of 27.5 or higher.

Dr. Giang said that most patients aim to lose weight through lifestyle changes, dietary adjustments or exercise. However, the effectiveness of these methods is often modest, resulting in an average weight loss of no more than 10 per cent of total body weight.

Notably, about 95 per cent of patients regain the weight after five years if they rely solely on conventional weight-loss measures. Certain extreme weight-loss methods, such as eliminating carbohydrates, carry significant health risks.

Dr. Giang emphasises that obesity is a condition with significant social implications that severely affects both physical and mental health; therefore, treatment requires a multidisciplinary approach integrating nutrition, endocrinology, psychology, rehabilitation, and surgery. Crucially, any weight-loss method must be supervised by a medical specialist.

“Surgery is the last choice when medical treatment and lifestyle changes fail, and it requires strict indications to ensure long-term effectiveness. Typically, surgery results in a 40–50 per cent reduction in total body weight,” Dr. Giang said.

Dr. Bùi Thanh Phúc, Deputy Head of the Department of Emergency Digestive Surgery at Việt Đức Friendship Hospital, said that bariatric surgery is not a cosmetic procedure and is not suitable for every overweight case.

It is indicated only for individuals who meet specific BMI criteria, suffer obesity-related health issues, or have failed to achieve results through medical treatment.

The surgery is typically indicated for individuals aged 16 to 65 with a BMI of 40 or higher — or 35 or higher accompanied by conditions such as diabetes, hypertension, dyslipidemia, respiratory disorders, or joint pain — who have attempted non-surgical treatments (including diet, exercise, medication, psychological counselling, and nutritional therapy) for six to 12 months without success.

Dr. Phúc stated that one year after surgery, patients lose an average of 50–60 kilos, with some losing nearly 100 kilos. A notable case is a male patient in HCM City who weighed 168 kilos and dropped to 78 kilos two years after surgery.

Following weight loss, many patients successfully managed diabetes and lipid disorders; additionally, some women who had previously been infertile due to obesity were able to conceive and give birth after treatment, according to Dr. Phúc.

Since the first case in 2007, Việt Đức Friendship Hospital has performed approximately 500 obesity treatment surgeries using various techniques, such as laparoscopic gastric reduction, with sleeve gastrectomy currently being the most widely applied method. — VNS