Are you dealing with a weight problem?
If you are, you are not alone. 12% of Malaysian population are obese, and more are overweight.  We are here to help. Talk to our dedicated physicians, dietitians, and physiotherapists to provide you the complete range of solutions for obesity.

Your initial screening process will consist of the following:

• Individual consultations with our doctors
• Nutrition counselling including anthropometric data gathering and body fat assessment
• Behavioural modification therapy
• Physical activity counselling and exercise prescription
• Blood tests (haemoglobin, kidney functions, thyroid profiles, glucose, and lipid profiles)
• Chest X-ray
• ECG. 

Act now before it is too late. Explore the treatment options together with your physicians. You do not need to be alone in the fight to regain your wellness. We are here to help!

Weight-Loss Surgery Programme:
Are you tired of trying to lose weight by means of dieting, exercise, and maybe even appetite-reducing drugs?  If you have failed, you are not alone.  Studies have shown that 95% of non-surgical methods of weight loss fail within 2 years. In fact, you may have subjected your body to severe and continuing cycles of weight loss and gain known as “yo-yo dieting”.  Weighing more than what is emotionally and physically healthy is increasingly a problem for Malaysians. If nothing you have done is helping your weight problem, surgery may be your best option.

Are you a candidate for weight-loss surgery?
If you are severely obese (over weight), i.e. body mass index (BMI) of 37.5 kg/m2 or more, you are eligible for weight loss surgery to reduce your weight. If your BMI is more than 32.5 kg/m2 with obesity related co-morbidity, such as diabetes mellitus, high blood pressure, high cholesterol level, back pain, and sleep apnea, you can also consider surgery to lose weight.

What is Body Mass Index (BMI)?
Body mass index is used to estimate your best weight range for your health. It is calculated by dividing your weight in kilograms by your height in meters squared (m2).

Classification*	BMI (kg/m2)
Underweight	<18.5
Normal range	18.5 – 22.9
Overweight at risk	23    – 24.9
Obese I	25    – 29.9
Obese II	≥  30

*Western Pacific Region of WHO classification, 2000

What is weight-loss surgery?
Weight-loss surgery can be divided into two main categories. The first is restrictive surgery where your stomach’s size is reduced and therefore, less food is allowed to go through, and directly also decreases your appetite. Laparoscopic adjustable gastric banding and laparoscopic sleeve gastrectomy are representatives of this type of surgery. These procedures tend to provide gentler weight loss with minimal risks of malnutrition.

The second type is mal-absorptive procedure, which involves some forms of intestinal bypass to reduce the absorption of food and nutrient. In combination with stomach stapling, the weight loss is good with small risk of malnutrition. The two main procedures in this category are gastric bypass and bilio-pancreatic diversion.

Laparoscopic Adjustable Gastric Banding (LAGB)
LAGB is using an inflatable band placing it around the top of the stomach to control how much food can go through and provide a sense of fullness. It is the safest operation available to achieve weight loss because it does not involve any cutting or stapling of your gastrointestinal tract. It is also fully reversible. The risk of malnutrition is negligible compared to other more invasive operations. This procedure is proven to achieve 50 to 60% of excess weight loss at 2 years.

Laparoscopic Sleeve Gastrectomy
Laparoscopic sleeve gastrectomy makes your stomach smaller and look like a tube. It will reduce your appetite and the amount of food that can go through your stomach. The divided stomach will be removed from your body. However, the gastrointestinal tract remains intact, which will allow endoscopic examination of the remaining stomach should the need arise later. The risk of malnutrition is significantly reduced compared to a gastric bypass procedure.

Laparoscopic Gastric Bypass
This involves making the top of the stomach as small as a golf ball, and bringing a loop of small bowel to connect to this stomach. Two connections need to be created, and food will go directly into the intestine without going through the divided stomach even though the “old stomach” lies in your body. It provides great weight loss in shorter period of times, but it does carry higher operative risks and post-operative mal-nutrition problem. You also need to take vitamin and iron supplements for life.

Intragastric Balloon – solution for those who do not want surgery or do not meet the surgery criteria?
This procedure involves putting a silicone balloon in your stomach. It is round and the surface is smooth. It is inflated with 500 to 700ml of normal saline. It sits in your stomach to reduce what you can eat. It is placed through a gastroscope, which the physician uses to look for any stomach ulcer or tumour. This procedure lasts about 30 mins and requires mild sedation. This is not a surgical procedure, as no cutting or stapling of the stomach is involved. The balloon is temporary, and it has to be removed 6 months after placement. The average weight loss ranges from 15 to 25 kg in the literature. The known complications are gastric ulcer, nausea and vomiting, rupture of stomach (in patients with previous stomach surgery), bowel obstructions, etc.

What are your role and responsibilities in the weight loss process?
Surgery is the proven way of sustainable weight loss for the severely obese patients, nevertheless, surgery is not an easy way out of obesity. It requires your full commitment and cooperation with your surgeon and dietitian to have a successful outcome. It will be a lifelong commitment to changes with sensible eating habits, regular exercise, and daily vitamins. Please remember, surgery is just a tool to help you lose weight. The ultimate responsibility still lies with you.

What is your next step?
If you would like to be evaluated as a possible candidate for weight-loss surgery, please contact your surgeon for further information regarding these operations and their risks and possible complications. We have a surgeon who is fully trained in the field of obesity surgery and who will be more than happy to discuss the details of this life-long commitment with you.

For more info, please visit www.weightlosssurgerymalaysia.com

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