Main author: Dr Loo Say Yee, Family Medicine Specialist, Lecturer, Department of Family Medicine, Faculty of Medicine UKM; Hospital Canselor Tuanku Muhriz UKM.
Co-authors: Dr Khaizurin Tajul Arifin, Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia; Committee of Malaysian Sepsis Alliance (MySepsis); Professor Dr Tan Toh Leong, Consultant Emergency Physician, Department of Emergency Medicine, Faculty of Medicine, UKM; Founder and President, Malaysian Sepsis Alliance (MySepsis)
Most of us know what a cluttered house feels like.
It starts innocently small with a few items left lying around, a drawer that can no longer close as they were stuffed with old receipts, clothes or gadgets that you forgot you owned. Then life gets busy. You promised you’ll sort it out next weekend, but nothing has been done. Slowly, too much cluster comes in, not enough go out, and over time, the whole house becomes difficult to manage.
Now imagine your body working in a similar way. That, in many ways, is what poor metabolic health looked like. Not visibly messy, but internally, your body is gradually accumulating excess fat, rising blood sugar, unhealthy cholesterol, and chronic inflammation. It does not happen overnight.
So what exactly is metabolic health?
In simple terms, it refers to how well your body handles energy.
When your metabolic system is working well, your body knows what to do with the food you eat. It maintains blood sugar, cholesterol and blood pressure within a healthy range. But when things go wrong, the system becomes overwhelmed, leading to conditions that many Malaysians are increasingly familiar with, such as obesity, diabetes, high blood pressure, fatty liver, heart disease, and even stroke.
Interestingly, not everyone with obesity shows obvious metabolic problems at first. This has led to the term “metabolically healthy obesity,” which refers to individuals who have excess body weight but do not yet show clear signs of metabolic disease (Global Burden of Disease Study 2021). This group may affect up to 300 million people worldwide (Obesity and Metabolic Outcome).
The worrying part is that many of them may feel “mostly okay” for years. Over time, the body’s ability to cope may decline, and health problems can begin to appear. This is why metabolic health should not be judged by body weight alone, but by what is happening inside the body.
Modern life makes this surprisingly easy.
Many of us spend long hours sitting at work, in the car, or at home scrolling through our phones. Besides, food has become more convenient, heavily processed, and often oversized. Sweet drinks, frequent snacking, and takeaway meals have become routine and easily available for delivery. Sometimes, food is also used for emotional support. We eat for celebration, when feeling stressed or tired, or simply because it is there in front of our eyes.
This doesn’t necessarily mean that people nowadays are lacking discipline. It means we live in a comfortable environment that makes unhealthy habits easy. With newer weight loss injections gaining popularity, many people wonder if medication is the answer. True enough, these treatments can be highly effective for the right patients. They may help reduce appetite, improve blood sugar, and support meaningful weight loss.
But medication alone is not enough.
Think of it as hiring professional cleaners for your cluttered house while continuing to bring home more unnecessary items. The house may look better temporarily, but unless habits change, the clutter returns.
This is why lifestyle remains the foundation of metabolic health.
Food choices with better planning
Healthy eating does not require extreme diets or giving up favourite foods forever. Frankly, most people can’t live that way long term, and they shouldn’t have to.
Instead of relying on rigid rules, sustainable change comes from practical adjustments that fit into daily life.
For examples:
Planning meals before shopping.
Keeping healthier options within reach.
Avoiding supermarket trips when hungry.
Adding vegetables to familiar dishes
Choosing smaller portions or sharing food when eating out.
Reduce sugary drinks gradually.
Controlled portions using Healthy Plate (quarter carb, quarter protein and half leafy green) can be adapted when eating out.
For many Malaysians, the Healthy Plate concept remains a simple and realistic guide: fill half the plate with vegetables, one quarter with protein, and one quarter with carbohydrates. This can still be applied when eating out, even if the meal is not ideal.
Major obesity guidelines suggest that different dietary approaches, whether lower in fat, lower in carbohydrates, or calorie-restricted, can work when people can follow them consistently (EASO Nutrition Therapy Statement) (AHA Obesity Management Guideline). In fact, there is no one “best” diet that is superior for weight loss, dietary adherence is the strongest predictor of success [5].
Movement doesn’t have to mean becoming a sport person.
One of the main reasons why people abandon exercise is by making it too ambitious. A new gym membership. A promise to run every morning. An intense fitness challenge. Then reality happens: work deadlines, family commitments and fatigue. And then, the plan disappears.
A more sustainable approach is to make movement a part of daily life with a gradual increment in duration. Walking is often underestimated, but it is simple and accessible. Wearables such as smart watches or phone apps can help to turn moving more into a clear and measurable goal. For those with limited time, activity can be broken into short sessions, such as 10 minute walk, taking the stairs, or moving during work breaks (Obesity Lifestyle Management. On top of being an adjunct to weight loss, it also improves heart fitness, body composition, muscle strength, and overall metabolic health.
Human behaviour is more complicated than that.
Stress, poor sleep, hormones, emotional eating, work demands, genetics, and mental health are the weight-related influences. Many people already know what healthier choices look like but struggle to maintain them consistently.
This is where psychological support matters. For many people, weight control is not just about knowing what to eat or how much to exercise. It is also about understanding what gets in the way. Motivational interviewing is one approach used in healthcare to support this process. Rather than blaming or lecturing, it helps people reflect on their own reasons for change. A simple conversation, such as, “What makes healthy eating difficult for you?” or “What is doable for you at this stage?” can open the door to more honest and practical solutions.
In the long run, people are more likely to change when they feel supported, not judged.
Start with one corner of the house.
Improving metabolic health does not require an overnight transformation. Just like decluttering a house, it can start with one small, manageable corner.
Start with something realistic: swap one sugary drink for water, take a 10-minute walk after dinner, track your daily steps, sleep earlier and prepare lunch from home once or twice a week. These changes may seem unimpressive initially, but with repetition, they can reshape health.
Weight loss injections can be helpful for selected individuals, but they work best when combined with healthier eating, regular movement, behavioural support and long-term follow-up. There is no single injection that creates motivation or permanently changes habits without daily effort.
As the saying goes: “Weight control begins when we move our feet and control what we eat.” Metabolic health is not about perfection. It is building a body that functions better, support daily life, and stays healthier for the years ahead.
陈沱良医生DrSeb (drsebchannel@gmail.com) is a content creator under the Newswav Creator programme, where you get to express yourself, be a citizen journalist, and at the same time monetize your content & reach millions of users on Newswav. Log in to creator.newswav.com and become a Newswav Creator now!
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