Summer body rush: How weight-loss pressure risks your physical and mental health

We’re in the middle of winter and in a month or two, there will be a rush by people to get into their ‘summer bodies’ just in time for the warm season.

The pressure to quickly have the perfect body leaves a lot of people vulnerable and places them at risk of physical and mental health issues.

These include addiction, psychotic episodes, stomach ailments and eating disorders.

Monday, 23 June, marks the beginning of the South African National Council on Alcoholism and Drug Dependence (SANCA) Awareness Week.

South African healthcare professionals have raised the alarm on the long-term health impacts of misuse of weight-loss drugs, taken in higher than recommended doses or used without a prescription and proper medical care for planned weight loss.

Body size dissatisfaction

With almost half 45.3% of South Africans over the age of 15 being “highly dissatisfied” with their body size, the risk of abuse of weight-loss medications is likely to be high, said Dr Kate Mawson, member of the South African Society of Psychiatrists (SASOP).

“Some people, especially adolescents, young women, certain athletes and models, are under enormous pressure to be thin,” averred the doctor.

“This may lead to trying different substances, medications, diets or behaviours to lose weight.  If these behaviours become a habit, then an eating disorder may result,” she said.

Misuse of prescription weight medications

Dr Mawson said misuse of prescription weight-loss medications, over-the-counter and so-called “herbal” weight-loss products, and off-label use of medications for other conditions, all hold the risk of various side effects.

These range from nausea, diarrhoea, other gastrointestinal illnesses, and increased risk of heart disease, to insomnia, hallucinations, mood swings and heightened anxiety.

It is estimated that as many as 15% of South Africans struggle with drug addiction.

Although the extent of addiction to prescription drugs versus illegal substances is not known, up to 7% of rehab admissions in SA are for prescription drug abuse.

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Globally, almost one in 10 teenagers report using non-prescribed or medically unapproved weight-loss products, despite them being largely ineffective and potentially harmful.

A further problem is the use of medications for other conditions, such as Attention Deficit Hyperactivity Disorder (ADHD) for their untested off-label side effects of appetite suppression and weight loss.

“Just because a product promising weight loss is freely available over the counter at a pharmacy or health store does not necessarily mean it is safe, especially when used outside of the recommended dose or method,” said Dr Mawson.

Eating disorders risks

Some eating disorders carry very high physical risks for those who develop them and are also associated with substantial psychological suffering and social dysfunction. 

“These are serious illnesses and should always be taken seriously. There is good evidence to show that the sooner a person gets help for the problem, the better their chance of having a full recovery,” Dr Mawson said.

She advises that those who are concerned that their use of weight-loss drugs has become problematic and need help with dealing with their body image or feel their weight concerns are heading towards an eating disorder should seek help from a general practitioner, local clinic or social worker.

“Your GP or local clinic doctor can evaluate your physical health, advise on healthy and sustainable weight loss, or refer you to a mental health specialist for further evaluation and treatment.”

The South African Depression and Anxiety Group (SADAG) has support groups for various mental health challenges, including substance abuse and eating disorders.

 “The same goes for weight-loss medication prescribed by a doctor, or prescription medication obtained illicitly. If used beyond the recommended dosage or without the guidance of a health professional on a planned weight-loss programme, there are risks of long-lasting adverse physical and mental health impacts that far outweigh the benefit of losing a few kilograms,” Dr Mawson said.

She said that misuse of weight-loss drugs could point to an underlying eating disorder that needs professional treatment or the misuse of the drugs could in turn lead to an eating disorder, in either case, “causing severe mental and physical suffering,” said Dr Mawson.

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