Findings from the National Health and Morbidity Survey 2019 indicate that one in every two Malaysian adults is overweight or obese.
Dr Lim Ting Song, medical director of Clique Clinic, understands the urgent need to raise awareness among Malaysians to be less complacent with unhealthy lifestyle habits. He offers his expert view on common misconceptions about obesity, lesser known health risks, and the steps towards better overall fitness.
“When we talk about obesity, the most common way of looking at it is through the body mass index (BMI). As per Asian BMI classification, a person within the range of 23-27.5 kg/m2 is overweight, and a BMI of >27.5 kg/m2 is obese,” Dr Lim explains. However, BMI only offers a snapshot view without factoring in the composition of muscle weight and fat distribution. “BMI does not give us the real picture of what a person’s build is,” Dr Lim says, adding that this method of calculation can lull someone into a false sense of good health.
Being observant of your body’s fat distribution is critical, as Dr Lim observes that abdominal obesity is becoming increasingly common. Some may recognise it as having a noticeable beer gut, spare tyre, or even a little muffin top. These terms refer to fat concentrated around an individual’s midsection, even if their limbs are thin. “Men with a waist circumference over 90cm, and 80cm for women are classified to have abdominal obesity,” Dr Lim clarifies. He estimates that this form of obesity is even more severe, as visceral fat wraps around abdominal organs deep inside your body – which we can’t see or feel.
“The extra fat in your body is causing a lot of inflammation,” Dr Lim explains. This inflammation can lead to lipotoxicity – chronic inflammation that causes organ dysfunction and contributes to metabolic syndromes such as diabetes, heart disease, non-alcoholic fatty liver disease, higher risk of stroke and also various cancers. Increased weight is also a burden to our joints, causing osteoarthritis.
“This kind of inflammation might not affect you right now, but years down the road, your organs will face issues much sooner compared to others,” Dr Lim says. He compares ignoring obesity to failing to service a car regularly. “With wear and tear, there will come a time when you have to change all the spare parts rather than just trying to maintain the vehicle,” the doctor describes. It is vital to act at an early stage and not ignore the early indicators.
Being obese doubles the risk of hospitalisation and increases the risk of Covid-19 deaths by 48%, according to a global analytical study by the University of North Carolina, Saudi Health Council and World Bank. Dr Lim explains that “when you have any viral or bacterial attack, the body goes into an inflammatory state, where there will be a lot of immune cells and particles in the body’s circulation to combat the virus. When the immune response is out-of-control, the patient’s body goes into cytokine storm state, where the body attacks good cells and tissues rather than just fighting off the virus. From what we understand, this is one of the underlying factors killing Covid-19 patients.”
When it comes to obesity management, Dr Lim explains that “the most common misconception is that you can easily go on a diet and exercise to shed the fat.” Although social media and the Internet are rich sources of diet plans and workout routines, in which some do result in short-term weight loss, it doesn’t take long for the body fat to return, and any muscles loss from intensive cardio/aerobic workouts are harder to regain. “You have to plan your physical activity and work on training your muscles. Core muscles help increase your metabolic rate,” Dr Lim explains. The next management option is medication, in the form of tablets or injections which can help to decrease appetite if appetite is something that they struggle to control. The last option comes under the heading of bariatric, or weight-related surgery such as gastric banding or gastric balloon to make the stomach feel full.
Dr Lim reminds Malaysians that weight loss is a gradual process that requires setting realistic goals. He encourages Malaysians to seek professional advice from doctors, nutritionists or even sports experts to formulate a lifestyle, diet and exercise plan that considers an individual’s overall health. “Stress, sleeping habits, hormones, medical conditions, medications and genetics are all factors to take into consideration when we talk about trying to help someone combat obesity.”
This story is published in Prestige Malaysia’s March 2021 issue. To read the latest issue, pick up a copy from the nearest newsstand or subscribe on Magzter. Signup to our weekly newsletter for latest news and interviews!