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Dr Ika Faizura Mohd Nor, Consultant Cardiologist Ampang Puteri Specialist Hospital

Injectable medications used for weight management have gained a lot of attention in Malaysia, especially through social media. Many people see these injections as an easy or fast solution to lose weight. From a medical perspective, particularly when it comes to heart health, it is important to understand what these medications really do, who they are suitable for, and the risks involved.

This article explains how these injections work, their effectiveness, safety considerations, and why proper medical supervision and a healthy lifestyle are essential.

How These Injectable Medications Work

These injections act on natural hormones in the body that regulate appetite, fullness and blood sugar levels. By influencing these pathways, they help reduce hunger, slow digestion and improve blood sugar control. As a result, many patients naturally eat less and experience gradual weight loss.

However, the response varies from person to person. Factors such as body chemistry, existing medical conditions, lifestyle, eating patterns and physical activity all influence how effective the medication will be. It is important to understand that these injections do not burn fat directly. They support weight loss by changing appetite and metabolism, which is why lifestyle changes remain crucial.

Are They Effective for Weight Loss

These medications can be effective for selected individuals, but results are not guaranteed. Some people lose a significant amount of weight, while others see only modest changes or reach a plateau early.

The best outcomes are seen when the injections are combined with healthy eating, regular physical activity, adequate sleep and long-term behaviour change. Without these, the effect is often temporary. These medications were originally developed for diabetes treatment, and weight loss was later recognised as a secondary benefit.

Regulation and Access in Malaysia

In Malaysia, injectable metabolic medications are regulated by the National Pharmaceutical Regulatory Agency and are prescription-only medicines. They must be prescribed by a registered doctor and dispensed through licensed healthcare facilities. Most are officially approved for the treatment of type two diabetes. In certain cases, doctors may prescribe them for weight management when it is medically appropriate.

This off-label use is an accepted medical practice when carried out responsibly with proper patient assessment and follow-up. Because these medications are temperature sensitive and require correct storage, there are concerns about counterfeit or improperly handled products. Patients should always ensure their medication is legitimate, properly stored, and NPRA registered.

Why Medical Supervision Is Necessary

These injections are not started at full dose. Treatment begins at a low dose and is increased gradually to reduce side effects and allow the body to adapt. Using these medications without medical supervision is dangerous and may lead to persistent nausea, vomiting, dehydration, low blood sugar, electrolyte imbalance and kidney problems. From a cardiology perspective, rapid weight loss and fluid imbalance can place additional strain on the heart, especially in individuals with existing heart conditions or high blood pressure.

Some patients may also experience worsening eye problems, particularly those with diabetes related eye disease. In a small percentage of patients, these medications could cause inflammation of the pancreas.

What Happens After Stopping Treatment

One important issue that is often overlooked is weight rebound. When the medication is stopped, appetite often returns. If healthy eating habits and lifestyle changes are not firmly established, weight can be regained quickly and sometimes exceed the original weight.

Repeated cycles of weight loss and regain are not beneficial for long-term metabolic and heart health.

Healthy Lifestyle for Sustainable Weight and Heart Health

Maintaining a healthy weight in the long term depends far more on daily habits than on medication alone. From a heart health perspective, lifestyle plays a major role in reducing the risk of heart attack, stroke, high blood pressure and diabetes. A heart-healthy lifestyle includes balanced meals with controlled portions, reduced intake of sugar and processed foods, and adequate fibre from fruits, vegetables and whole grains. Regular physical activity such as brisk walking, cycling or swimming helps improve heart strength, blood circulation and metabolism. Even simple daily movement makes a difference.

Adequate sleep and stress management are also important, as poor sleep and chronic stress can affect weight, blood pressure and heart rhythm. Avoiding smoking and limiting alcohol intake further reduces cardiovascular risk. When lifestyle habits improve, weight becomes easier to maintain, and the heart benefits directly. Medications may assist certain patients, but they should support these habits, not replace them.

Who Should Consider These Injections

These medications are not cosmetic treatments or quick fixes. They may be considered for patients with obesity related health risks or metabolic conditions where weight reduction improves long term health outcomes. They should always be used as part of a comprehensive medical plan that includes lifestyle management, behaviour change and regular medical follow-up.

Key Points on Injectable Weight Management Medications

• These injections are prescription-only medicines in Malaysia and must be prescribed by a registered doctor. They were originally developed for diabetes treatment, with weight loss as a secondary benefit.
• The injections work by reducing appetite and increasing the feeling of fullness, not by burning fat directly. Not everyone responds the same way, as effectiveness depends on body chemistry, lifestyle, eating habits and existing health conditions.
• Weight loss is more sustainable when combined with diet and lifestyle changes. The medication is started at a low dose and increased gradually to reduce side effects.
• Taking these injections without medical supervision is dangerous and may cause dehydration, low blood sugar, electrolyte imbalance and kidney problems. Heart health can be affected if weight loss is rapid or if the body becomes dehydrated, especially in people with existing heart conditions.
• Some patients may experience worsening eye problems, particularly those with diabetes related eye disease and inflammation of the pancreas.
• There is also a real risk of weight rebound after stopping, especially if lifestyle changes are not maintained.
• These injections are not cosmetic or quick-fix treatments and are not suitable for casual use. Patient needs to be on these medications for at least 12-18 months before the weight-reducing ability reaches its maximum benefit.
• They may be considered for patients with obesity related health risks where weight reduction improves long term health, and decisions should always be based on medical advice rather than social media trends.

Final Message from a Cardiologist

As a cardiologist, my focus is on long-term health rather than rapid weight loss. Maintaining a healthy weight through good nutrition, regular physical activity, and healthy daily habits is one of the most effective ways to protect your heart. Injectable weight management medications can be helpful for selected patients, but only when used correctly, responsibly and alongside a healthy lifestyle.

If you are considering this option, speak to a qualified healthcare professional who can assess your overall health and advise whether this approach is safe and suitable for you.