Malaysia’s sustained economic growth and political stability over the last five decades has brought about rapid demographic and nutrition transition which has inevitably generated marked changes in dietary habits and life styles of Malaysian. The prevalence of obesity in all age-groups once thought to be an urban phenomenon, has now spread to the rural population at an alarming rate, implying calories imbalance that contribute to weight gain. The “fat - sugar laden” local dishes and the “westernization” of global eating habits, made possible through food imports, fast foods and 24 hours food outlets has led to a rising consumption of fats and sugars coupled with, sedentary lifestyle are largely responsible for the rising epidemic of obesity and associated diseases. It is becoming more apparent that the traditional approach appears to have failed while actions to act decisively to help combat the increasing prevalence has been few and overall rather uncoordinated while efficacy of intervention programmes are rarely reported. A recent study (EIU, 2017) revealed total cost of obesity estimated to be between 10% and 19% of national healthcare spending. It is imperative that both short and long term preventive strategies need to be developed since Malaysians are susceptible to enhanced co-morbidities with quite modest weight gain. Unless we could make policy makers, professionals and the population at large understand the threat obesity poses and the urgency to implement possible solutions now, the natural course would be an obesity epidemic that will continue to grow beyond our control in the coming decades. This paper will highlight the prevalence and trends, issues related to the problem, efforts made to curb them and the mounting challenges that we faced in Malaysia.