The landscape of adult obesity in Malaysia: a mapping of evidence and contemporary narrative review.

Abstract

Malaysia has one of the highest adult overweight/obesity rates (54.4%) regionally, with prevalence projected to keep rising. We mapped and synthesized updated Malaysian adult overweight/obesity research to guide practice and policy. We searched Web of Science, PubMed, and Google Scholar (English, 2016-2024) for studies on adult overweight/obesity in Malaysia. We organized eligible studies into the scopes defined by the national Nutrition Research Priority and conducted thematic narrative synthesis. The evidence base is heavily skewed toward descriptive epidemiology (≈70%), while longitudinal cohorts, experimental designs and health systems research remain scarce. Community-based studies dominate (≈68%), with limited data from clinical or population-based cohorts. Metabolic risk emerges even below BMI 23 kg/m², and waist-to-height ratio >0.5 is a consistent unhealthy threshold. Research on disease burden, economic impact, and long-term outcomes remain limited, constraining policy prioritization. Lifestyle interventions deliver modest effects and are largely confined to micro- and meso-level programmes. Uptake of obesity management medications remains low, bariatric surgery services are expanding but still developing, while policy implementation gaps persist despite existing frameworks. Addressing obesity in Malaysia will require a coordinated, whole-of-society response. Future studies should adopt disease-oriented strategies, harnessing longitudinal national cohorts, pragmatic trials, scalable meso/macro interventions, and a national research collaborative leveraging available resources.