In South Africa, obesity is a rapidly growing concern as nearly 70% of women and 31% of men are classified as overweight or obese.
With such alarming statistics, it is important to consider the various treatment options available to combat this problem.
Dr Sindeep Bhana, head of endocrinology and metabolism at Chris Hani Baragwanath Academic Hospital and private practice at the Centre of Advanced Medicine in Waverley, Johannesburg, sheds light on some of the most effective treatments for obesity in South Africa.
The mainstay of treatment in the South African market is three classes of obesity treatment.
The first one is the GLP classes of drugs. Currently, only one GLP drug, liraglutide 3mg, is registered for use in South Africa for weight loss and obesity.
This injectable product is administered daily, starting with small doses and gradually increasing over time, due to its potential side effects, including nausea, bloating, and loose stool, said Bhana.
He added: “The second class is a tablet that is taken twice a day and controls appetite and cravings similarly to GLPs. The third class of the drug class is orlistat. It's not a weight loss pill; rather, it’s a tablet that must be taken daily with each meal to stop some fat from being absorbed, which helps you lose weight more steadily over time.”
Another weight-reduction method used in South Africa is Duromine, although it should only be used for a maximum of three months due to its side effects, which include heart palpitations, excessive sweating, and trembling.
“A large percentage of patients lose at least 5% of their weight after about 12 weeks of use on the maximum dose. Moreover, bariatric surgery and behavioural interventions make a huge difference,” said Bhana in conversation with IOL Lifestyle.
Although bariatric surgery is a more invasive treatment option that involves altering the digestive system to restrict the amount of food that can be consumed, it has proven very effective in weight management.
Particularly effective for those with a body mass index (BMI) over 40, but is also suitable for those with a BMI over 35 with additional obesity-related health concerns.
Despite being a more drastic measure, bariatric surgery has been found to offer long-lasting results in many patients, making it an important option for tackling obesity in South Africa.
What are some of the challenges that patients face when trying to manage obesity and how can health-care professionals help to overcome these challenges?
In a study that included more than 2.4 million obese individuals from seven countries, the researchers discovered that when these individuals were interviewed, they frequently felt uncomfortable discussing their weight with their doctors and believed that they wouldn’t be able to get much help from them.
They also discovered that 93% of health-care professionals believed that the individuals were not motivated to lose weight.
Bhana notes that there may be a six-year delay between requesting assistance from healthcare professionals to lose weight and actually receiving it.
In South Africa, 70 to 80% of adult women are either overweight or obese, while more than 31% of adult men are obese.
“These numbers point to an epidemic, so it’s important that healthcare professionals must bring it up as part of routine discourse during any session.”
Finally, lifestyle interventions, including diet and exercise plans, are often recommended as an effective treatment for obesity. These interventions are easily accessible and can be customised to suit individual needs.
However, while lifestyle interventions are effective in promoting weight loss, adherence to these programmes is often challenging, making it necessary for more comprehensive treatment options to be explored.
“We know that with obesity comes hypertension, Type 2 diabetes, cholesterol, sleep apnoea, breathing problems fertility issues, mechanical issues like lower back pain and knee problems, higher risk of cancers, the conditions go on and on. There are over 229 different medical conditions that are directly linked to being overweight or obese, making it essential for effective interventions to be adopted,” Bhana said.
The importance of effective obesity treatment options in South Africa cannot be overstated. The availability of a range of treatment options, including GLP classes of drugs, bariatric surgery, and lifestyle interventions, means that individuals struggling with obesity can explore a treatment path that works best for them.
With the support of health-care professionals, patients can make progress in achieving their weight loss goals, thereby improving their overall health and quality of life.
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