Rebuilding Health: Chronic Disease and the New Advances in Treatment

05 November 2025

Obesity is far more complex than it appears. The World Health Organisation (WHO) has classified it as a chronic disease — a recognition that goes beyond the outdated notion of obesity as a mere lifestyle problem. In truth, obesity is not merely a disease but also a fundamental cause of numerous health conditions and comorbidities. Numerous studies have shown that obesity significantly increases the risk of cardiovascular disease, diabetes, hypertension, sleep apnea, and even cancer.

With Malaysia’s combined overweight and obesity rate exceeding 70%, it is critical to understand the true nature of this condition and explore new, evidence-based treatment options.

Obesity: A Chronic, Complex Disease with Multiple Contributing Factors

Obesity is not simply a matter of excess weight. It is a complex condition influenced by genetics, physiology, environment, and psychology. Some individuals may have a genetic predisposition to store more fat, while modern lifestyles, characterised by high-calorie diets and limited physical activity, further contribute to the problem. Psychological factors such as stress, anxiety, and depression can also lead to emotional eating, creating a vicious cycle that makes weight management more challenging.

Effectively managing obesity requires a personalised, long-term approach. For those who have struggled for years, seeking professional medical help is the first step toward recovery.

Limitations of Traditional Weight Loss Methods

When it comes to weight management, diet control, exercise, and medications are often the first approaches people consider. While healthy eating is essential, extreme dieting can lead to nutritional deficiencies, muscle loss, and digestive issues. Exercise offers numerous benefits; however, for individuals with severe obesity, excess weight limits mobility and make it difficult to burn enough calories for meaningful weight loss. Medications may provide temporary relief, but they often come with side effects and the risk of weight gain after discontinuation.

For patients with severe obesity, conventional methods often yield limited and short-lived results. In such cases, bariatric surgery offers a more sustainable option, producing significant and lasting weight loss. However, surgery carries certain risks and requires longer recovery — and not everyone is medically suitable or willing to undergo it.

Endoscopic Sleeve Gastroplasty (ESG): A Minimally Invasive Alternative

Endoscopic Sleeve Gastroplasty (ESG) offers a new, less invasive option that balances efficacy with safety.

ESG is a non-surgical endoscopic procedure that reduces stomach size internally by stitching the stomach walls into a sleeve-like shape, decreasing stomach volume by about 70–80 percent. This alteration helps patients feel full faster, prolongs food retention in the stomach, and sustains post-meal satiety.

The procedure is performed via a gastroscope inserted through the mouth, allowing doctors to suture the stomach walls without any external incision or removal of tissue. It typically takes less time, poses lower risks, and has a faster recovery period with minimal complications. Most importantly, ESG is reversible, offering patients greater flexibility.

ESG: Patient Suitability and Selection

While ESG offers hope, it is not suitable for everyone. It is generally recommended for patients with a body mass index (BMI) above 27.5 kg/m², who have not achieved satisfactory results with other weight-loss methods, need weight reduction to control obesity-related diseases, or are unsuitable or unwilling to undergo bariatric surgery.

Before undergoing ESG, patients must complete a full medical evaluation, including gastroscopy, blood tests, and cardiopulmonary assessments, to determine suitability. They should also understand the procedure, potential risks, and expected outcomes to make informed decisions together with their physician.

Long-Term Management is Key

ESG is an effective tool for weight loss, but not a shortcut to replace healthy living. Post-procedure, patients must follow a personalised diet plan and gradually develop consistent eating and exercise habits under the guidance of a multidisciplinary medical team.

As an innovative minimally invasive treatment, ESG acts as a powerful starting point in one’s weight-loss journey. However, achieving long-term success requires continued commitment and discipline from both doctor and patient. With proper guidance, perseverance and lifestyle adjustments, obesity can be effectively managed over the long term, restoring health and improving overall quality of life.

Learn more about this minimally invasive approach to weight loss by speaking with Dr Yong Karl King, Consultant Gastroenterologist & Hepatologist & Bariatric Endoscopist.

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