When I first came to Thailand, I wondered: given the healthy Thai cuisine, why are so many people – especially expats – overweight?

Take a look on any street: at least one in three expats is obese. This is a high percentage, comparable only with the ‘fattest’ States in the USA, and  is responsible for many of the health problems some expats have to deal with after living just for a few years in their new home.

But how exactly is ‘overweight’ actually defined? That’s an easy one: to calculate your BMI (Body Mass Index), you simply divide your weight in kilograms by the square of your height (or multiply your weight in pounds with 703 and divide the result by the square of your inches). At a height of 1.72m and 75kg weight, the formula would be: [75 ÷ (1.72 m)² = BMI 25.4] (or at 150 lbs weight and 5’5″ (65″) height: [150 ÷ 65²] x 703 = 24.96). Overweight is defined as a BMI of 25.0 or greater, obesity starts at 30.0. According to doctors, a BMI higher than 27.5 imposes major risk factors for cardiovascular disease, certain types of cancer, type 2 diabetes and joint problems.

But what makes some of us so prone to gain weight rapidly in Thailand? Alcohol is one explanation, fats another. Of course, many expats drink too much and forget (or repress) that alcoholic beverages are real calorie bombs. And, many Thai kitchens cook with too much fat, and in the past several years, the food has become too sweet and salty; while these dishes may taste good, they are no longer healthy.

But where does this tendency to eat and drink too much derive from? One explanation is that eating and drinking is a compensation option for everyday frustration and boredom. Many expats have little to fill their days, and kill time by eating and drinking, for some, a visit to the buffet can be the highlight of the week.

As a sex therapist, I have to mention the hormonal and psychological changes experienced, particularly by aging men. In their younger years it was their daily goal to have sex and workout, now that they are older the epitome of sensual delight is enjoying their lunch or dinner … unfortunately to the chagrin of their body and often enough also of their psyche. Because obesity increases the incidence  of depression, a vicious spiral might be triggered driving them to eat even more. One of the difficulties in finding a balanced diet, is that eating too much often has downright addictive dynamics. This is one reason why serious weight loss programs always involve counseling and psychotherapy as an integral part of the recovery plan. One can do a lot alone – but with some outside support, success usually comes much easier and faster.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2011)