Life-changing medicine or beauty hack? How Ozempic came to be seen as both, and why that's risky

After surviving a complicated pregnancy that led to heart failure in November 2023, Ms Jane Chambers was told four months after giving birth that her heart was functioning at only 28 per cent capacity.

Diagnosed with preeclampsia during pregnancy, she had fluctuating blood sugar levels and rapid weight gain. By the time she gave birth prematurely at 35 weeks, she weighed about 120kg.

"I was so worried because I just had a newborn. I did not want to die," the 40-year-old Singaporean told CNA TODAY.

During her postpartum recovery, she was later referred to an endocrinologist, who saw fit to prescribe her Ozempic.

It is a GLP-1 medication, a type of drug that mimics a hormone involved in appetite regulation, originally developed for the treatment of Type 2 diabetes. Now, it is also used to treat obesity and support weight loss.

At 1.6m tall, Ms Chambers, who works as the head of marketing at a golf travel platform, described herself as "massive" at the time. Before becoming pregnant, she weighed about 82kg and had long struggled with polycystic ovary syndrome (PCOS), a condition associated with insulin resistance and weight gain.

After taking Ozempic, she found herself eating much smaller portions at meals and often skipping lunch because she was not as hungry as before.

Eventually, this also led to her blood sugar stabilising and her energy levels improving.

While she is still on heart medication, she said that she can breathe more easily and is no longer dependent on inhalers as she used to be.

For Ms Chambers, getting on Ozempic had little to do with vanity – her doctor even told her that she was at risk of a heart attack if she did not lose weight.

However, her experience is not one that most people would associate with Ozempic.

On social media and in popular culture, Ozempic and similar GLP-1 medications have increasingly been portrayed as a shortcut to weight loss, closely associated with transformations among famous personalities and before-and-after photos that go viral online.

The phenomenon has propelled these medications into the global spotlight, making them among the most talked-about medications today.

GLP-1, short for glucagon-like peptide-1, is a hormone released in the small intestine after eating.

GLP-1 medications, such as semaglutide and tirzepatide, work by mimicking this hormone or its effects, helping people feel fuller for longer, reducing appetite, slowing the rate at which food leaves the stomach and improving blood sugar control.

The Ministry of Health (MOH) told CNA TODAY that the number of patients using semaglutide injections such as Ozempic and Wegovy rose from about 1,500 in 2023 to about 6,400 in 2025.

This is attributed to greater awareness of the drugs and to doctors' increased familiarity with prescribing them.

In Singapore, doctors across specialities told CNA TODAY that they have seen demand surge over the last three years as public awareness grows.

Some clinics now receive between 50 and 70 enquiries a day about GLP-1 medications, although only a fraction of those patients qualify for treatment with the prescription-only drugs.

Doctors said that the people seeking them comprise:

Adults, often women in their late 30s to 50s, who have struggled with weight management

Patients with obesity-related health conditions or risk factors such as diabetes, hypertension and heart disease

Increasingly, healthy or near-healthy individuals hoping to lose weight for aesthetic reasons

As Ozempic's popularity continues to grow – be it for health or aesthetic reasons – the trend raises a broader question that extends beyond medicine.

Why are so many people drawn to these drugs, and what does that say about the way Singaporeans view body image and self-worth?

THE GLP-1 BOOM

"Ozempic" is often used today as a catch-all term in public conversation to describe a growing family of diabetes and weight-management medications. Several different brands are available, including Wegovy, Rybelsus and Mounjaro.

Ozempic and Rybelsus, both containing the drug semaglutide, were approved in Singapore in 2021 for the treatment of Type 2 diabetes.

Wegovy, a higher-dose range formulation of semaglutide, was approved for weight management in 2023.

That same year, Mounjaro, a tirzepatide-based medication, was approved for Type 2 diabetes. Its approval for chronic weight management came later last year.

Doctors interviewed by CNA TODAY said that GLP-1 medications work through multiple effects.

They stimulate the pancreas to release insulin when blood sugar rises, reduce appetite by acting on hunger signals in the brain, and slow the rate at which food leaves the stomach, helping people feel full for longer.

Dr Ben Ng, senior consultant endocrinologist at Arden Endocrinology Specialist Clinic with more than 20 years of clinical experience, said: "This has genuinely been one of the biggest breakthroughs we have seen in my career.

"Historically, obesity treatment was frustrating for both doctors and patients because the effects were minimal and very often, patients would lose weight temporarily and weight regain was common."

Several specialists echoed Dr Ng's view.

Dr Amanda Lim, a consultant in the division of endocrinology at the National University Hospital, noted that previously, lifestyle interventions might result in weight loss of around 3 to 8 per cent.

Although this may be beneficial, such weight loss may still not be enough to alter the trajectory of many weight-related diseases significantly, she said.

"The other option was bariatric surgery, which some people may find invasive and may not be open to it," Dr Lim said, referring to a weight-loss procedure that reduces the functioning capacity of the stomach.

The benefits of the medication also go beyond the numbers on the weighing scale.

Doctors said that some GLP-1 medications have been shown to improve cardiovascular outcomes and reduce complications linked to diabetic kidney disease.

For patients with obesity, diabetes, heart disease or metabolic disorders, the doctors also said that the drugs can improve several aspects of health at once.

News agency Reuters reported that at the recent American Society of Clinical Oncology meeting, researchers found a growing body of evidence suggesting that the medications may be associated with lower risks of developing cancer and also improved outcomes among some cancer patients.

Experts noted, though, that these findings are preliminary and more studies are needed before drawing firm conclusions.

In view of growing public interest, doctors stressed that GLP-1 medications are prescription drugs for a reason, because they require careful assessment and monitoring.

In Singapore, eligibility is generally based on a patient's body mass index (BMI), overall health profile and whether they have obesity-related conditions such as diabetes, hypertension or high cholesterol.

Under commonly used obesity treatment criteria in Singapore, patients with a BMI of 30 or above may be considered for anti-obesity medication even without other medical conditions. Those with a BMI between 27.5 and 29.9 may qualify if they also have obesity-related conditions.

Some doctors and specialists may also consider lower BMI thresholds when patients have weight-related conditions, reflecting evidence that Asian populations tend to develop obesity-related metabolic complications – including Type 2 diabetes and cardiovascular disease – at lower BMI levels than Western populations.

Dr Wong Siu Kwan, a general practitioner and founder of Amber Family Clinic, said that in her experience, some people with BMI within the normal range tend to view GLP-1 drugs as suitable for cosmetic use or as over-the-counter weight-loss medicines.

"They may come in very casually, for example, for a skin condition or a cold, and then ask, 'By the way, doctor, do you have this medicine? Can you prescribe this for me?'" Dr Wong added.

"They may not fully understand how these medicines work, the criteria for starting them and the possible side effects.

"Some may be influenced by social media or hear successful weight-loss stories from friends, and are therefore keen to try them for themselves."

Doctors from various practices interviewed by CNA TODAY stressed that GLP-1 medications should be prescribed only after a proper medical assessment and when the potential benefits outweigh the risks.

Dr Zac Yeo, founder of obesity-focused telehealth clinic Trimly, said that patients there undergo screening and medical assessment before treatment is prescribed, and those with normal BMI readings are generally turned away.

Dr Harvey Ho, founder and medical director of Skinscape Clinic, said that his clinic similarly evaluates factors such as body composition, medical history and metabolic risk factors before prescribing GLP-1 medications.

"If the treatment is likely to do more harm than good, I would not prescribe it."

WHO STANDS TO GAIN THE MOST?

For patients with serious health issues, GLP-1 helped them regain better control of their lives when managing one or more chronic conditions.

One of them is a 44-year-old product support specialist who wanted to be known only as Mr Lam, as he has not told his family members he is taking GLP-1 medication.

He lives with Type 2 diabetes, high blood pressure and obesity. He believes his weight gain was due to prolonged steroid treatment for eczema during his university years.

His treatment journey started in 2022 with medication for blood sugar and high blood pressure. Last August, after hearing more about GLP-1 drugs, he sought a referral to an endocrinologist and was prescribed Ozempic, a once-weekly injection that can be self-administered.

This February, his prescription changed to Mounjaro, another once-weekly injectable medication in the same class.

"Ozempic gave me quite bad side effects. I always took it on Friday night after work. The next day, I would feel very tired and sleep the whole day. I also had constipation," he said.

Yet, one thing was certain: Mr Lam realised that he had stopped snacking and stopped thinking about eating all the time.

Some days now, he eats just one full meal and a smaller meal, with no snacking in between.

From his heaviest at 75kg pre-treatment, Mr Lam, who is 1.6m tall, said that he is now at 61kg, just 6kg shy of reaching his ideal, healthy range of 55kg.

"This drug has been life-changing. I am more energetic now. It also reduced my eczema. I used to perspire a lot when I was fatter, and that made my eczema worse," he said.

"It was frustrating. I would stay at home most of the time with the air-conditioning on because whenever I went out, I felt hot and was frustrated with my skin. The improvement in eczema was a surprise benefit."

"Life-changing" was also an adjective repeatedly used by other GLP-1 users who spoke to CNA TODAY.

Civil servant Lily, a Type 2 diabetic patient who prefers to remain partially anonymous because she does not feel comfortable revealing her medical conditions to others beyond her immediate family, finds it "unthinkable" to return to a life before GLP-1.

While some patients can reduce or discontinue treatment under medical supervision, doctors said that GLP-1 medications are often used for the long term, particularly for chronic conditions such as obesity and Type 2 diabetes.

The 39-year-old, who was diagnosed two years ago and has kidney damage, described Ozempic as "life-changing" because it allows her to maintain a normal diet without extreme restrictions to keep her blood sugar stable.

Having struggled with weight management for so long, Ms Lily said that Ozempic helped her immensely by eliminating the "food noise".

"Back then, it was almost impossible for me to stop eating even when I felt full. I would also keep thinking of my next meal."

Adding to her strife back then was the need to manage her restrictive diet after diagnosis, carefully choosing what to eat and cutting out what she could not tolerate.

Now, things feel much more balanced for Ms Lily and she can live a relatively normal life as before.

"At one point, doctors were telling me not to eat too many carbohydrates because of my diabetes, but also not to eat too much protein because of my kidneys. I remember thinking, 'Then what exactly can I eat?'"

However, she is not completely out of the woods.

She said that she is likely to have to stay on Ozempic for life, because stopping it would lead to her regaining weight.

"I also have kidney damage, and my doctor wants me to stay on the medication because it helps protect my kidneys. The damage is not reversible, so the goal for me now is to slow (its) progression."

Despite her endocrinologist's suggestion to switch to a different GLP-1 to manage the slight plateau she is experiencing now, she has decided to stay on Ozempic because switching would likely cost her a few hundred dollars more than the S$250 she pays for her monthly supply of four doses.

"Of all my medications, it's the only one not subsidised," she said, adding that she hopes GLP-1 medications will eventually be subsidised for patients using them to manage chronic, life-threatening conditions.

For public relations practitioner Sally Yeo, 33, GLP-1 medications also achieved a feat that had previously seemed impossible despite years of exercise and dieting.

With high cholesterol and an unhealthy visceral fat percentage, she must lose weight to reduce her higher risk of weight-related illnesses.

After her weight rose from about 50kg at university to 72kg in 2024, the medication helped her lose about 8kg in the first six months, bringing her weight down to about 60kg.

It also drastically reduced the food cravings that had previously dominated her life.

"Before taking Ozempic, I was someone who lived to eat. Now I eat to live," she said.

However, Ms Yeo's experience was not entirely positive, because while she was on the medication, she developed anhedonia – a reduced ability to experience pleasure, including from food – alongside symptoms of depression and suicidal thoughts.

"My doctor told me that it was likely a rare reaction. When I stopped taking it, my mood improved. When I went back on it, it dipped again."

She said that she will be switching to Mounjaro soon under her doctor's supervision.

Doctors said another group that has benefited from GLP-1 medications are women with polycystic ovary syndrome (PCOS), a hormonal condition commonly associated with weight gain, insulin resistance, irregular menstrual cycles and fertility challenges.

Dr Khoo Chong Kiat, a senior consultant obstetrician and gynaecologist in private practice, described the drugs as a "game changer" for many of his patients.

He explained that weight gain causes irregular menstruation – a common issue in PCOS – and therefore, it can lead to reduced reproductive ability.

Dr Khoo, who practises at CK Khoo Clinic for Women & Laparoscopy, added that GLP-1 medications have made weight loss more attainable for many women and have helped them regulate their menstrual cycles and improve their chances of conception.

However, he cautioned that GLP-1 medications are not suitable during pregnancy or while breastfeeding.

WHEN HEALTH AND APPEARANCE OVERLAP

Even though treatment and prescriptions are largely straightforward for patients who meet the criteria, there is a group that falls somewhere just outside the lines.

These are people who are not critically ill or suffering from chronic conditions, but whose weight still significantly affects their sense of well-being.

For instance, Ms Lynn Cheah, a 29-year-old facial therapist, began taking Rybelsus (semaglutide in pill form) about eight months ago when she weighed 64kg at 1.57m tall.

After reviewing her weight, her doctor assessed her to be overweight and prescribed the pills, which she takes one a day.

She was motivated to lose her post-pregnancy weight after hearing about the medication on social media, so that she may achieve a slimmer figure and reduce her carbohydrate intake to ease her acne concerns.

Since then, Ms Cheah has lost 11kg and now weighs about 53kg – within the normal BMI range.

"I've tried dieting before, but it wasn't successful because it's hard to curb my appetite and reduce snacking. So I was assessed to be suitable for Rybelsus due to my weight and unhealthy eating habits," she said.

"When I first took the pills, I lost interest in food and felt nauseated, but those symptoms went away after three to four days."

Now that she is just 3kg away from her ideal weight of 50kg, a goal set by herself, Ms Cheah admitted that she is concerned about what would happen when she eventually stops taking the medication.

She noted that after trimming her waistline, people have told her that she looks "younger and more attractive", boosting her self-confidence.

Similarly, retail manager Katey, 36, who requested partial anonymity due to the discomfort of discussing her weight in public, did not report having diabetes or other major obesity-related medical conditions.

Despite maintaining an exercise routine and paying attention to her diet, she wanted help reaching her target weight. At 1.64m tall and 75kg, her doctor described her as borderline overweight.

After starting Rybelsus in December last year, her weight fell from 75kg to 67kg over six months. Her goal is to reach around 62kg eventually.

Not only did she find herself eating around a quarter less than before, but she also noticed that her cravings for carbohydrates and fried food had gone away.

At the beginning of her weight loss journey, Ms Katey remembered facing some stigma when she told friends that she was using Rybelsus. They questioned her about taking the medication instead of relying on diet and exercise.

She believes that the criticism overlooks the effort still required to lose weight.

"I still have to put in the effort to maintain my exercise and diet routine to keep the weight off," she said. "It definitely helps to speed up weight loss by curbing food cravings."

WHAT THE GLP-1 CRAZE SAYS ABOUT SOCIETY

To some extent, the rise of GLP-1 medications is a medical success story.

But it is also a societal phenomenon, which highlights the long-standing pressures many people face regarding their body image and self-worth.

The shift can be seen in how casually the drug is now discussed and in the corresponding level of interest.

Several interviewees told CNA TODAY that discussions about GLP-1 occasionally come up in their social circles and among colleagues, often phrased casually as something they would like to try in order to lose some weight, despite having no major underlying health condition.

Assistant Professor Nur Hani Zainal, who specialises in clinical psychology at the National University of Singapore, said that the intense public interest in GLP-1 medications reflects a longstanding belief that "a thinner body is a better body".

"This belief is not new; it has been amplified by decades of diet culture. Even individuals who are medically healthy may feel that their bodies are somehow insufficient."

And today, social media has further magnified those pressures and narratives.

Visual-heavy platforms such as TikTok and Instagram expose users to a constant stream of images depicting idealised bodies and famous personalities who have undergone transformations.

Over time, appearance-based social comparison worsens body image, Asst Prof Nur Hani said.

Dr Kimberly Chew, principal clinical psychologist at AO Psychology, which offers counselling and psychotherapy services, said that the human nervous system was never designed to process hundreds of curated and filtered images daily.

"Celebrity and influencer transformations can distort people's perception of what is normal, attainable or necessary, especially when these transformations are presented without context around genetics, editing, privilege or medical intervention."

She also noted that medications such as GLP-1 can be clinically appropriate for some people, but in vulnerable populations, they may reinforce the belief that the body needs to be controlled or "fixed" to be acceptable.

Both psychologists expressed concern that younger people may come to see pharmaceutical intervention as necessary to achieve an acceptable or ideal body.

"Adolescence and young adulthood are already periods of heightened identity formation and social comparison," Dr Chew said.

"If the cultural narrative becomes 'your body is only acceptable if medically modified', we risk increasing body dissatisfaction, perfectionism and appearance-related anxiety in younger generations."

Such concerns, however, are only one way of looking at the Ozempic phenomenon.

Assistant Professor George Wong, a sociologist at the Singapore Management University (SMU), said that he is less concerned about Ozempic, or GLP-1 drugs in general, than the systems governing how such drugs are developed, regulated and used.

He acknowledged that unrealistic beauty standards can be harmful, but argued that people should be free to pursue their own appearance goals as long as they do not become obsessive or affect their daily functioning.

The more important question, he highlighted, is whether healthcare institutions, regulators and drugmakers can ensure medications such as GLP-1 remain safe and accessible to those who need them.

They may not fully understand how these medicines work, the criteria for starting them and the possible side effects.

The growing popularity of GLP-1 medications has fuelled interest in obtaining the drugs through unofficial channels, including overseas purchases and unregulated online sellers – and the doctors interviewed by CNA TODAY strongly cautioned against the trend.

MOH also cautioned that even though GLP-1 medications are often promoted on social media as quick weight-loss solutions, there are "considerable risks" if they are used inappropriately without a prescription and clinical supervision.

On top of that, doctors stressed that GLP-1 medications should not be viewed as a quick fix.

Dr Cheah Ming Hann, a family physician at National University Polyclinics, said that obesity is increasingly recognised as a chronic disease and that many patients do not realise that weight regain is common once treatment stops.

This means that for some patients, GLP-1 medications are often used over the long term for weight management, which can result in substantial ongoing treatment costs.

Several patients interviewed by CNA TODAY estimated spending a few hundred dollars a month on the medications.

Ultimately, with demand expected to grow and generic versions likely to become more widely available, Asst Prof Wong from SMU said: "People do want to use it, and there are many reasons why this can be life-changing for many people.

"The goal is to ensure the right kind of education and awareness around its use go alongside what would inevitably be a very popular treatment for many."

Source: CNA/yy/sf