Fast GDP Growth, Faster Waistlines in Vietnam

GDP is higher, we’re probably richer, 

but healthier ? and happier ?, let’s see.

Everyone has been talking about the number this year: 8% GDP growth Factories are humming. Exports are surging. A growing middle class is celebrating well-earned prosperity. By all measures, it’s an extraordinary economic story.

Let me talk about another number — one that’s rising even faster.

Vietnamese waistlines.

Overweight and obesity rates in Vietnam have jumped 38%, the fastest rise in Southeast Asia[1]. In Ho Chi Minh City, once better known for bustling markets and motorbikes than fast food, more than half of urban youth are now overweight or obese[2].

From Rice Bowl to Fast Food Nation

Prosperity has profoundly altered how Vietnamese eat. As recently as a generation ago, Vietnam’s dietary challenges centered on undernutrition.

Today, it is overnutrition.

The countryside diet of fresh vegetables, rice, and fish is yielding to an urban appetite for fried chicken and bubble tea.

Modern retail is expanding, and foods are becoming more processed and packaged, with unhealthy food marketing ubiquitous both on the street and on smartphones[3]. Tomorrow, when you walk into any Hanoi/HCMC convenience store and you’ll likely see “Mua 1 tặng 1” (buy-one-get-one) promos on sugary drinks, nudging consumers toward sweet excess. And sadly, it’s working! Over a third of teenagers in Ho Chi Minh City drink at least one sugary beverage every day[4]. 

The combination of higher incomes and Western-style consumerism has super-sized the national diet. Eating out – once reserved for special occasions – is now routine for a growing middle class. The country’s food service market topped $26 billion in sales[5], fueled by rapid urbanisation and a taste for convenience. Global fast-food chains and local imitators are proliferating.

Vietnam’s embrace of capitalism has come with extra calories.

Economic growth has brought calorie abundance. People with more money in their pockets are understandably indulging in previously unaffordable treats – meat, cooking oil, milk, and processed snacks.

But the “nutrition transition” is hitting Vietnam with a vengeance, as it has elsewhere in Asia. Researchers note that Vietnam’s significant economic transition and urbanisation in the past two decades have created an “increasingly obesogenic environment” of high-calorie food consumption and sedentary lifestyles[6]. In other words, the same forces lifting Vietnam’s GDP – industrialization, urban migration, rising incomes – are also driving an unhealthy shift in how people eat and live.

Expanding Waistlines by the Numbers

The statistics on Vietnam’s growing girth are sobering.

The World Health Organization has declared obesity a global epidemic, and Vietnam is no exception[7]. Obesity prevalence has surged from about 10% of adults in 2009 to roughly 15% by the mid-2010s, according to national surveys – a steep climb in such a short period. Among children and adolescents (5–19 years old), the share who are overweight or obese more than doubled from 8.5% in 2010 to 19% in 2020[8][9]. Urban areas are worst hit: the prevalence of overweight/obesity among youth is 26.8% in cities vs 18.3% in rural districts[10][11]. In Ho Chi Minh City, an obesity rate above 50% in urban youth would have been unthinkable a generation ago, yet is now a grim reality. This burgeoning “prosperity paunch” afflicts adults too – one in every six Vietnamese adults is now obese[12], and millions more are overweight.

Such figures represent a dramatic shift for a country that, within living memory, battled food scarcity. Vietnam’s rapid gains against poverty and child stunting are being offset by a new epidemic of diet-related diseases. Doctors report rising cases of diabetes and hypertension in their clinics, even among younger patients. Associate Professor Nguyễn Anh Tuấn of Hanoi’s 108 Military Hospital warns that obesity’s consequences “extend far beyond aesthetics,” contributing to diabetes, heart disease, cancers, depression, infertility and more[13].

In short, Vietnam’s people are living longer but also living larger – and not in a healthy way.

The Heavy Toll: Health and Productivity

The costs of Vietnam’s expanding waistlines will be counted not just in hospital beds, but in lost economic potential. Obesity and its related ills (from heart disease to stroke) are chronic conditions that strain healthcare budgets and sap workforce productivity. Overweight and obesity already cost Vietnam an estimated $3.7 billion in 2019 – roughly 1.1% of GDP[14][15] – when one tallies healthcare spending, lost work days and premature deaths. A global study projects the economic burden could balloon to 2.8% of Vietnam’s GDP by 2060[16][17], as today’s overweight youth become tomorrow’s chronically ill adults. In effect, some of the hard-won gains from 8% annual growth may be eaten up – literally – by the fallout of obesity.

The hit to labour productivity is already evident in subtle ways. Employers face more absenteeism and “presenteeism” (workers showing up but performing sub-par) due to obesity-related ailments. Data show the bulk of obesity’s economic cost in Vietnam comes from such indirect losses – about 90% of the total[18]. Simply put, a workforce with higher rates of obesity is likely to suffer more sick days and lower energy on the job. A review of Asian economies found obesity is putting a multi-billion-dollar strain on health systems and “stifling economic growth” in developing countries[19][20]. Vietnam, with ambitions to sustain high growth, cannot afford to carry the extra weight of so many unwell citizens. As the WHO’s representative in Hanoi bluntly noted, the rapid rise in sugar-laden diets and other unhealthy habits among Vietnamese youth “are threats to both health and economic growth”[21]. The link is direct: a less healthy population means a less productive one, and higher public and private expenditures to treat preventable diseases.

Profits, Ultra-Processed Foods and Public Policy

Vietnam’s obesity surge is, in part, a side-effect of success – but also of corporate strategy. Big Food and beverage companies have descended on Vietnam’s market of 100 million consumers, peddling colas, chips and instant noodles in every corner shop. Ultra-processed food, once scarce, is now omnipresent – and deadly. Just four product categories (tobacco, fossil fuels, ultra-processed food and alcohol) are estimated to cause more than one-third of global deaths[22]. Vietnam’s experience bears this out, as diets high in processed fats and sugars drive lifestyle diseases upward. Health experts argue that expecting individual willpower alone to solve the problem is folly when the “default choice” is unhealthy and aggressively marketed[23]. In the words of one nutrition specialist, when junk food is everywhere, “asking families to ‘try harder’ is not good policy”[24]. The onus, they say, must shift to reshaping the environment – through regulation and public-health interventions – so that the healthier choice becomes the easier choice.

Policymakers in Vietnam are waking up to this challenge. In a landmark move this year, the National Assembly approved an excise tax on sugary drinks – 8% starting 2027, rising to 10% in 2028[25][26] – aiming to curb the nation’s growing sweet tooth. The measure, touted as a “win-win” by health officials, should both reduce consumption and raise revenue for healthcare[27]. It aligns Vietnam with over 100 countries taxing soda in an effort to nudge consumers away from sugar. Yet this nascent regulatory response also reveals the tug-of-war with industry. Lobbyists are already busy carving out exceptions (pushing, for instance, to exempt certain “fruit” drinks)[28][29].

Such maneuvers are familiar in the playbook of Big Food, reminiscent of tobacco industry tactics. Indeed, University of Bath researchers warn that governments must be wary of partnerships with “health-harming industries” like ultra-processed food, whose profit-driven tactics conflict with public health goals[30][31]. Vietnam’s policymakers would do well to remember that lesson as they balance economic interests and health imperatives.

Beyond taxes, Vietnam has a National Strategy on NCDs aiming to keep adult obesity below 15%[32]. But implementation has lagged, as evidenced by obesity well exceeding that target already. There are glimmers of progress: cities like Hanoi have toyed with banning junk food sales in school canteens; public awareness campaigns urge exercise and traditional diets. Yet more robust steps – tighter advertising curbs, front-of-pack nutrition labels, urban planning for physical activity – remain on the to-do list. Britain’s recent ban on junk-food ads before 9pm, for example, underscores how shaping the food environment requires regulatory muscle[33][34]. Vietnamese officials have generally been adept at steering the country through economic reforms; now they must apply the same resolve to public health.

Weighing the Future

The rise of obesity in Vietnam is a cautionary tale of unintended consequences.

The country’s sprint from bicycles to BMWs, from $2 pho to $4 Frappuccinos, has lifted millions into the middle class – but it has also introduced the maladies of affluence. Left unchecked, today’s dietary excesses could become a drag on tomorrow’s growth, as mounting healthcare costs and reduced productivity weigh down the economy. The economic boom that added protein to Vietnamese diets must not end in a public health bust that pads hospital bills. Hanoi’s leaders, prideful of their 8% growth, now face the unenviable task of trimming a different kind of fat.

In the sharp phrasing of one UK health expert, governments need to tackle “the broader issues that lead to obesity – the way our environment pushes us towards eating more and exercising less, and the influence of big businesses on what we eat and how we live”[35]. For Vietnam, this means confronting fast-food culture and junk-food commerce with the same vigor that it courted foreign investment. It may mean reining in the marketing blitz of soda and snacks, even as those industries create jobs. The trade-offs are delicate. Yet the stakes are clear: a healthier population is not just a social good but an economic necessity. Vietnam’s extraordinary growth story will ring hollow if prosperity merely swaps one set of health problems for another.

Ultimately, Vietnam’s success should be measured not only in the growth of its GDP but in the health of its people. The challenge before the nation is to ensure that the fruits of economic progress do not end up clogging its arteries. The Economist might quip that Vietnam is getting fat on the spoils of growth – but the burden of obesity is no joke for its future. The country has defied the odds to become an Asian growth champion; with wise policy and firm resolve, it can likewise avoid becoming an Asian obesity cautionary tale. The price of prosperity need not be an ever-expanding waistline – but curbing this trend will require Vietnam to take stock, quite literally, of its diet of success.