In recent years, weight loss medications have become widely recognised, not only within medical circles but also in popular culture. Media coverage and endorsements by public figures such as Oprah Winfrey have contributed to growing public awareness of weight loss medications as a treatment for weight loss.
As a psychiatrist, I have observed a noticeable increase in patients asking about these medications. While the growing interest reflects legitimate medical needs for some individuals, it also raises important psychological and ethical considerations.
Weight is not only a metabolic issue but also a psychological one. Concerns about body image, self-esteem, trauma, and eating behaviours often intersect with weight management. For this reason, conversations about weight-loss treatments should consider both physical and mental health.
Key Takeaways
- Weight loss medications can be effective treatments for obesity when prescribed appropriately.
- Growing public awareness has led more patients to enquire about these medications.
- Individuals with eating disorders such as Anorexia Nervosa or Bulimia Nervosa may be vulnerable to misusing weight-loss medications.
- Careful medical and psychological assessment is important before prescribing weight loss treatments.
Why patients are seeking weight loss medications
Many individuals struggle with weight despite sustained efforts through diet and exercise. In some cases, genetics may contribute to a higher weight “set point”. Others may gain weight due to medical conditions such as thyroid disorders or as a side effect of medications.
For example, certain psychiatric medications used to treat severe mental illnesses—including Olanzapine—are known to cause weight gain. For patients who have experienced significant weight gain despite healthy lifestyle efforts, weight loss medications may provide an effective, evidence-based treatment option.
In clinical practice, I have seen meaningful weight-loss outcomes in patients who were previously severely overweight and had struggled for many years to manage their weight.
When weight-loss medications intersect with mental health
However, the growing popularity of weight loss medications also raises concerns in the context of eating disorders.
Patients with conditions such as Anorexia Nervosa or Bulimia Nervosa may be particularly vulnerable to misusing weight-loss treatments. Historically, some individuals with eating disorders have used appetite suppressants such as Duromine, fat-absorption medications like Orlistat, or other methods such as laxatives, diuretics, or slimming teas in attempts to control weight.
In my practice, a small number of patients with eating disorders have also asked about weight loss medications, including those who struggle with binge-eating symptoms.
This highlights the importance of assessing not only physical health but also psychological factors when patients seek weight-loss treatments.
The importance of careful medical and psychological assessment
When patients present with concerns about weight, a comprehensive evaluation is essential.
In addition to reviewing diet, exercise, and metabolic health, clinicians should screen for possible psychiatric conditions. These may include eating disorders, Body Dysmorphic Disorder, depression, or Alcohol Use Disorder.
If such conditions are present, they should be addressed as part of the treatment plan. In some cases, psychological therapy, medication, or both may be necessary to support long-term recovery and well-being.
Addressing these underlying issues is important because concerns about weight are sometimes linked to deeper emotional experiences, including low self-esteem or past trauma.
The influence of social media and public awareness
The widespread attention surrounding weight loss medications has also led to new patterns of patient enquiries.
Occasionally, individuals contact our clinic through social media, asking specifically for these medications. In one instance, a woman reached out through Instagram, stating that several clinics had declined her request and asking whether we would prescribe the medication. She also disclosed that she was underweight. Eventually, she agreed to consult with one of our psychiatrists and psychologists to address her eating disorder.
In another case, a male patient whom I was treating for depression asked about weight loss medications despite being of normal weight. For him, the request reflected deeper concerns about self-esteem related to past experiences with his parents.
In psychiatry, it is often important to listen for what I sometimes describe as “the song beneath the words”—the deeper emotional narrative that may lie behind a patient’s request.
Balancing accessibility with responsible prescribing
Weight loss pens represent an important advancement in the treatment of obesity. For many patients who have struggled with weight for years, they can provide meaningful medical benefits.
At the same time, these injections are not appropriate for everyone. Evidence supporting their use in individuals of normal weight remains limited. They also carry potential medical risks, including gastrointestinal side effects and a possible association with pancreatitis.
They are also contraindicated in patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2.
For individuals with eating disorders or those seeking treatment primarily for cosmetic reasons, the risks may outweigh the benefits.
The role of medical safeguards
Singapore already has relatively stringent prescribing standards. Most doctors follow clinical guidelines and discuss the risks and benefits carefully with patients before initiating treatment. When weight loss medications are prescribed off-label, proper documentation is important.
Telemedicine, however, introduces new challenges. Ideally, patients seeking weight-loss medications should undergo an in-person medical assessment. This allows for accurate measurement of weight, physical examination, and appropriate investigations such as blood glucose, cholesterol levels, and blood pressure.
Such safeguards help ensure that these medications are prescribed safely and appropriately.
Expert perspective
“The growing popularity of medications reflects an important shift in how society views obesity—as a medical condition rather than simply a matter of willpower. These medications can be life-changing for individuals who have struggled with weight for many years despite genuine efforts with diet and exercise.
However, weight and body image are also closely linked to mental health. For individuals with eating disorders such as Anorexia Nervosa or Bulimia Nervosa, medications that suppress appetite can potentially reinforce unhealthy patterns of thinking and behaviour. This is why careful screening and a holistic medical assessment are so important before prescribing these treatments.
Ultimately, the goal should not simply be weight loss, but healthier lives—physically and psychologically.”
A balanced approach to weight and health
Obesity is a genuine medical condition that increases the risk of diseases such as heart disease, stroke, and diabetes. Effective treatments should remain available to those who need them.
At the same time, clinicians must remain mindful of the psychological dimensions of weight and body image. For some individuals, particularly those with eating disorders, weight-loss medications may pose additional risks.
A careful, patient-centred approach—one that considers both physical and mental health—remains essential.
About the Author
Dr Victor Kwok is a psychiatrist at Private Space Medical, a sister clinic of Private Space Aesthetics & Wellness. He has extensive experience treating a wide range of mental health conditions and has a special interest in the psychological factors that influence eating behaviours, body image, and overall well-being.
Explore Weight Management Support
At Private Space Aesthetics & Wellness, we believe that weight management is best approached through a thoughtful and medically guided process that considers both physical and psychological well-being.
If you are exploring options for appetite regulation or medically supervised weight management, our doctors can help you understand whether treatments such as weight loss medications may be appropriate for you. Reach out to our team to learn more about how we support sustainable, health-focused outcomes as part of your overall wellbeing.
