Staying slim and having a tight body can be difficult to achieve, much less maintain. Sometimes, because of health and other conditions, it’s hard to lose weight, no matter what diet we use, what we eat, or how hard we workout.
The problem gets worse if we start to lose control over our weight, and end up overweight, or even obese. At that point, it gets even more difficult to deal with the weight. Exercise gets more difficult, and the obesity can cause other health complications.
To understand how to deal with obesity, and whether patients should consider weight loss injections, let’s take a look at what obesity means, and what forms of treatment are available first.
People tend to use the words “overweight” and “obese” interchangeably. However, there is a medical distinction between the two. Obesity is a complex disease that involves excessive amounts of body fat, and is defined as a person having a BMI of 30 or higher, while overweight persons are medically defined as having a BMI of 25 – 29.9.
Obesity is related to a large number of other serious health issues like:
Due to its complexity, a large range of factors can contribute to obesity. Fortunately, a good number of them are within your control, should you want to make changes.
While some might consider food intake to be about caloric intake alone, this cannot be further from the truth. While caloric intake is an important factor in the overall cause of obesity, it is not the only factor of note. Nutrient density in food intake is also a key consideration. Being able to take in food that is packed with vitamins and minerals ensures that the organs which provide for the body’s vital functions stay healthy. This can be vital in obesity prevention, as other comorbidities can compound obesity issues.
Physical activity is important as well. While physical activity is generally thought of as working out and exerting our bodies, part of maintaining a certain level of physical activity is also about low and medium-intensity activity. Taking walks, carrying groceries, cleaning the home or even cooking can be considered “lifestyle” physical activity as there is some strain on the body, causing an increase in caloric consumption in the body. Singapore’s Health Promotion Board recommends at least 150 minutes of physical activity every week, with lifestyle, aerobic and strength-related activities mixed in.
Sleep is another important factor that is not usually considered. Most studies that explore the link between sleep duration and obesity have found some form of connection between insufficient sleep and increased weight. Researchers suspect that a lack of sleep could lead to weight gain either by increasing food intake or reducing the calories their body can burn.
Some people are affected by genetics. An estimated 5% of obesity cases are linked to single-gene syndromic and nonsyndromic disorders. Another study which looked at 15 years of gene identification efforts found that there is a biological connection between genes and obesity, with the goal of identifying subgroups of people that ate genetically predisposed to obesity.
What we choose to eat is as important as how much we eat, as it plays a large role in determining whether we become obese or not. Unfortunately, much of our food choices are derived from where we live, whether our family eats out often or not, whether junk food is chosen because it is the closest to home, and even by whether the government places an importance on fresh food imports or not. This “food environment” influences what we eat, which can make it hard for people to choose healthy foods. In the past few decades, research on “obesogenic” food environments have made progress into how social, economic, and geographic situations affect obesity in humans.
The spread of culture from one country to another has been both a force for good and bad. While economies grow, these same shifts also bring about increased wealth, and waistlines, for people in developing and newly-developed countries. The shift in the economics and society make lifestyles more sedentary, diets more calorie-rich, and even brings down the price of food, leading to overconsumption.
When talking about the treatment for obesity, the objective is to achieve and maintain a healthy weight. Most weight loss goals aim to reduce about 5 – 10% of the initial body weight over a period of 6 months, with weight loss not exceeding 1kg to ensure that treatment is safe.
This form of treatment involves lifestyle changes, which include:
This regular method of treating obesity depends on the idea of increasing caloric output while controlling caloric input. To lose weight, caloric intake needs to be less than what is being used by the body, so that it taps on the fat stores for energy. This method is safe and effective but tends to be slow. The process can also be uncomfortable and can be psychologically challenging to undergo.
In some situations, bariatric surgery can be used. This surgery physically limits the amount of food a person can consume. It is effective and tends to result in weight loss and improvement of obesity related health issues. However, undergoing surgery is often not an option for obese persons, unless their BMI begins to exceed 40, or they have a BMI of 35 with one or more obesity-related health problem.
Weight loss injections are daily or weekly injections that contain drugs like liraglutide and semaglutide, which can help with weight control. Popular names for these injections include brand names like Saxenda, WeGovy, Ozempic and Mounjaro.
Saxenda, which contains liraglutide, is a weight loss medication that mimics a natural hormone in the body called Glucagon-like peptide-1 (GLP-1). GLP-1 receptors can be found in several organs, including the brain, pancreas, gastrointestinal tract, heart, vasculature and kidneys. Saxenda works by binding to the receptors in the arcuate nucleus of the hypothalamus in the brain, where it stimulates satiety and inhibits hunger neurons. This means that liraglutide’s presence in the body helps the patient by making the patient feel fuller, faster. This leads to a decrease in eating, and a gradual loss of weight. Saxenda is useful in overweight or obese adults that have weight-related medical problems and have trouble keeping the weight off. A new injection, Mounjaro (tirzepatide), also works by the same mechanism – but it contains GLP-1 and GIP agonists.
WeGovy and Ozempic, on the other hand, contains semaglutide. While semaglutide also belongs to the family of GLP-1 agonists, it has a longer half-life in the human body when compared to liraglutide. Additionally, this means that while a WeGovy or Ozempic injection is done once a week, a Saxenda liraglutide injection has to be done daily. However, Ozempic is approved for treatment of Type 2 diabetes, while WeGovy and Saxenda has been approved for treatment of obesity.
Saxenda, Ozempic, Mounjaro and WeGovy are available in Singapore via a doctor’s prescription. A doctor’s consultation is required to assess your suitability.
The use of each injection is the key difference. Saxenda and WeGovy are used for weight loss, while Ozempic is approved for the treatment of Type-2 Diabetes. Ozempic’s prescription for weight loss in persons without Type-2 Diabetes is considered an off-label use.
|
Name |
GLP-1 Agonist Used |
Application Period |
Treatment Type |
|
Saxenda |
Liraglutide |
Daily |
Weight Loss |
|
WeGovy |
Semaglutide |
Weekly |
Weight Loss |
|
Ozempic |
Semaglutide |
Weekly |
Type-2 Diabetes |
In Singapore, not everyone can get a weight loss injection. Patients who have a higher risk of obesity-related health issues can get weight loss injections. These injections are recommended for patients who have:
Serious reactions to weight loss injections are minimal. In those that are affected by any side effects, Saxenda tends to cause reactions like nausea, acid reflux, diarrhoea, constipation, fatigue and gas. In more severe situations, Saxenda in Singapore can cause gallbladder issues, and pancreatitis, which is the inflammation of the pancreas.
Additinally, those who have close relatives who have thyroid problems or family history of thyroid cancers should not take take Saxenda as there is at least a small pool of evidence that suggests the possibility of an increased risk of thyroid cancer in relation of the use of Saxenda.
Currently, Saxenda and Ozempic are the only weight loss injections available for prescription in Singapore. However, doctors can prescribe other medications that can help with weight management.
If you’re looking for other options when it comes to weight loss, here are some you can take note of. Do take note that not all of these options are available in Singapore.
Phentermine is an anorectic that has been around for a while. This appetite suppressant is popular for weight management and is usually prescribed as a part of a wider weight loss plan. Similar to an amphetamine, its appetite suppressing capability comes with an increased heart rate and blood pressure. Common side effects of Phentermine include dry mouth, heart palpitations, skin flushing, fatigue, sleep problems, constipation, nausea and vomiting. Duromine is one of the brands that contains phentermine as an active ingredient.
Orlistat is a prescription drug that helps to prevent fat absorption in the gut. Considered an “intestinal lipase inhibitor”, it is often sold under the brand name Xenical. It works by reducing the number of calories being absorbed into the body. Orlistat has a modest effect on weight management, and seems to help control blood pressure. However, due to the mechanism of this drug, there can be gastrointestinal side effects like gas, loose stools and diarrhoea.
Some patients might have heard of Mounjaro, which uses Tirzepatide as a key ingredient. This injection is more powerful than Saxenda or Ozempic because it uses a combined GLP-1 and GIP agonist.
Losing weight healthily needs proper guidance and customised plans tailored to each unique individual. If you want to find ways to help improve your obesity condition, you should consider a detailed examination by our qualified doctors, who will then customise a suitable treatment plan based on your health condition.
If you are seeking to lose weight in a safe and sustainable manner, SL Aesthetic Clinic can provide you with the necessary diagnosis and treatment to work toward your ideal aesthetic look. Call us now at 6235 3246, or Whatsapp us at 9850 7112.
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