Did you know as per World Obesity Atlas 2023, Malaysia is expected to experience a “very high” increase in adult and child obesity in the coming years? As much as 41% of Malaysian adults are set to be in the obese category by 2035.

Obesity is a chronic disease that can increase the chance of several illnesses and health issues, such as excessive cholesterol, high blood pressure, diabetes, heart disease, liver disease, sleep apnea, and certain cancers.

Obesity: A Major Cause of Chronic Illness

The relationship between obesity and health is complex and multifactorial. Obesity can cause or worsen chronic diseases by affecting biological pathways and mechanisms such as inflammation, oxidative stress, insulin resistance, hormonal imbalance, endothelial dysfunction, and immune dysregulation.

Some of the major chronic diseases that can be accentuated by obesity include:

Cardiovascular Diseases

Obesity can raise the chances of developing cardiovascular heart failure, illness, peripheral vascular disease, and stroke by increasing blood pressure, cholesterol levels, triglyceride levels, and blood clotting factors.

Diabetes

Obesity can impair the ability of the pancreas to produce insulin or the cells’ power to react to insulin, resulting in high blood sugar levels and diabetes.

Metabolic Syndrome

Obesity is a crucial contributor to metabolic syndrome, a range of disorders or problems that affect your blood pressure, blood sugar, cholesterol levels, and belly fat. Your susceptibility to type 2 diabetes, heart disease, and stroke, is all markedly exacerbated by metabolic syndrome.

Cancer

Obesity can alter the growth factor concentrations (like insulin-like growth factor-1), hormones (including oestrogen, testosterone, insulin, and leptin), and other substances, as well as inflammatory mediators (such as cytokines) that can affect cell growth and division. This can increase the risk of some cancers.

Breathing Problems and Sleep apnoea

Another major risk factor associated with obesity is obstructive sleep apnoea. The airway becomes blocked during sleep because of additional fat in the throat and neck. It can result in snoring, interrupted breathing, low oxygen levels, and poor sleep quality.

Obesity can make it hard to breathe, especially if you have obstructive sleep apnea. As a result of this, less oxygen enters your body causing a range of other issues.

Gallbladder disease

Obesity can alter the gallbladder’s equilibrium of bile acids, lecithin, and cholesterol, which help digest fat. Gallstone formation may result from solid cholesterol or bilirubin deposits that can block the outlet of the gallbladder. Gallstones can cause inflammation, infection, or gallbladder rupture, resulting in severe pain, fever, jaundice, or even death.

Obesity also makes it harder for the gallbladder to empty correctly, allowing bile to accumulate and harden into stones.

NAFLD (Non-alcoholic fatty liver disease)

Obesity can cause fat accumulation in the liver, interfering with its function and causing inflammation and scarring (fibrosis) of the liver tissue. It can impair the liver’s ability to process toxins, hormones, and nutrients and increase the risk of liver failure or liver cancer. NASH (non-alcoholic steatohepatitis), a more severe form, can develop from NAFLD. Severe form of liver damage involving hepatocyte ballooning and necrosis. NASH can result in cirrhosis, which causes irreversible scarring and hardening of the liver.

Musculoskeletal Problems

Too much weight can strain your joints, causing problems such as osteoarthritis and chronic back pain. Both osteoarthritis and chronic back pain can limit your daily activities, affect your mood, and reduce your quality of life. Your joints and back may experience less pressure if you lose weight, improve your posture and muscle strength, and prevent further damage to your bones and discs.

Mental Health

Obesity can affect mental health, causing problems such as depression and anxiety. This can be related to how society views and treats an obese person because of their weight and appearance. It can also lower someone’s self-esteem, confidence, and body image.

Kidney Disease

Obesity can damage your kidneys by causing high blood pressure and diabetes, the main causes of kidney problems. These conditions can harm the blood vessels and the filtering units in your kidneys, leading to chronic kidney disease (CKD). CKD can make you feel sick, swollen, tired, and itchy. CKD can also raise your risk of heart disease, bone disease, and kidney failure.

Reproductive Health

Obesity can harm fertility and pregnancy outcomes. Issues such as gestational diabetes and high blood pressure can affect your and your baby’s health and lead to serious issues like preeclampsia, which can damage your organs. Obesity can also raise the risk of losing a baby or having complications during delivery.

Immune Function

Obesity can harm your immunity, making you more prone to infections. Obesity can trigger inflammation, which can damage your infection-fighting white blood cells. Obesity can also interfere with the antibodies, which identify and destroy foreign invaders. Your chance of getting sick can increase if you are obese. Obesity can also lower the benefits of vaccines by weakening your immune response and protection.

Overall, obesity can increase the risk of death, mostly due to its close relationship with chronic diseases.

Many factors affect the intake and use of calories:

• Dietary habits: What, how much, how often, and how well one eats can change the calorie intake. For example, eating more high-calorie foods, processed foods, fast foods, sugary drinks, and snacks can raise calorie intake. But eating more whole grains, fruits, veggies, lean proteins, low-fat dairy products, and water can lower calorie intake.
• Food environment: How easy or hard it is to get food and drinks can influence what and how much one eats. For example, living close to places with healthy food options such as farmers’ markets, or community gardens, can make it easy to eat a balanced diet. But living in places with many unhealthy food options such as convenience stores, fast food outlets, or vending machines, can make it easy to eat junk food.
• Food marketing: How food and drink are advertised, promoted, and labelled can affect how one thinks and feels about them. For example, seeing food advertisements on TV, radio, the internet, social media, or billboards can increase the desire for some foods and drinks. However, seeing nutrition information or health claims on food packages or menus can affect how one chooses and buys them.
• Physical activity: How much, what kind, how hard, how long, and how often one moves can change the calorie expenditure. For example, moderate to vigorous physical exercise for at least 150 minutes a week can help burn calories and prevent weight gain. However, sitting still or being inactive most of the day can lower calorie use and increase obesity risk.
• Sedentary behaviour: How long one sits or lies down without moving can also change the calorie expenditure. For example, watching TV, playing video games, using computers or smartphones, or driving can reduce energy and muscle activity. But breaking up long periods of sitting with quick physical activities or standing still can raise energy use and muscle activity.
• Metabolism: The speed at which the body turns food and drinks into energy can also change calorie expenditure. For example, having a slow metabolism can make it hard to burn fat and lower calories. But having a quick metabolism can make it easy to burn calories and lose weight.

Tips for Achieving a Healthy Energy Balance to Prevent and Manage Obesity

Calories are the energy you get from food and drinks. You use this energy for physical activity and metabolism. To prevent and manage obesity, you must balance your energy intake and expenditure so that your body doesn’t store fat.

So how can you do that? Here are a few helpful pointers:

• Eat a healthy diet consisting of different food groups, such as fresh produce, nutritious grains, lean protein, fruits, low-fat dairy, nuts, seeds, and healthy fats.
• Control your portions. The best way to achieve this is to use smaller plates, bowls, and cups or measure the servings. This can help you eat fewer calories, waste less food, and save money too!
• Eat breakfast daily to get energy and calories at the start of the day and prevent hunger and overeating later. A balanced meal should have complex carbohydrates, protein, and fibre. Oatmeal with fruits and nuts, yoghurt with fruit or eggs and whole-wheat bread, granola and berries are great breakfast options.
• Snack smartly with nutritious snacks that fill you up and give you energy between meals. Fresh fruits, raw veggies with hummus or salsa, low-fat cheese with whole-grain crackers, or nuts and dried fruits are useful snacking options. They can help you avoid hunger pangs and sudden cravings.
• Drink water regularly to hydrate your body, control body temperature, remove toxins, and assist digestion. Water can also curb your appetite and reduce calorie intake by making you feel full. Every day, consume at least eight glasses of water or more.
• Avoid eating out. We all love to eat out, but restaurant food is often high in calories, fat, salt, sugar, and additives. Eating out less often can help you control what and how much you eat. And if you are dining out, pick healthier selections such as grilled or steamed dishes instead of fried or creamy ones, salads or soups instead of bread or chips, or fruit or yoghurt instead of cake or ice cream.
• Cook more at home to have more control over the ingredients and methods used to make food. Cooking more at home can help you eat less processed foods too.
• Increase physical activity by doing moderate-to-vigorous exercise for at least 15 or 30 minutes daily, five days a week. Exercise can aid in fat and calorie burning, build muscle and strength, improve your fitness and endurance, boost your mood and mental health, and prevent or manage many diseases.
• Reduce sedentary behaviour by limiting your time on activities involving little or no movement, like sitting, playing electronic games, watching television, or using the internet. Take frequent breaks from working on the computer and take a walk. This will improve your metabolism and help you destress as well.

Personal Dietetic Consultation

Personal dietetic consultation is a service where a licensed nutritionist helps you achieve your health goals. It is a worthwhile investment in your health and well-being. With a certified dietician’s help, you can reach your weight loss goals and management objectives and improve your quality of life.

A Personal dietetic consultation includes:

• A complete evaluation of your medical background and way of living, eating habits, and nutrition needs.
• A conversation about your health issues, challenges, and expectations.
• A customised nutrition plan that suits your taste, budget, and time for your health.
• A follow-up session to check your progress, solve problems, and give feedback and support.

Personal dietetic consultation can help you manage weight by providing professional nutrition advice and guidance. It can help you:

• Learn how calories, macronutrients, micronutrients, and water affect weight management.
• Read food labels, control portions, and plan meals.
• Overcome barriers to good eating such as stress, cravings, emotional eating, and social circumstances.
• Choose foods that are nutritious, filling, and tasty.
• Develop lasting and enjoyable healthy eating habits.
• Control your blood sugar, blood pressure, cholesterol levels, diabetes, heart disease risk factors, and metabolic syndrome.
• Lower inflammation, oxidative stress, and immune problems that worsen chronic diseases like arthritis, cancer, and autoimmune disorders.
• Improve digestion, absorption, and elimination of nutrients and waste products.
• Boost your energy levels, mood, sleep quality, and cognitive function.
• Prevent or delay problems like kidney damage, nerve damage, eye damage, and amputation.

Sources:

• https://www.nhlbi.nih.gov/health/overweight-and-obesity
• https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes
• https://www.who.int/health-topics/obesity
• https://www.who.int/news-room/fact-sheets/detail/obesity
• https://www.amdietetics.com/articles/a-good-dietetic-consultation
• http://eatright.sg/personal-dietics-consultation/
• https://shahalam.avisena.com.my/services/personal-dietetic-consultation/
• https://www.worldobesity.org/news/world-obesity-day
• https://knowridge.com/reasons-why-obesity-causes-high-blood-pressure
• https://indiependenceday.org/an-effective-fitness-program-for-chronic-disease-prevention/
• https://www.how-shop.online/the-importance-of-balanced-diet-in-weight-loss
• https://firstfinancejournal.com/diet-counseling-helping-you-achieve-your-health-goals/
• https://codeblue.galencentre.org/report-41-of-malaysias-adults-will-be-obese-by-2035/