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Anti-Obesity Medications (AOM): Addressing Stigma and Balancing Public Health Needs

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Anti-Obesity Medications (AOM)

Addressing Stigma and Balancing Public Health Needs

The Malaysian Obesity Society (MyOS) is compelled to address a recent media coverage that highlighted two interconnected issues.

The Malaysian Obesity Society (MyOS) is compelled to address a recent media coverage that highlighted two interconnected issues: the shortage of certain medications that are affecting treatment for patients with diabetes and the surge in demand for such medications that is driven by celebrity endorsements. As well as raising societal, medical, and ethical conundrums, these trends also reflect the stigma and bias surrounding obesity and its treatment.

The use of AOM and Diabetes Treatment

Recently, a body of literature is showing an extensive health benefit from the medical use of AOM, especially Glucagon-Like Peptide-1 receptor agonists (GLP-1 RA). Originally approved for the treatment of diabetes twenty years ago, the use of GLP-1 RA at high dose has been licensed for obesity treatment in 2014. Recently, GLP1-RA has been shown to offer cardiovascular and renal protection, among others. However, there have been reports surrounding inappropriate use of these medications, without adhering to proper guidelines on obesity management. As a result, both patients with diabetes and patients living with obesity are experiencing shortage of supply and lack of access to GLP-1 RA.  

Stigma and Bias in Obesity Treatment

The public discourse on GLP-1 RA medications also exposes the deep-seated stigma and bias associated with obesity. Obesity is often perceived as a result of poor lifestyle choices rather than a chronic and complex, multi-factorial disease influenced by genetics, environment, and biological factors.

 

This stigma creates barriers to obesity treatment in several ways:

  • Medication Bias: There is a tendency to perceive weight-loss medications as a “lazy” or “undeserved” approach to managing obesity, reinforcing negative stereotypes about individuals with obesity.
  • Healthcare Discrimination: Many patients report feeling judged or dismissed by healthcare providers when seeking medical interventions for weight management. This prevents them from accessing effective, evidence-based treatments.

 

It is essential to recognize obesity as a chronic and relapsing disease that requires a range of treatment options, including lifestyle interventions, medications, and, in some cases, surgery. GLP-1 RA are an important part of the toolkit, especially for individuals who struggle with obesity despite healthy lifestyle modifications.

Celebrity Influence and Misuse

The influence of celebrities endorsing GLP-1 RA for weight loss may exacerbates the problem. Social media amplifies these endorsements, creating unrealistic expectations and promoting a culture of “quick fixes.” This reinforces the stigma by implying that achieving weight loss through medications is only acceptable for cosmetic purposes, not as a legitimate medical treatment for obesity.

Ethical Concerns in Healthcare

The growing demand for GLP-1 RA raises ethical questions about their use and distribution:

  • Prescription Practices: The ease of access to these medications for cosmetic purposes highlights the need for stricter regulations to ensure they are used appropriately based on regulatory approval and clinical guideline.
  • Healthcare Inequities: Wealthier individuals can bypass regulatory barriers, further marginalizing patients with diabetes or obesity who need these medications for medical reasons but restricted by supply or cost constraints.

Public Health Solutions

We must adopt a holistic and equitable approach to the use of GLP-1 RA:

  • Addressing Stigma: Educational campaigns should emphasize that obesity is a disease with underlying pathologies that requires evidence-based interventions, including medications, rather than dismissing them as “shortcuts” or “vanity treatments.”
  • Regulatory Oversight: Authorities must implement stricter controls to ensure that GLP-1 RA are prioritized for patients with diabetes and individuals with medical indications for obesity treatment.
  • Promoting Comprehensive Care: Programs like the Diabetes Prevention Program and structured obesity support groups should be scaled up to provide long-term solutions that integrate lifestyle changes, behavioral counseling, and pharmacotherapy.
  • Celebrity Responsibility: Public figures should advocate for responsible health practices, using their influence to promote sustainable, evidence-based approaches to weight management rather than quick fixes.

A Call for Equity in Obesity Treatment

The stigma and bias surrounding obesity must be addressed seriously and urgently. Alongside the misuse or abuse of medications. As a society, we need to recognize obesity as a chronic, multifaceted disease that deserves the same medical attention and empathy as other diseases. Striking a balance between meeting the needs of patients with diabetes while addressing the rising demand for effective obesity treatment requires deliberate collaboration among healthcare providers, policymakers, and the public.

 

It is time to shift the narrative. By embracing a compassionate, science-driven approach, we can ensure equitable access to effective treatments while fostering a healthier society free from stigma and bias.

 

Prof Dr Rohana Abdul Ghani

Consultant Endocrinologist

President, Malaysia Obesity Society