Treating Obesity With Weight Loss Injections

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.

What is Obesity?

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:

• Heart disease and stroke: Obese persons are more likely to have high blood pressure, and higher than normal cholesterol levels. These contribute to the probability of developing heart disease and stroke.
• Type 2 Diabetes: Obese persons are at risk of becoming more insulin resistant.
• Sleep Apnea: Obese person also face a higher chance of developing sleep apnea, a condition where the breathing repeatedly pauses and restarts while the person sleeps.
• Osteoarthritis: Obesity stresses weight-bearing joints, and promotes inflammation within the body, and can lead to issues like such as osteoarthritis.
• Organ problems: Obese persons face a higher chance of developing gallbladder and liver diseases.

What Causes Obesity?  

Due to its complexity, a large range of factors can contribute to obesity. Fortunately, a good number of them are within your control.

Food, Activity and Sleep  

• Food 

While caloric intake is an important factor in the overall cause of obesity, nutrient density in food intake is also a key consideration. Nutrient dense food are food that are rich in nutrients and relatively low in calories – these include lean meat, wholegrains and vegetables. Incorporating nutrient dense food into your diet ensure you are both healthy and satiated.

• Physical activity 

Physical activity is often thought of as working out and exerting our bodies – but part of maintaining an active lifestyle also includes low and medium-intensity activity, such as walks, carrying groceries, and even doing housework. 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

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.

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.

Food Environment  

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.

 Globalization 

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.

What is the Normal Treatment for Obesity?

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:

1. Reducing the amount of calories that a patient takes in.
2. Choosing nutrient dense foods
3. Engaging in sufficient and regular physical activity

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.

What are Weight Loss Injections?

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 

• Contains liraglutide and 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, helping patients feel fuller faster.
• This leads to a decrease in eating, and a gradual loss of weight.
• Useful for: overweight or obese adults that have weight-related medical problems and have trouble keeping the weight off.

Mounjaro

• Also works by the same mechanism – but it contains GLP-1 and GIP agonists.
• Update: As of 9 Nov 2023, tirzepatide is approved by the US Food and Drug Administration (FDA) as a weight loss drug.

WeGovy and Ozempic 

• 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.
• This means that while a WeGovy or Ozempic injection is done once a week, a Saxenda liraglutide injection has to be done daily.
•  Ozempic is approved for treatment of Type 2 diabetes, while WeGovy and Saxenda has been approved for treatment of obesity.

What Weight Loss Injections are Available in Singapore?

Saxenda, Ozempic, Mounjaro and WeGovy are available in Singapore via a doctor’s prescription. A doctor’s consultation is required to assess your suitability.

What’s the Difference Between each Weight Loss Injection?

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.

How to get Weight Loss Injections in Singapore 

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:

1. BMI of 30 or higher
2. BMI of 27 or higher, with 1 comorbidity like diabetes, high blood pressure, or high cholesterol, etc.

What Are The Risks of Getting Weight Loss Injections?  

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.

What Other Options Are Available For Weight Loss Injections  

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

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  

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.

Mounjaro  

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.

Where to Get Weight Loss Injections in Singapore?  

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.

This article was last updated on 9 Nov 2023 by Dr Kelvin Chua.