Did you know that over half of Malaysians are tipping the scales into unhealthy territory? The National Health Screening Initiative 2023 reveals that 53.5% of those screened are either overweight (31.3%) or obese (22.2%).

With sedentary lifestyles becoming the norm and convenience foods dominating daily diets, this trend could lead to a surge in chronic illnesses.

A New Frontier in Obesity Treatment

Dr Kok Wei Hao, Gastroenterologist and Medical Specialist (left), and Dr Lee Chong Chearn, Gastroenterologist and Medical Specialist (right) at Hospital Canselor Tuanku Muhriz UKM (HCTM), demonstrated the suturing equipment used in the Endoscopic Sleeve Gastroplasty (ESG) procedure.

Hospital Canselor Tuanku Muhriz (HCTM) has become the first teaching and government hospital in Malaysia to perform Endoscopic Sleeve Gastroplasty (ESG), an innovative obesity treatment also known as the "accordion procedure."

What is ESG?

YBhg. Prof. Madya Dato’ Dr Nik Ritza Kosai Nik Mahmood, Upper Gastrointestinal & Obesity Surgeon at Hospital Canselor Tuanku Muhriz UKM (HCTM), shared his expertise on the role of ESG in innovative obesity treatments, safe weight loss options, and the importance of a multidisciplinary approach.

“Unlike surgical options that require incisions, ESG is performed entirely through the mouth using an endoscope and a suturing device to reduce the stomach’s size and volume by about 70%. The procedure typically takes 1–2 hours under mild sedation or anaesthesia. Most patients are discharged the same day and can return to their daily activities within a few days,” said Prof. Dato' Dr Nik Ritza Kosai Nik Mahmood, Upper Gastrointestinal & Obesity Surgeon, HCTM.

Dato’ Dr Azmi Baharudin, Director of Hospital Canselor Tuanku Muhriz UKM (HCTM), shared that HCTM is the first government hospital to introduce the Endoscopic Sleeve Gastroplasty (ESG) procedure and highlighted the importance of addressing obesity during his opening speech.

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Dato’ Dr. Azmi Baharudin, Director of HCTM, shared in his opening remarks that the procedure was conducted on March 11 during the 1st UKM Endo Sleeve (ESG) Workshop: Weight Loss without Scars. Three patients underwent the initial procedure, and all were safely discharged without any complications.

According to studies involving over 15,000 patients worldwide, ESG has a low complication rate of around 1.25 percent and can lead to an average weight loss of 15.9 percent within five years.

An ideal candidate for Endoscopic Sleeve Gastroplasty (ESG) is someone with a Body Mass Index (BMI) between 30 and 50 who has faced challenges losing weight through conventional methods like diet and exercise.

This non-surgical procedure is especially suitable for individuals seeking an alternative to bariatric surgery and looking for a less invasive yet effective option for long-term weight management. It is also beneficial for those dealing with obesity-related health conditions such as sleep apnoea, joint pain, or metabolic syndrome, as ESG can support both weight loss and improvement in these associated issues.

The Silent Threat: Fatty Liver Disease

Dr Deborah Chew Chia Hsin, Consultant Gastroenterologist at Hospital Canselor Tuanku Muhriz UKM (HCTM), discussed the impact of obesity on gut health, fatty liver, and medical weight management.

During a sharing session, Dr. Deborah Chew Chia Hsin, Head of the Gastroenterology Unit at HCTM, provided an overview of the risks and health complications associated with fatty liver disease. She highlighted that fatty liver often develops silently, with few or no symptoms in the early stages, but can progress to more serious conditions such as liver fibrosis, cirrhosis, and even liver cancer if left unmanaged.

She noted that ESG offers a minimally invasive option for weight reduction, which can significantly improve fatty liver and other metabolic conditions when combined with lifestyle changes.

Encik Nor Azmin Aziz, a patient who underwent the ESG procedure at HCTM shared his personal experience with the procedure and how he is doing well post-treatment.

Encik Nor Azmin Aziz, a patient at HCTM, underwent the ESG procedure following his doctor’s advice after being diagnosed with cirrhosis - a serious liver condition linked to obesity. “When I was told I had cirrhosis, it was a wake-up call. My doctor recommended ESG as a safe, non-surgical option to help manage my weight and improve my liver health,” he shared.

Following the procedure, Encik Nor Azmin noticed positive changes in his well-being and energy levels. “I feel better, and it’s motivated me to maintain a healthier lifestyle. ESG has been a crucial step in my recovery journey,” he said.

Tackling Childhood Obesity

Prof Dr Norlela Sukor, Consultant Endocrinologist at Hospital Canselor Tuanku Muhriz UKM (HCTM), shared her insights on endocrinology, metabolic syndromes, diabetes, and the importance of early intervention.

The fight against obesity must also start early. Prof. Dr. Norlela Sukor, Consultant Endocrinologist, highlighted the dangers of childhood obesity, including high blood pressure, cholesterol issues, and early-onset Type 2 diabetes.

“If young people who are obese don’t lose weight, they’re more likely to develop diabetes in their 20s or 30s,” she said. “Type 2 diabetes is traditionally more common in adults, but we’re seeing it rise in children due to obesity.”

Looking Ahead
HCTM stated that they aim to expand awareness and train more medical professionals in the procedure to ensure a safer, less invasive, and effective treatment option is available for high-risk obesity patients.

While ESG helps reduce appetite and support weight loss, lasting results come from combining it with regular exercise and a healthy diet.

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.