Weight loss cost: Beyond TikTok celebrity medical endorsements

The allure of fast, visible weight loss is dominating health and wellness discourse today, fuelled by celebrity endorsements, viral TikTok testimonials, and sleek before-and-after transformations that often gloss over the complexity of human biology.

What was once considered niche or last-resort, medical intervention for weight management, is now entering the mainstream. But as enthusiasm grows for injections like Ozempic (a diabetes drug) and irreversible procedures such as gastric surgery, experts are raising caution about the physiological, psychological and reproductive implications of these methods.

Plastic surgeon Dr Benjamin Wabwire explains the current landscape of clinical weight management and why deeper scrutiny is necessary before taking the plunge.

“The most basic, and what most people would be advised, is dieting and exercise, which is probably the safest way to manage weight as it has almost no side effects,” he says.

These lifestyle changes, though often difficult to sustain, form the foundational rung of the weight loss ladder. But where behavioural interventions prove insufficient, many are now turning to pharmacological aids.

“There are drugs that have been formulated to help with weight loss. These drugs are primarily designed for blood sugar control, but then people realised that when patients use them, they start losing weight,” Dr Wabwire explains.

A prominent example is Ozempic, a trade name for the drug semaglutide. “There’s a cousin of it called tirzepatide, which is not available locally, but it’s reported to be equally as effective,” he adds.

Originally developed for type 2 diabetes, these drugs mimic naturally occurring hormones that regulate blood sugar and satiety.

“Ozempic was developed to act like a hormone the body produces that dampens how we pick up blood sugar when we eat. The drug helps the pancreas to produce insulin and push sugar away from the bloodstream, and then it suppresses the hormones that push sugar into the blood circulation.”

Its weight-loss effects come down to its interaction with the digestive system and brain. “It also slows down the speed at which things move in your stomach and your gut. If you eat, then it takes longer for the food to move, and you don’t feel hungry quickly,” says Dr Wabwire.

But the results are far from permanent. “No matter how many times you do these non-surgical methods, they are not permanent. If you stop and go back to your habits, you will gain the weight and balloon up,” he cautions.

Side effects and risks

Ozempic is administered via weekly subcutaneous injections, starting at low doses that are gradually increased. “We start with one milligram this week, then next week we go to 1.2, the third week we go to 1.5,” Dr Wabwire notes. This titration helps patients manage tolerability.

Still, side effects remain a concern. Mild fatigue and gastrointestinal discomfort are common, but more serious issues have been documented.

“Because it works on the pancreas, which makes insulin, it has been reported to cause inflammation or a condition called pancreatitis. Pain in the centre of the stomach, especially above the navel, should be a point of concern,” he warns.

Rare complications may also include vision disturbances. “Very rarely, there are people who have been reported to have their vision disappearing in one eye. That can be temporary or even a long-term effect of using the drugs.”

Read:  The ‘tiktokenisation’ of professionals

While there is no maximum recommended duration for semaglutide use, Dr Wabwire warns that rapid and excessive weight loss is dangerous. “Beyond a 20 percent drop, you can still be okay. But if you drop to more than 30 percent of your body mass, that can bring serious problems to the body.”

Gastric balloons

Between medication and surgery lies a reversible but invasive option: the gastric balloon. “These would involve a form of surgical procedure or some way of reducing the amount of food that is available to the stomach,” he says.

“The balloon is inserted into the stomach, either swallowed or placed using an endoscope, then inflated using saline. The balloon will effectively reduce your food intake by occupying space in the stomach. Once the desired weight is achieved, the balloon is removed.”

Surgical interventions

More definitive options include sleeve gastrectomy, which involves removing a significant portion of the stomach. “It means a part of your stomach is shaved off or cut off through surgery. Most of them are done with minimal access or laparoscopy, but they can also be done as open surgery,” he says.

While effective, such procedures disrupt the stomach’s role in nutrient absorption. “The stomach doesn’t just store food temporarily before it goes into the digestion mode, but it also plays a role in the absorption of micronutrients and vitamins like B12 and iron,” says Dr Wabwire.

This can lead to long-term complications such as anaemia or micronutrient deficiencies. “There are things which the stomach produces, like chemicals that help in the absorption of nutrients. With gastrostomies, there’s a risk that patients may need to be followed up for anaemia.”

Reproductive health concerns

The impacts of dramatic weight loss can also extend to reproductive health. “If someone is in the reproductive age group and they have massive weight loss over a short time, or it dips even below their body mass index, then there are chances that they can start having abnormal menstrual cycles, and that can, of course, affect their reproduction,” Dr Wabwire notes.

Medical weight loss interventions are not universally appropriate. “Patients who have a history of pancreatitis, gallbladder disease, thyroid cancer or hormonal instability should avoid Ozempic unless evaluated carefully,” he says.

Surgical procedures, too, demand rigorous screening. “Patients with poor surgical fitness, unmanaged chronic illnesses or those psychologically unprepared should not be considered until medically cleared.”

Unrealistic expectations and an unwillingness to commit to long-term behavioural changes are more red flags.

“We will look at your body mass index (BMI), medical history, whether you’ve tried other options like dieting and exercise and whether there are any hormonal imbalances. Then we decide if medication or surgery is suitable.”

A holistic approach

Even when interventions are deemed appropriate, Dr Wabwire emphasises the need for a multidisciplinary strategy: psychological evaluation, nutritional counselling, and a supervised exercise programme.

“If one had an option to work out, whether you are doing Ozempic or balloon,that would be ideal,” he says.

Social media’s influence can also skew expectations. “You should not compare your body journey with another person’s experience. Everyone responds differently to interventions,” he cautions.

He stresses that weight loss should be a medical—not purely cosmetic—undertaking. “Being lean doesn’t necessarily mean being healthy, and being overweight doesn’t always mean you’re sick. It’s important to work with professionals who can guide you appropriately.”

Cost implications

Cost remains a significant barrier for many.

“For Ozempic, an original weekly dose might cost between Sh90,000 to Sh120,000 depending on where you buy it. The balloon procedure can range from Sh350,000 to even Sh1 million, depending on the hospital. The surgical options, like sleeve gastrectomy, cost between Sh750,000 and can go to over Sh 1 million,” Dr Wabwire explains.

→ [email protected]