Experts say obesity is often a hormonal disorder, not a lifestyle failure, as over 50% of Malaysian adults avoid treatment due to stigma and shame.
KUALA LUMPUR: Over half of Malaysian adults are classified as obese but many avoid treatment due to self-blame, even though untreated hormonal and metabolic conditions could worsen health outcomes, experts say.
Malaysian Obesity Society president Prof Dr Rohana Abdul Ghani said obesity care remains underutilised partly because of stigma, with many patients feeling ashamed to seek help, believing their condition reflects personal failure rather than a complex hormonal and metabolic disorder.
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“Many patients wrongly blame themselves for their weight, but obesity is often caused by underlying physiological and hormonal factors.
“In women, conditions such as polycystic ovary syndrome are highly prevalent, while in men, issues such as hypogonadism also contribute to weight gain.
“These conditions need to be properly identified and diagnosed so that appropriate treatment can be given,” she said yesterday after an event announcing that an injectable obesity treatment would be available here soon.
Rohana, who is also senior consultant endocrinologist, said some patients struggle with persistent “food noise”, which makes appetite control extremely difficult, and stressed the need for medical intervention.
She said many patients turn to supplements in an attempt to manage their weight but these products are often poorly regulated, with inconsistent dosing, and have been linked to serious complications, including liver and kidney failure.
“Earlier weight-loss medications relied mainly on appetite suppression by targeting the brain alone. While initially effective, their benefits diminish over time and rapid weight regain often occurs once treatment is stopped.
“Newer injectable obesity treatments target both the brain and the gut, helping regulate appetite more effectively, so weight regain happens more slowly when treatment is reduced or stopped, making them a better option for patients who need medical support.”
She emphasised that treatment should start early as weight gain becomes harder to reverse, and healthcare providers should act without delay.
“Historically, weight loss and organ protection were difficult to achieve due to limited treatments, but newer drugs that enable significant weight loss are improving overall health, focusing on restoring health rather than appearance.”
Rohana said for patients who are morbidly obese, the focus should shift from prevention to preventing obesity-related complications, such as using functional therapies.
“We will continue to advocate better access to treatment and recognition of obesity as a medical condition that requires proper management,” she said, adding that obesity should be treated as a chronic disease rather than a lifestyle failure.
She also said urbanisation contributes to obesity through sedentary lifestyles, while Malaysia faces unique challenges, such as costly and less accessible healthy food.
She highlighted that cultural habits such as feeling obligated to finish all food served need to be challenged, and education on portion control and diet, especially reducing carbohydrates and prioritising protein, is essential.
She often reminds patients that while skipping rice might seem difficult, failing to control their diet could lead to far more serious consequences, such as heart disease or kidney failure.
Rohana called on policymakers, the government and insurance companies to invest in effective obesity medications, highlighting that some ethnic disparities still exist in access to treatment and willingness to pay.
“By combining medical therapy with education, empathy and multidisciplinary care, we could promote a holistic approach, such as one that reduces stigma and encourages individuals to achieve sustained health improvements.”
