The Malaysian Ministry of Health (MOH) has released new guidelines to evaluate and treat individuals who are overweight/obese.
The MOH’s latest CPG for the management of obesity emphasises the complexity and chronicity of said condition. The CPG update involves behavioural change, recommendations for anti-obesity medications and surgery.
Should We Be Concerned?
Yes, we should. The National Health Screening Initiative (NHSI) 2023 showed that 53.5% of Malaysians screened are overweight (31.3%) or obese (22.2%). The results translate to 283,100 Malaysians with a body mass index (BMI) of over 25kg/m2 and 199,400 Malaysians with a BMI of over 30kg/m2.
In fact, 62,346 Malaysians who were not yet diagnosed as diabetics were seen to have high blood sugar levels (glucose reading of more than 7.8mmol/L). Childhood obesity is also another cause for concern. It has quadrupled from 6.1% in 2011 to 29.8% in 2020. This data was obtained from the National Health and Morbidity Survey (NHMS) in 2019.
Key Updates In The CPG
Screening for individuals who are overweight and obese
All individuals seen at health care centres should be screened for weight-related issues. The presence of excess body fat and the probability of associated diseases are used as a guide to diagnosing individuals who are overweight/obese.
Focus on lifestyle changes
Lifestyle changes such as healthy eating, regular physical activity, and behaviour modification are listed as the most effective methods to manage individuals who are overweight/obese.
Individualised treatment plans
Personalised treatment should be available for each individual, especially when considering one’s age, gender, medical history and socioeconomic background.
Multidisciplinary approach
A team of multiple healthcare professionals, including dietitians, exercise specialists, psychologists and physicians, would provide more holistic and comprehensive care for individuals who are overweight/obese.
Pharmacotherapy
Pharmacotherapy should be used together with lifestyle modification for individuals with a BMI of 30 or higher and a BMI of 27 or higher with weight-related comorbidities.
Bariatric surgery
It is important to remember that bariatric surgery is not a solution and requires a lifelong commitment to a healthy lifestyle. However, it can be considered for individuals with a BMI of 37.5 or higher and a BMI of 32.5 or higher with weight-related comorbidities.
Prevention
Prevention is always better than cure. Early education to improve awareness among Malaysians could help reduce the prevalence of obesity and obesity-related diseases. This is particularly important among the younger generation
Doctor’s Insight
Dr Nurain Mohd Noor, the president of the Malaysian Endocrine and Metabolic Society (MEMS), emphasised that excess body weight has serious health implications, including Type 2 diabetes mellitus (T2DM), high blood pressure, coronary artery disease, and cancer.
She further explained that the disease burden was significant. “The disease burden is significant. Obesity accounts for 19.4% of total healthcare spending, the highest rate among ASEAN countries. Additionally, the estimated productive years lost for individuals with obesity are substantial. It currently stands at approximately 6-11 years for males and 7-12 years respectively.
Professor Dr Norlaila Mustafa, the chairperson of the CPG development committee, stated the importance of adopting an updated, holistic and multidisciplinary approach in the battle against obesity. She also recommended that all individuals with obesity engage in physical activity. This includes a minimum of 30 minutes a week and can go up to 60 minutes a week.
Call For Action
Prevention of obesity involves practising a healthy lifestyle, improving physical activity, maintaining a balanced diet, and proper stress management. Additionally, individuals who are at risk of developing obesity should have access to stress management counselling as well. Sedentary behaviour and proper sleep hygiene can also contribute to the fight against obesity.
