Tag : OBESITY

With obesity and metabolic syndrome reaching alarming levels in Malaysia, clinicians are looking beyond conventional approaches to expand the bariatric toolbox. Among the emerging options, intragastric balloons (IGBs) are gaining momentum as a minimally invasive, endoscopic solution to support the initial step in weight loss alongside lifestyle change. At the recent “Intragastric Balloon” workshop hosted by the Department of Surgery, Hospital Canselor Tuanku Muhriz (HCTM) UKM in Kuala Lumpur, leading experts in bariatric innovation shared their perspectives on advancing IGB therapy in clinical practice. 

Malaysia continues to face a rising burden of obesity, with more than 54% of adults classified as overweight or obese. In response, Hospital Canselor Tuanku Muhriz UKM (HCTM-UKM) introduced endoscopic sleeve gastroplasty (ESG) into the public healthcare sector earlier this year. It became the first government and teaching hospital in Malaysia to offer the procedure, an effort led by Dato' Dr. Nik Ritza Kosai, head of upper gastrointestinal (UGI), metabolic and bariatric surgical unit at HCTM-UKM.

Obesity has traditionally been viewed as a risk factor for other conditions and the concept of obesity as a standalone disease remains a subject of debate. In a landmark 2025 publication, the Lancet Diabetes & Endocrinology Commission redefined obesity through a clinical lens—shifting away from body mass index (BMI)-based assessments and introducing a diagnostic framework that recognizes clinical obesity as a chronic, systemic illness when specific clinical criteria are met. Growing evidence shows that excess adiposity, independent of other obesity-related diseases, can directly and adversely affect the organ function and overall health of an individual, leading to the typical clinical manifestations of illness. To address the gap in current clinical characterization, the Commission defines clinical obesity as a chronic, systemic disease characterized by functional impairments in tissues, organs, or the individual, directly caused by excess adiposity. The redefinition aims to provide a more medically meaningful framework to guide diagnosis, inform clinical decisions, and shape healthcare policies.

Weight loss is commonly recommended for treating obstructive sleep apnea (OSA) in those with obesity. However, achieving and maintaining this weight loss is often difficult without bariatric surgery, and no approved anti-obesity medications have proven effective for OSA management. Recently, the United States Food and Drug Administration (US FDA) approved tirzepatide, a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, as the first pharmacological treatment for moderate-to-severe OSA in adults with obesity. This approval, based on the results of the phase 3 SURMOUNT-OSA trial, introduces a new treatment option for sleep medicine, providing an alternative to traditional management methods such as positive airway pressure (PAP) therapy.