Medical weight management treatments are attracting widespread interest, with recent local regulatory approvals paving the way for healthier waistlines. Amid an ocean of online misinformation and social media influencers’ claims, pharmacist Hanri du Preez , is urging South Africans to approach these therapies responsibly, emphasising the need for medical oversight and healthier lifestyles.

“The growing interest in prescription weight-management medicines reflects both the rising burden of obesity-related disease and the need for better public understanding,” Du Preez says.

“Storing fat was crucial for our primitive ancestors’ survival, yet in our modern lives, our food is more calorie-dense and we often lead more sedentary lives, contributing to a global rise in obesity and associated diseases, such as type 2 diabetes, which are significant health burdens here in South Africa.”

Medicines receiving significant attention for their potential to treat and manage obesity are the glucagon-like peptide-1 (GLP-1) and GIP receptor agonists. These prescription treatments work by mimicking hormones naturally produced in the body that help regulate appetite, slow digestion and improve blood sugar control.

However, du Preez stresses that these medicines are not suitable for everyone and should never be viewed as a quick fix or cosmetic solution. “GLP-1 injections are no magic bullet; they are a medical tool that must be used appropriately, responsibly and as part of a broader health plan, as prescribed by a doctor,” she says.

“When used correctly and under medical supervision, GLP-1 medicines can support weight loss and improve metabolic health. This class of medication can also reduce inflammation across multiple organs, which is particularly important for patients managing chronic conditions.”

Appropriate use is critical

Du Preez explains that GLP-1 medicines may be considered for adults and adolescents over the age of 12 who are living with obesity, or those who are overweight and living with related health conditions such as type 2 diabetes, high blood pressure or high cholesterol. These medications can be particularly helpful where lifestyle changes alone have not delivered sustainable results.

“Every patient must be assessed individually by a qualified medical practitioner to evaluate their medical history, current treatment and overall health before deciding whether the benefits outweigh the risks.”

She notes that certain groups should not use these medicines, including pregnant or breastfeeding women, patients scheduled for surgery under anaesthesia, and those with specific medical conditions such as certain thyroid disorders.

“Medical supervision is non-negotiable for safe use, as using these medicines without proper assessment can be dangerous,” Du Preez warns.

Understanding side effects and expectations

As with all prescription medications, GLP-1 therapies may cause side effects, particularly at the onset of treatment or when doses are increased. These can include gastrointestinal symptoms such as vomiting, diarrhoea, constipation, and loss of appetite. Headaches, irritation at the injection site, and loss of lean muscle mass have also been reported.

“Some people notice their facial skin sagging or wrinkling, which can occur with any extreme or rapid weight loss. Side effects are usually manageable and often temporary, however they should never be ignored or self-managed without healthcare guidance. It is important to have realistic expectations and view the medication as just one aspect of a wider plan for ongoing management as part of a commitment to long-term wellbeing.”

She also highlights the importance of nutrition and physical activity during treatment. “Safe weight management means losing fat, not muscle. Ensuring adequate protein intake and regular strength-based exercise are essential to protect lean muscle mass,” she says.

Du Preez warns that medication alone will not deliver lasting results. “There is no short-term solution to long-term weight management. If lifestyle changes are not implemented and maintained, it’s likely that the weight will be regained when the person is no longer using the medication.”

She adds that many patients who seek weight-management support are also managing diabetes, cardiovascular disease, hypertension or mental health conditions, making coordinated care essential.

“Effective weight management requires a comprehensive, patient-centred approach that includes balanced nutrition, regular physical activity suited to individual ability, mental and emotional wellbeing support and ongoing medical follow-up.”

“Medication can support the journey to a healthier waistline, but it cannot replace healthy habits. Informed decisions, professional guidance, and long-term commitment are the foundations of sustainable health outcomes,” concludes Du Preez.