Malaysia is the fattest country in the region. How so? Well, according to the World Population Review 2019, Malaysia has the highest prevalence of obesity among adults in South-East Asia at 15.6%, followed by Brunei (14.1%), Thailand (10.0%) and Indonesia (6.9%). The National Health and Morbidity Survey (NHMS) 2019 findings showed that 50.1% of adults in Malaysia were either overweight or obese.
This is extremely worrying because obesity is found to be linked to many other health conditions and diseases, such as diabetes, high blood pressure, heart disease, certain cancers and osteoarthritis. Read more about the health risks of obesity in this infographic.
It goes without saying that in order to lose weight, one has to adopt a well-balanced diet and an active lifestyle. This is almost a no-brainer, but you may be surprised to find that 25.1% of Malaysian adults are physically inactive and almost 95% of Malaysians do not consume the recommended fruits and vegetables of 5 servings per day (NHMS 2019). Hence, many people who would like to lose weight prefer slimming pills as it seems like a quick fix.
An Overview of Slimming Pills
Slimming pill is a type of weight-loss product that be sold commercially (non-prescriptive) or available as prescription medicines.
1. Commercial/ non-prescriptive slimming pills
Commercial slimming pills can be purchased without a doctor’s prescription. The fact that anyone can sell non-prescriptive slimming pill through any channel makes it a lucrative business. However, many commercial slimming pills have the following ‘red flags’:
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Many slimming pill sellers make groundless claims about their effectiveness and safety profile. These claims are often backed up by poor scientific evidence, or worse still, the lack thereof.
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Slimming pill sellers love to showcase a comparison photo of their users to demonstrate the effectiveness of products. However, these are merely anecdotal testimonies that are highly variable among different users.
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A slimming pill may contain high caffeine content and/or prohibited herbs such as ephedra which can cause a lot of adverse effects, such as irregular heartbeats, heart attack and stroke.
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Some of the slimming pills do not list their ingredients and doses clearly.
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Some of the slimming pills are not even registered with the National Pharmaceutical Regulatory Agency (NPRA).
When you are buying non-prescriptive slimming pills, keep the following in mind:
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Check if the products are registered with the National Pharmaceutical Regulatory Agency (NPRA).
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Read the product label and dose carefully.
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These products are licensed as either OTC, traditional or cosmetics product; therefore they are not allowed to make certain claims such as “stops fat from being absorbed” or “speeds up metabolism”. If you find these claims being made on the packaging or product insert, report it to the regulating authority.
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Avoid slimming products that claim:
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Promote rapid weight loss and promise quick results
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Suggest that you do not need to change your diet or exercise.
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Fail to recommend dietary advice, and worse still encourage you to eat anything.
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Because the truth is, all slimming pills need to be taken in conjunction with other measures such as well-balanced diet and exercise to show weight loss effect. If any seller tells you otherwise, you should take this as a red flag.
2. Prescriptive/Licensed slimming pills
These slimming pills are licensed for the treatment of obesity and can only be purchased with a doctor’s prescription. They are the only products that are proven to lead to meaningful weight loss. However, one should see a doctor first before starting the treatment. This is to make sure that the medications are only used by people who really need it and is clinically fit to take the medications.
In general, licensed slimming pills can be classified into:
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Lipase inhibitor, e.g. orlistat (Xenical®)
Image credit: The Independent Pharmacy
Orlistat works by inhibiting the function of lipase enzyme.
💡 Lipase enzymes are naturally present in the human body. This enzyme breaks the fat molecule from the food ingested which will then be absorbed into the body.
As a result of the inhibition of lipase, about one-third of the fat molecules ingested into the body will not be absorbed by the body and will be excreted through stool.
Orlistat is a long-term treatment (maximum 2 years) and is only given to obese patients who fail to reduce weight by 5% after six months of following a healthy diet and exercise.
In other words, the doctor would not arbitrarily initiate orlistat in any obese patient unless a risk-benefit analysis has been done. Physical activity or exercise should be done regularly even though you are taking orlistat.
You should not get this medication without a doctor’s prescription because unsupervised use of orlistat may expose you to the following adverse effects:
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Cholelithiasis, i.e. gallstones
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Liver impairment
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Kidney impairment due to increased urinary oxalate
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If you are a diabetic patient, taking orlistat concurrently may affect your blood sugar control. Your doctor may adjust the dose of your diabetic medications.
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If you have thyroid disease, seizure, or currently taking anticoagulant or other weight loss product, you should consult a healthcare professional before taking orlistat.
If you’re taking orlistat under the supervision of healthcare professional, you may experience unpleasant side effects, such as fatty smelly stools, the urgency to get to the toilet, oily spotting on your underclothes, and excess flatulence. These side effects can be minimised if you have a low-fat diet.
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Centrally-acting appetite suppressants, e.g. sibutramine, phentermine
Image credit: Alpha Apotek. This is sibutramine.
These medications are less common than orlistat as they are known to cause many adverse effects. For instance, the Sibutramine Cardiovascular OUTcomes (SCOUT) study conducted by Abbott Laboratories confirmed increased cardiovascular risks such as heart attacks and strokes in obese and overweight patients taking sibutramine as compared to those on diet and exercise alone.
Image credit: Thailand Diet Pills. This is phentermine.
Phentermine may cause a wide range of side effects, such as nausea, vomiting, diarrhoea, dry mouth, constipation, an unpleasant taste, hives, impotence, palpitations and high blood pressure. As phentermine acts directly on your central nervous system, it may cause hyperactivity, insomnia, restlessness, tremor, dizziness and headache.
Takeaway
So is slimming pill the ‘legit’ way to lose weight? The answer is: it depends.
Not everyone needs to lose weight. In fact, if your BMI is normal and you’re physically healthy, you don’t need to take any slimming products. Remember, always prioritise your own health over the unrealistic beauty standards the society has subjected you to.
If you’re overweight or obese, you’re advised to consult a healthcare professional to explore weight loss approaches. Do not use any slimming product without a thorough background check and a good understanding of your own health. Adopting a healthy diet and exercising is still the golden rule for losing weight.
Calculate your BMI here
Cover image credit: KIKAYSIKAT
