Beyond The Three Highs: The Silent Threat Of Obesity In Malaysia

KUALA LUMPUR, Sept 12 (Bernama) -- Obesity is one of the most pressing health concerns in Malaysia, with nearly 20 per cent of the population classified as obese.

The World Obesity Atlas projects that this number could increase to 41 per cent by 2035, stressing the urgent need for comprehensive prevention and treatment strategies.

This concerning trend comes alongside the already alarming increase in chronic diseases, rooted in what’s commonly known as the ‘three highs’ - high blood sugar, high blood pressure and high cholesterol, where over half a million Malaysian adults are currently living with all four conditions.

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Sunway Medical Centre Velocity (SMCV) consultant endocrinologist and internal medicine physician Dr Lim Kim Piow highlighted that obesity extends beyond a physical issue of excess body weight and can also impact both mental and emotional well-being, creating a cycle of worsening health outcomes.

“Obesity is often associated with depression and anxiety, which can promote binge eating and lead to a sedentary lifestyle, further weight gain and worsening the condition,” he said in a statement.

He noted that obesity, classified by a Body Mass Index (BMI) of 27.5 or higher, is one of the contributing risk factors to multiple health conditions, including diabetes, stroke, heart attack, chronic kidney disease, gout, obstructive sleep apnea (OSA), fatty liver, gallstone, polycystic ovary syndrome (PCOS), infertility, osteoarthritis, pelvic inflammatory disease (PID), cataract, pancreatitis, cancer, deep vein thrombosis, depression and anxiety.

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Dr Lim explained that obesity leads to insulin resistance, causing the pancreas to work harder to produce more insulin to overcome the resistance, which results in hyperinsulinemia (abnormally high blood sugar levels).

"This compensatory mechanism can eventually progress to prediabetes and Type 2 diabetes," he said,  adding that women with a history of or who have Type 2 diabetes are at higher risk of developing PCOS, a condition often linked to obesity that causes symptoms such as irregular period and excess facial or body hair due to elevated levels of androgens (male hormone).

Moreover, PCOS is also one of the leading causes of infertility due to irregular ovulation or the absence of ovulation.

Malaysia is reported to have one of the highest diabetes rates globally, with over 3.6 million Malaysians diagnosed with diabetes in 2019 and the Ministry of Health (MOH) has projected this figure to double by 2025, impacting an estimated seven million Malaysians.

Even more concerning, many Malaysians are unaware they have diabetes - statistics reveal that two in five adults and 84 per cent of young adults aged 18 to 29 are unaware they have the disease.

Meanwhile, SMVC consultant cardiologist and internal medicine physician Datuk Dr Foo Yoke Loong said obesity can also increase the risk of cardiovascular issues, with obese individuals more likely to suffer heart attacks and symptoms such as chest pain, body discomfort, heartburn, nausea and shortness of breath.

He said obesity can lead to other cardiovascular diseases, such as ischemic cardiomyopathy, where the heart muscle becomes damaged due to inadequate blood supply, and left ventricle hypertrophy, a condition where the heart muscle thickens and both of these conditions can result in heart failure.

For obesity prevention and management, Dr Lim underscores the importance of self-awareness, stressing that patients must recognise and accept how obesity underpins common health complications affecting the heart, brain and kidneys.

He also highlighted the significant role of genetics in obesity and related endocrine disorders, urging individuals to acknowledge these potential risks and take necessary proactive steps to combat obesity.

“Recognising both personal habits and genetic factors may help foster a sense of determination and perseverance in their weight loss journey, turning guilt and disappointment into actionable strategies,” Dr Lim added.

Dr Foo also highlighted the importance of being vigilant for early signs of cardiovascular issues related to obesity, noting that central chest pains which may deviate to other parts of the body like the left hand, back or neck are often an early symptom of heart disease.

Another key strategy recommended by Dr Lim is meal management, as he encourages following a low-calorie, low-carbohydrate diet and conducting self-monitoring by tracking food intake through journaling or by using authorised health and wellness mobile phone applications.

Dr Foo supports this approach and advises consulting a dietitian to identify deficiencies or excesses in one’s current diet, while simple changes, such as reducing sugar intake by requesting less or no sugar in beverages and avoiding highly processed, sugary foods like doughnuts, candies and ice cream can significantly improve blood sugar levels and prevent further health deterioration.

Additionally, lifestyle changes would not be complete without regular and consistent exercise, with Dr Foo encouraging any form of exercise that suits one’s condition and Dr Lim recommending setting realistic goals and participating in exercise groups to stay motivated.

“Cardio exercises such as jogging, swimming and cycling are effective in improving both heart health and managing obesity. Swimming is an excellent universal exercise, especially for individuals with knee problems, as it reduces the impact on the joints compared to running,” Dr Foo said.

He added that for patients with more advanced conditions such as high blood sugar and cholesterol levels, combining lifestyle changes with medical intervention is essential for a faster recovery process.

Dr Lim emphasised that routine health checkups and screenings are also essential for early diagnosis and preventive care, and should be done every three months to once a year, depending on an individual's BMI, current health status and family history.

Dr Foo stressed the importance of early diagnosis, warning that delaying treatment could lead to numerous complications and the potential for permanent heart damage.

"Overall, early diagnosis allows patients to pursue less invasive treatment options, reduces the risk of complications, and improves the chances of better treatment outcomes," he said.

As the prevalence of the ‘four highs’ - high blood sugar, high blood pressure, high cholesterol and obesity - continues to rise among Malaysians, with alarming projections for the future, urgent actions are needed.

As obesity can be prevented and managed to reduce the risk of getting multiple diseases, the key strategies to address this pressing issue include enhancing self-awareness, managing meals, incorporating regular exercise, seeking professional guidance and regular health checkups and screenings.

-- BERNAMA

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