By Nurhafizah Tan
KUALA LUMPUR, Sept 16 (Bernama) -- A new generation of weight-loss medication such as tirzepatide, better known by its brand name Mounjaro, is gaining increasing attention following its popularity on social media, with some viewing the weekly injection as a shortcut to achieving their desired body shape.
The trend, however, has also raised questions as tirzepatide is a medical treatment that should be tailored to an individual's health condition and administered under a doctor's supervision.
Medical lecturer and bariatric specialist at Hospital Canselor Tuanku Muhriz (HCTM), Universiti Kebangsaan Malaysia (UKM), Dr Loo Guo Hou, said modern obesity treatment was now facing a new dilemma involving individuals with a normal Body Mass Index (BMI).
“In the past, the majority of patients sought treatment when their obesity had become critical, accompanied by complications such as diabetes and high blood pressure. Now, patients are seeking treatment earlier because they know there are options beyond diet and exercise. This is a positive development.
“However, we are seeing a new group of individuals with normal BMI who want to use the medication simply to lose two to three kilogrammes for short-term cosmetic purposes. Mounjaro is not a cosmetic drug, but a treatment for metabolic diseases and obesity for those who meet the medical indications,” he told Bernama.
Dr Loo said the official indications for weight-management treatment in Malaysia were for individuals with a BMI of 30 and above, or between 27 and below 30 with health-related comorbidities.
He said forcing drastic weight loss without proper dietary control could backfire, particularly due to the risk of losing muscle mass (sarcopenia) and the threat of weight regain (rebound) once the medication was discontinued without a sustainable plan.
“Based on studies, when the medication is stopped abruptly, the group switched to a placebo experienced significant weight regain. Obesity is a chronic and relapsing disease, unlike an infection that is resolved after taking antibiotics for a few days,” he said.
Dr Loo said medication should also not be viewed as a substitute for a healthy lifestyle, as the period when appetite is better controlled could be used to develop new habits that support long-term weight loss.
“I always tell my patients that medication helps control hunger, but we still need to watch what we eat. Use the opportunity when your appetite is under control to develop new habits, including consuming sufficient protein, maintaining a quality diet and engaging in physical activity for better long-term outcomes,” he said.
Meanwhile, Premier Clinic senior aesthetic physician Dr Foo Wing Jian said one of the risk factors that was often overlooked was visceral fat, or fat accumulated around the internal organs.
Citing statistics from the National Health and Morbidity Survey (NHMS), he said more than half, or approximately one in two Malaysian adults, faced the problem of being overweight or obese.
“Subcutaneous fat, which is the layer of fat that can be pinched, such as around the chin or waist, is more of a cosmetic concern. However, the real health risk comes from visceral fat, which surrounds internal organs such as the liver, intestines and pancreas.
“That is why obesity assessment cannot rely solely on the number on the weighing scale. A person who appears slim may still have metabolic obesity if their waist circumference exceeds 90 centimetres for men and 80 centimetres for women, or if blood tests show abnormal blood sugar and liver enzyme levels,” he said.
He said the Mounjaro injection worked through two hormonal pathways, namely glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), to help regulate appetite and food intake, thereby resulting in significant weight loss and a reduction in visceral fat.
Dr Foo said a balanced diet, physical activity, adequate sleep and behavioural changes remained the foundation of weight management, although some individuals might require additional medical support depending on their health condition and a doctor's assessment.
To ensure healthy weight loss, Dr Foo recommended adequate protein intake to help maintain muscle mass throughout the weight-loss process, in addition to maintaining a healthy lifestyle, including regular exercise.
He also urged the public not to be tempted to purchase the prescription-controlled medication, either on the black market or through e-commerce platforms, without medical supervision, to avoid the risk of receiving counterfeit or damaged products that could result in organ failure.
-- BERNAMA