Klinik Temasya
Primary Care Medicine

Getting a Grip on Obesity 

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Nearly 1 in 3 Malaysia adults have high risk BMI. The World Health Organization (WHO) and other internationally recognised health institutions now recognise obesity as a chronic disease. Our country is experiencing rapid urbanisation leading to 'westernisation' of lifestyle and dietary changes with mushrooming of fast food restaurant chains leading to rapid increase in prevalence of obesity in Malaysia

Body mass index (or BMI) is a simple widely establised measurements of obesity. It is defined as a person's weight in kilograms divided by the square of his height in meters (kg/m2)

  • Underweight is BMI less than 18.5
  • Healthy BMI is between 18.5 to 24.9
  • Overweight is BMI 25 to 29.9
  • Obesity grade I is BMI 30 to 34.9 (moderate)
  • Obesity grade II is BMI 35 to 39.9 (severe)
  • Obesity grade III is BMI 40 or more (very severe)

Obesity carries wide range of complications to our health. Among these are: 

  • Type II diabetes
  • Cardiovascular disease (high blood pressure, ischaemic heart disease, heart failure and stroke)
  • High cholesterol 
  • Metabolic syndrome
  • Sleep apnoea
  • Gallbladder disease (gallstone and fatty liver disease)
  • Osteoarthritis (of hips and knee)
  • High uric acid (hyperuricaemia) and gout
  • Stomach problems such as dyspepsia and reflux
  • Hormone imbalance causing irregular menses, reduced fertility and sexual function
  • Increase risk of certain type of cancer (endometrial, breast, liver, colorectal, prostate and gallbladder) 
  • Increase risk of pregnancy-related complications

Weight reduction may help to improve obesity-related comorbidities such as:

  • Reduction in risk of type II diabetes and pre-diabetes
  • Improvement in blood pressure control 
  • Improvement in blood lipid profile 
  • Reduction in cardiovascular risk factors
  • Improvement in severity of obstructive sleep apnoea
  • Improvement in health-related quality of life

Here are several ways that you can do today to help you manage obesity:

1. Consult your doctor today for comprehensive health check. There could be other various underlying causes of your obesity such as underlying hormonal disorder, side-effects of medications or genetic disorders. Your doctor will take a proper history, doing a physical examination and perform several tests to screen for obesity-related diseases such as diabetes, high cholesterol and fatty liver and if indicated a full hormonal assessment

2. Healthy meal plate using 'suku- suku separuh' or 'quarter-quarter half' concept as recommended by KKM. All you have to do is 'divide' your plate in the following manner:

  • ¼ plate of healthy carbohydrates preferably whole grains such as brown rice or wholemeal bread
  • ¼ plate fish or, poultry, meat, or egg
  • ½ plate of fruits and vegetables

Avoid sweet foods and drinks and excessive salt intake and foods with lots of thick gravy. Choose meals that are prepared with less oil such as pan-fry or steamed methods. Avoid processed and fast foods

3. Avoid ‘fad’ diets that promise rapid weight loss without changing to healthy lifestyle. Avoid use of supplements without advise from your doctor as this may contained harmful ingredients such as stimulants like sibutramine, diuretics and excessive caffeine which can be detrimental to your health. Extreme restrictive diets can cause issues like malnutrition, inadequate vitamins and minerals in the body, hormonal imbalance and high chance of regaining back the weight once the diet is stopped 

4. Exercise should be an integral part of weight loss therapy and weight maintenance. It contributes to weight loss by altering energy balance. It favourably changes body composition, decreases risk for disease, and improves quality of life. All exercise programmes should be introduced gradually. Aim for 30-40 minutes of low to moderate intensity exercise and slowly increase. Aim for 150 minutes of physical activity a week

5. Keep yourself active and moving. Take a stair instead of elevator. Increase your movement in your daily life with activities such as cleaning the house or gardening 

6. Getting adequate sleep every night. People who do not have enough sleep everyday tend to be more hungry throughout the day and eating more than usual

7. Keeping your stress level at bay by managing your emotion and mental health well. Practice such as deep breathing exercise and relaxation technique can help you feel more relax and focus.  Patients may sometimes use food to manage their emotions and might not recognize when they are doing it. Whether they are happy, sad, bored, excited, lonely or stressed, these emotions can lead to a patient eating when they are not hungry

If you would like to know more information about obesity and healthy weight management, visit our clinic for more information

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