OBESITY has long carried a heavy burden, not only physically but socially, as it has often been reduced to questions of appearance, willpower or self-discipline.
Bernama cited today that experts now insist that this narrative is outdated, urging a re-evaluation of societal assumptions.
In line with this year’s World Obesity Day, medical professionals emphasise that obesity is a complex, chronic disease requiring structured, empathetic long-term care, rather than a reflection of personal failure.
Dr Kiran Nai, Consultant Endocrinologist and Internal Medicine specialist at ParkCity Medical Centre, said one of the most common misconceptions is the belief that obesity results solely from laziness or a lack of self-control.
“This assumption is medically inaccurate. Obesity is a chronic disease officially recognised by the World Health Organization since 1997, just like diabetes or heart disease,” he said, explaining that genetic factors, hormonal signals, brain-regulated appetite, sleep patterns, stress, medications and the environment all play critical roles.
Modern treatment has moved beyond simplistic advice such as “eat less and move more” and now embraces multidisciplinary strategies addressing biological, psychological and lifestyle factors simultaneously.
“Obesity can affect nearly every organ system in the body—from the lungs and liver to the joints—and increases the risk of type 2 diabetes, heart disease, hypertension, certain cancers and infertility,” Dr Kiran said.
He noted that despite years of dieting, exercise programmes and weight-loss plans, many individuals struggle to achieve sustainable results. Biologically, the body is programmed to defend its baseline weight, triggering hormonal pathways that increase hunger and reduce metabolism whenever weight is lost.
“Our bodies are designed to protect us from starvation, not to lose weight. When someone sheds weight, the body interprets this as a threat and responds by increasing hunger hormones and reducing energy expenditure,” he explained.
Other complicating factors include hormonal imbalances, medication use, stress, menopause and underlying health conditions. Repeated failure to lose weight should therefore be viewed not as a lack of willpower, but as a signal for structured medical support.
A significant shift in obesity management has been the recognition of obesity as a biologically complex disease, changing clinical treatment approaches.
For individuals with substantial biological resistance to weight loss, care now includes medically supervised weight management programmes, prescription therapies, and in selected cases, minimally invasive bariatric or endoscopic procedures.
A major advance is the emergence of Glucagon-Like Peptide-1 (GLP-1) therapies. Unlike earlier weight-loss drugs that primarily suppressed appetite via the brain, GLP-1 drugs harness natural hormonal signals controlling hunger, satiety, blood sugar and metabolism.
“These medications work in harmony with the body’s systems rather than bypassing them. They help individuals feel full sooner and improve blood sugar processing, rather than merely blocking appetite,” Dr Kiran said.
He emphasised that drugs such as Ozempic, Mounjaro or Wegovy are not instant solutions or “magic injections,” but tools within comprehensive, long-term treatment plans that integrate lifestyle changes, behavioural support and ongoing medical care. Sudden discontinuation can result in weight regain.
Dietary management remains a cornerstone of sustainable obesity care. Dietitian Ng Kar Foo from ParkCity Medical Centre warned against extreme or trend-based diets often promoted online, which can lead to temporary weight loss but are rarely sustainable.
“Common mistakes include skipping meals, excluding entire food groups, and following extreme fad diets promoted on social media. These may produce short-term results but often lead to rebound weight gain,” Ng said.
He highlighted the importance of realistic, flexible habits and understanding one’s emotional and cultural relationship with food.
Medical interventions are complemented by minimally invasive endoscopic procedures.
Dr James Emmanuel, Consultant Gastroenterologist and Hepatologist, explained that treatments such as Endoscopic Sleeve Gastroplasty (ESG) and intragastric balloons are performed via the mouth without abdominal incisions.
ESG reduces stomach volume using internal sutures, promoting early satiety and smaller portions, with recovery typically lasting only a few days. Intragastric balloons provide temporary stomach volume restriction, supporting short-term weight loss of up to six months.
“These procedures preserve the natural gastrointestinal anatomy, offer shorter recovery, and carry lower procedural risks compared to traditional bariatric surgery,” Dr Emmanuel said.
Patient selection and participation in structured multidisciplinary programmes remain crucial for lasting results.
Realistic outcomes generally range from 15 to 20 percent total body weight reduction in the first year, with metabolic improvements including better blood sugar control, reduction in fatty liver and cardiovascular risk factors.
Long-term success depends on consistent adherence to nutritional guidance, physical activity and clinical monitoring.
Looking ahead, obesity treatment is expected to become increasingly personalised, with endoscopic interventions bridging the gap between medical therapy and surgery, forming an integral component of comprehensive obesity care.
Dr Emmanuel added, “Obesity is a chronic metabolic condition, and sustained success depends on continuous engagement with lifestyle changes and medical support. Minimally invasive endoscopic procedures are not a one-time fix but a key part of holistic, long-term care.” - March 4, 2026
