Obesity is a global health problem that societies, Hong Kong’s included, are struggling to deal with. Whether it is a disease, as some people are trying to have governments recognise, is a matter of debate. With such a classification involving the likelihood of laws, enforcement and financial obligations, there is an obvious reluctance for officials to make such a decision. But whether it is a chronic illness, a condition or the result of behavioural choices, what is important is that authorities push ahead with concerted efforts to stem what is increasingly being described as an epidemic and if those measures fail, to consider more far-reaching action. Half of Hong Kong’s population between the ages of 15 and 84 were considered either overweight or obese in the Department of Health’s latest survey, released last year. It showed a 12 per cent increase in the proportion from the previous study, carried out a decade earlier. About one in five schoolchildren are also seen as being overweight or worse. They were not eating enough fruit and vegetables, taking in too much salt and not getting enough exercise. The government’s strategy to fight the problem is based on awareness through education, labels on food products and setting guidelines on salt and sugar consumption. It uses the body mass index, commonly referred to as BMI, to determine what constitutes being normal, overweight or obese for adults: a formula based on calculating weight in kilograms divided by the square of the person’s height in metres, with a figure of 25 or more being overweight, and 30 and above obese. Different calculations are needed for children and the index is not accurate for those with exceptional bodies, such as athletes. An above-normal BMI is considered a risk factor for cardiovascular diseases including heart ailments and stroke, diabetes and some cancers, among them breast, ovarian, prostate and kidney. A recent study by an interest group found more than 70 per cent of Hongkongers do not think of obesity itself as a disease and 44 per cent were unaware it could lead to serious health problems . Some diseases cause obesity and genetics can also play a part, but for the majority of sufferers, it comes about due to the widespread availability of inexpensive, calorie-rich foods and insufficient exercise. That has led some politicians and policymakers to brand it a lifestyle choice caused by greed. But stigmatising and shaming does not solve a serious problem that as the population ages, will strain public health resources. The government’s awareness campaign should be made as expansive as possible and improvements made to infrastructure for leisure and sports. If obesity shows no sign of slowing, a tougher approach has to be considered, perhaps through regulations and taxes on sugary food and drinks.