More mindful approach to obesity

KUALA LUMPUR: After a comprehensive review of the Malaysian clinical practice guidelines for the management of obesity, it now includes extensive psychological assistance.

In the second edition of the Clinical Practice Guidelines (CPG) on the Management of Obesity unveiled by the Health Ministry yesterday, its first revision in 20 years, some key updates included new criteria for the diagnosis of obesity, a more mindful approach towards the condition, the provision of pointers on medical nutrition therapy as well as pharmacotherapy and prevention tips for the younger generation.New and updated: This is the first time in 20 years that the CPG on the management of obesity has been revised.  — LOW BOON TAT/THE STARNew and updated: This is the first time in 20 years that the CPG on the management of obesity has been revised. — LOW BOON TAT/THE STAR

CPG development committee chairman Prof Dr Norlaila Mustafa said the second edition of the CPG, features several key recommendations that also addresses the stigma of being obese.

“That is the big part, where we bring in psychologists to help us, where we stress on behavioural modification, the approaches to managing someone with obesity, and so on,” said Dr Norlaila at the launch event here yesterday.

She added that there was no emphasis on how healthcare professionals should talk to patients with obesity in the first edition of the CPG, and the revision aims to change that.

Also in attendance at the event was Malaysian Endocrine and Metabolic Society president Dr Nurain Mohd Noor.

On obesity, Dr Norlaila said that “people don’t put on weight overnight; it takes years” which is where “detailed investigation of how a person arrived at that state is necessary in order to help them and teach them how to turn their negative behaviours into positive ones in terms of lifestyle, exercise and diet.”

Dr Norlaila said the new CPG included pharmacotherapy recommendations that should be used only as an adjunct (supplement) to diet, exercise and behavioural modification and not a standalone by itself.

“There are five pharmacotherapy medications available in Malaysia, and can only be prescribed by doctors ... we will bring in the physiotherapists, dieticians and counsellors to provide holistic and comprehensive management,” said Dr Norlaila, who also addressed the use of surgery, of which the “intragastric balloon” is an intervention available in Malaysia.

Gastric bypass and other weight-loss surgeries – known collectively as bariatric surgery – is done when diet and exercise could not work, or when a person has serious health problems because of weight.

“Our management approach is individualised and based on the patient’s age and goals,” Dr Norlaila said.

“That’s why motivational intervention and talking to the patients is important, as different people have different goals in trying to lose weight,” said the consultant endocrinologist, who emphasised that managing obesity is not only about medication.

Dr Norlaila added that it is everyone’s responsibility to address and prevent behaviours that may lead to obesity from a young age.

“We should focus on not just treating but preventing obesity.”

On bariatric surgery, Dr Norlaila said it was not a “quick fix” meant for everyone, as patients have to be examined first based on certain criteria.

She said if one is not psychologically prepared for the surgery and to make the necessary changes in lifestyle, the outcome may not be desirable even after the surgery.

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