Risking lives for vanity

Health authorities should clamp down on the alarming trend of taking medical procedures — driven by the need to conform to beauty standards of being slim and fair — that not only put patients’ lives at risk but also deprive those with chronic diseases of much-needed treatments.

Such is the case for the diabetic drug Ozempic which has recently gained popularity because of its weight loss effects. It is so in demand among those who want to lose weight but do not have type 2 diabetes that there is a supply shortage in local pharmacies, depriving real patients of their weekly treatment needs. The drug’s popularity was boosted by testimonials from social media fitness influencers and has turned its Danish manufacturer Novo Nordisk into a multibillion company. Many local aesthetic clinics — not diabetes treatment centers — have been openly advertising the sale of Ozempic on social media and supposedly administering them to “qualified clients.”

But doctors have warned that patients using Ozempic, which costs from P5,000 to P8,000 per box, must have a doctor’s prescription. A pack contains one pen with six needles delivering four weekly doses between 2-1.5 milligrams. “Ozempic is a prescription drug … It is for patients with type 2 diabetes,” said Dr. Maricar Limpin of the Philippine College of Physicians. She acknowledged that while it has weight loss benefits, it is not sold as a weight-reduction drug. Ozempic helps lower blood sugar due to its active ingredient called semaglutide which slows down the digestion of food, thus suppressing appetite, reducing hunger, and increasing satiety resulting in weight loss. The United States Food and Drug Administration (FDA) approved the injectable drug in 2017 solely for treating adults with type 2 diabetes.

Moral issue

The FDA should look into the sale of this drug, especially in clinics that do not even specialize in diabetes treatment. They not only put their clients’ health at risk — the US FDA is looking into reports that the drug also causes alopecia or hair loss and suicidal ideation — but it also raises the moral issue of taking away much-needed medication from diabetic patients. They also exploit the vanity of those who want to lose weight the easy way without the required lifestyle change, exercise, and healthy diet.

This obsession to meet certain beauty standards has put patients’ lives at risk not only in the case of taking weight loss drugs but also in other beauty enhancement procedures. Some of these have resulted in death such as the recent case of a 39-year-old woman from Quezon City who died of complications due to an administered intravenous (IV) glutathione and stem cell therapy. Health Secretary Teodoro Herbosa said products like IV glutathione, which is popular as a skin whitening procedure, are off-label use and illegal because they have not been approved by the FDA.

Death from injectables

In 2019, the FDA issued an advisory that it has not approved any injectable products for skin lightening and that injectable glutathione is permitted only in cisplatin chemotherapy as an adjunct treatment. Yet in 2020, a restaurant manager died while undergoing an IV glutathione procedure where neither the clinic nor the nurse that administered it had the proper licenses. This has been a common practice—back in 2011, police arrested a midwife who was administering fake glutathione treatments.

Health authorities have warned that drug glutathione can cause serious conditions such as kidney failure, blood poisoning, and toxic epidermal necrolysis where a large portion of the skin peels off exposing the body to infection. “The alarming increase in the unapproved use of glutathione administered intravenously as a skin-whitening agent at very high doses is unsafe and may result in serious consequences to the health of users,” said an advisory issued by the FDA in 2011.

Beauty perceptions

But such skin whitening agents are popular in the Philippines where colonial mentality that equates fair skin to beauty and brown skin to poverty still prevails. Despite campaigns promoting diversity in beauty and skin color, aesthetic clinics that offer skin-lightening and slimming services continue to enjoy patronage, and clients most of the time don’t even bother to check their credentials or the safety of their products and procedures. Inquirer columnist Eleanor Pinugu noted in her column last week the “persistent willingness to embrace risk in pursuit of conventional beauty ideals” even with the awareness that such procedures can be dangerous and even cause death.

There needs to be tighter regulation and oversight on the sale of drugs and operations of aesthetic clinics that administer harmful products. Herbosa himself acknowledged the need to educate the public on the risks of these treatments. Beyond these, as Pinugu pointed out, there has to be a cultural shift to “dismantle the harmful stereotypes that drive the demand for risky treatments.”

No one has to suffer or die because of misguided perceptions about beauty.