• Overview
  • Obesity prevalence
  • Trends over time
  • Population breakdowns
  • Drivers
  • Comorbidities
  • Health systems
  • Actions
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Obesity prevalence

Women, 2016

Survey type:Measured
Age:15-49
Sample size:16806
Area covered:National
References:Department of Census and Statistics (DCS) and Ministry of Health, Nutrition and Indigenous Medicine 2017. Sri Lanka Demographic and Health Survey 2016 Sri Lanka. https://www.aidsdatahub.org/resource/sri-lanka-demographic-and-health-survey-2016 (Accessed 02.09.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 2013-2014

Survey type:Measured
Age:16-72
Sample size:2469
Area covered:Regional
References:Jayawardana NWIA, Jayalath WATA, Madhujith WMT, et al. Lifestyle factors associated with obesity in a cohort of males in the central province of Sri Lanka: a cross-sectional descriptive study. BMC Public Health. 2017;17:27. doi:10.1186/s12889-016-3963-3.
Notes:Region of Kandy BMI cutoff values for Asians defined by WHO were used in the present study to categorize the participants as overweight (23–27.5 kg/m2 and obese (>27.5 kg/m2)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2009

Survey type:Measured
Age:15-49
Sample size:2146
Area covered:National
References:Jayatissa, R., Hossain, S.M., Gunawardana, S., Ranbanda, J.M., Gunathilaka, M. and De Silva, P.C., 2012. Prevalence and associations of overweight among adult women in Sri Lanka: a national survey. Sri Lanka Journal of Diabetes Endocrinology and Metabolism, 2(2).
Notes:15-49 years only
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2006-2007

Survey type:Measured
Age:15-49
Sample size:12757
Area covered:National
References:Department of Census and Statistics (DCS) and Ministry of Healthcare and Nutrition (MOH). 2009. Sri Lanka Demographic and Health Survey 2006-07. Colombo, Sri Lanka: DCS and MOH.
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2005-2006

Survey type:Measured
Age:18+
Sample size:4532
Area covered:National
References:Katulanda P, Jayawardena MAR, Sheriff MHR, Constantine GR and Matthews DR. (2010). Prevalence of overweight and obesity in Sri Lankan adults. Obesity Reviews, pp 1 - 6.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2003

Survey type:Measured
Age:10-15
Sample size:6264
Area covered:National
References:Jayatissa R and Ranbanda RM. (2006). Prevalence of challenging nutritional problems among adolescents in Sri Lanka. Food and Nutrition Bulletin, 27(2): 153 - 160.
Notes:IOTF International Cut Off Please note these figures are for combined overweight & obesity (NOT Obesity)
Cutoffs:IOTF

Overweight/obesity by education

Women, 2016

Survey type:Measured
Age:15-49
Sample size:16806
Area covered:National
References:Department of Census and Statistics (DCS) and Ministry of Health, Nutrition and Indigenous Medicine 2017. Sri Lanka Demographic and Health Survey 2016 Sri Lanka. https://www.aidsdatahub.org/resource/sri-lanka-demographic-and-health-survey-2016 (Accessed 02.09.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 2013-2014

Survey type:Measured
Age:16-72
Sample size:2469
Area covered:Subnational: Kandy
References:Jayawardana NWIA, Jayalath WATA, Madhujith WMT, et al. Lifestyle factors associated with obesity in a cohort of males in the central province of Sri Lanka: a cross-sectional descriptive study. BMC Public Health. 2017;17:27. doi:10.1186/s12889-016-3963-3.
Notes:BMI cutoff values for Asians defined by WHO were used in the present study to categorize the participants as overweight (23–27.5 kg/m2 and obese (>27.5 kg/m2)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2006-2007

Survey type:Measured
Age:15-49
Sample size:12757
Area covered:National
References:Department of Census and Statistics (DCS) and Ministry of Healthcare and Nutrition (MOH). 2009. Sri Lanka Demographic and Health Survey 2006-07. Colombo, Sri Lanka: DCS and MOH.
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Overweight/obesity by age

Women, 2016

Survey type:Measured
Sample size:16806
Area covered:National
References:Department of Census and Statistics (DCS) and Ministry of Health, Nutrition and Indigenous Medicine 2017. Sri Lanka Demographic and Health Survey 2016 Sri Lanka. https://www.aidsdatahub.org/resource/sri-lanka-demographic-and-health-survey-2016 (Accessed 02.09.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 2013-2014

Survey type:Measured
Sample size:2469
Area covered:Sub-national: Kandy
References:Jayawardana NWIA, Jayalath WATA, Madhujith WMT, et al. Lifestyle factors associated with obesity in a cohort of males in the central province of Sri Lanka: a cross-sectional descriptive study. BMC Public Health. 2017;17:27. doi:10.1186/s12889-016-3963-3.
Notes:BMI cutoff values for Asians defined by WHO were used in the present study to categorise the participants overweight (23–27.5 kg/m2 and obese (>27.5 kg/m2)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Overweight/obesity by region

Women, 2016

Survey type:Measured
Age:15-49
Sample size:16806
Area covered:National
References:Department of Census and Statistics (DCS) and Ministry of Health, Nutrition and Indigenous Medicine 2017. Sri Lanka Demographic and Health Survey 2016 Sri Lanka. https://www.aidsdatahub.org/resource/sri-lanka-demographic-and-health-survey-2016 (Accessed 02.09.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2006-2007

Survey type:Measured
Age:15-49
Sample size:12757
Area covered:National
References:Department of Census and Statistics (DCS) and Ministry of Healthcare and Nutrition (MOH). 2009. Sri Lanka Demographic and Health Survey 2006-07. Colombo, Sri Lanka: DCS and MOH.
Notes:Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Overweight/obesity by socio-economic group

Women, 2016

Survey type:Measured
Age:15-49
Sample size:16806
Area covered:National
References:Department of Census and Statistics (DCS) and Ministry of Health, Nutrition and Indigenous Medicine 2017. Sri Lanka Demographic and Health Survey 2016 Sri Lanka. https://www.aidsdatahub.org/resource/sri-lanka-demographic-and-health-survey-2016 (Accessed 02.09.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 2013-2014

Survey type:Measured
Age:16-72
Sample size:2469
Area covered:Sub-national: Kandy
References:Jayawardana NWIA, Jayalath WATA, Madhujith WMT, et al. Lifestyle factors associated with obesity in a cohort of males in the central province of Sri Lanka: a cross-sectional descriptive study. BMC Public Health. 2017;17:27. doi:10.1186/s12889-016-3963-3.
Notes:Prevalence of obesity by income. BMI cutoff values for Asians defined by WHO were used in the present study to categorize the participants as overweight (23–27.5 kg/m2 and obese (>27.5 kg/m2)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2006-2007

Survey type:Measured
Age:15-49
Sample size:12757
Area covered:National
References:Department of Census and Statistics (DCS) and Ministry of Healthcare and Nutrition (MOH). 2009. Sri Lanka Demographic and Health Survey 2006-07. Colombo, Sri Lanka: DCS and MOH.
Notes:Prevalence of overweight and obesity in females by wealth quintile Demographic Health Survey data includes ever married women aged 15-49 years only and may include males aged 15-59.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Insufficient physical activity

Adults, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Men, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Women, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Children, 2010

Age:11-17
References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)

Boys, 2010

Age:11-17
References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)

Girls, 2010

Age:11-17
References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)

Estimated per-capita fruit intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita fruit intake (g/day)

Prevalence of less-than-daily fruit consumption

Children, 2008-2015

Survey type:Measured
Age:12-17
References:Global School-based Student Health Surveys. Beal et al (2019). Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-food consumption: A meta-analysis of global school-based student health surveys. Food and Nutrition Bulletin. https://doi.org/10.1177/0379572119848287. Sourced from Food Systems Dashboard http://www.foodsystemsdashboard.org/food-system
Definitions:Prevalence of less-than-daily fruit consumption (% less-than-daily fruit consumption)

Prevalence of less-than-daily vegetable consumption

Children, 2008-2015

Survey type:Measured
Age:12-17
References:Beal et al. (2019). Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-food consumption: A meta-analysis of global school-based student health surveys. Food and Nutrition Bulletin. https://doi.org/10.1177/0379572119848287 sourced from Food Systems Dashboard http://www.foodsystemsdashboard.org/food-system
Definitions:Prevalence of less-than-daily vegetable consumption (% less-than-daily vegetable consumption)

Estimated per-capita processed meat intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita processed meat intake (g per day)

Estimated per-capita whole grains intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita whole grains intake (g/day)

Mental health - depression disorders

Adults, 2015

References:Prevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
Definitions:% of population with depression disorders

Mental health - anxiety disorders

Adults, 2015

References:Prevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
Definitions:% of population with anxiety disorders

Oesophageal cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20+. ASR (World) per 100,000

Breast cancer

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, breast, females, ages 20+. ASR (World) per 100,000

Colorectal cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20+. ASR (World) per 100,000

Pancreatic cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20+. ASR (World) per 100,000

Gallbladder cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20+. ASR (World) per 100,000

Kidney cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20+. ASR (World) per 100,000

Cancer of the uterus

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, cervix uteri, females, ages 20+. ASR (World) per 100,000

Raised blood pressure

Adults, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Men, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Women, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Raised cholesterol

Adults, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Men, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Women, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Raised fasting blood glucose

Men, 2014

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A869?lang=en
Definitions:Age Standardised % raised fasting blood glucose (>= 7.0 mmol/L or on medication).

Women, 2014

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A869?lang=en
Definitions:Age Standardised % raised fasting blood glucose (>= 7.0 mmol/L or on medication).

Diabetes prevalence

Adults, 2017

References:Reproduced with kind permission of IDF, International Diabetes Federation. IDF Diabetes Atlas, 8th edition. Brussels, Belgium: International Diabetes Federation, 2017. http://www.diabetesatlas.org
Definitions:Diabetes age-adjusted comparative prevalence (%).

Health systems

Economic classification: Upper Middle Income

Health systems summary

Sri Lanka’s public health sector has traditionally provided the bulk of healthcare in the country (despite health expenditure being evenly split between the public and private sector). This state-financed system provides free at point of service care for curative and preventative services, and is widely praised for recent improvements in health indicators such as maternal and infant mortality. However, despite the existence of this public coverage, out of pocket expenditure remains high, making up 38% of total health expenditure. The private sector in Sri Lanka is flourishing as people increasingly seek care privately due to the underfunded and stretched public system.

Like elsewhere, Sri Lanka is being challenged by an ageing population and the increasing burden of chronic and non-communicable diseases (that are now estimated to contribute to 75% of deaths). The health system to date has done well in providing near- universal coverage, but these new challenges threaten continued progress. In late 2019, the Sri Lankan prime minister announced government plans to establish a national health insurance scheme.

Indicators

Where is the country’s government in the journey towards defining ‘Obesity as a disease’?Some progress
Where is the country’s healthcare provider in the journey towards defining ‘Obesity as a disease’?Some progress
In practice, how is obesity treatment largely funded?Out of pocket
Is there specialist training available dedicated to the training of health professionals to prevent, diagnose, treat and manage obesity?No
Have any taxes or subsidies been put in place to protect/assist/inform the population around obesity?Yes
Are there adequate numbers of trained health professionals in specialties relevant to obesity in urban areas?Partial
Are there adequate numbers of trained health professionals in specialties relevant to obesity in rural areas?No
Are there any obesity-specific recommendations or guidelines published for adults?Yes
Are there any obesity-specific recommendations or guidelines published for children?Yes

Perceived barriers to treatment

  • High cost of out of pocket payments
  • Poor adherence to and fear of treatment
  • Obesity considered a sign of wealth
  • Lack of support
  • Lack of opportunity for physical activity

Summary of stakeholder feedback

Stakeholders report that there is some recognition of obesity as a disease (especially by the Ministry of Health). Work underway to address obesity includes traffic-light food labelling, community-led health promotion and school-based programmes. All stakeholders felt that obesity could be better prevented by encouraging people to do more physical activity.

There is also a broad focus on non-communicable diseases (NCD). There is an NCD prevention clinic in every hospital and there is an NCD council chaired by the Minister of Health that reviews interventions. However, while BMI is routinely measured in Sri Lanka, it is said that it is not typical for obesity to be treated. When treatment is offered, it is often paid for by a mix of government, insurance and out of pocket expenditure - and only when the individual has comorbidities or complications.

Although there are no obesity treatment guidelines from any governmental organisations, the Sri Lankan College of Endocrinologists have published treatment guidelines for adults and children. Allegedly, most healthcare professionals are not aware of the existence of these guidelines.

Based on interviews/survey returns from 3 stakeholders

Last updated: June 2020

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