Weight and metabolic health have become urgent challenges in South Africa, and the conversation around weight management is evolving rapidly. This evolution is not isolated, it mirrors a worldwide trend. Obesity is no longer seen as a simple matter of willpower; it’s increasingly recognized as a complex, chronic condition requiring multi-faceted solutions.

Globally, the numbers are staggering, by 2035, roughly 25% of the world’s population could be classified as obese, with lower- and middle-income countries, including many in Africa, bearing the brunt of this burden by 2030. South Africa stands out with about three in ten adults obese, the highest proportion in Africa. This reality underscores both the challenges and opportunities in tackling obesity.

New weight-loss medications—such as semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro)—have generated global excitement, fueling a ten-fold increase in anti-obesity medication spending since 2020, surpassing $30 billion in 2024 alone. But behind the headlines are real people’s stories. A recent deep dive into South Africans’ experiences reveals a nuanced mix of hope, frustration, and practical barriers, especially when it comes to medication.

The Long Road Before Medication

In South Africa, most people don’t wake up one day and decide to try obesity medication. It’s a long journey of contemplation, on average, individuals spend 16 months thinking about getting medical help before taking action. During this time, they experiment with diets and exercise, often cycling through multiple attempts.

When they finally seek advice from a medical professional, the first stop is usually the family doctor. Nearly 68% of South Africans in a recent survey said their general practitioner was their go-to when beginning a weight-loss journey, with internet searches and social media close behind. Most of these patients are women between the ages of 35 and 44.

Globally, this drawn-out journey is familiar. Across the US, UK, and Spain, patients often treat medical intervention as a last resort, driven by stigma and the hope that “I can do this myself.” Many report feeling let down by healthcare systems early on; doctors offering little more than “lose weight” advice without meaningful support. By the time they consider medication, they’ve endured years of frustration and perceived failure. Whether in Johannesburg or New York, the pattern is clear: people exhaust personal efforts before embracing medical solutions, and they crave empathetic, informed support from healthcare providers early on.

Why Diet Alone Isn’t Enough

South Africans have tried everything – Keto, calorie counting, green smoothies, bootcamp workouts. The verdict? Diet-based approaches often aren’t sustainable. Even when diets lead to initial weight loss, maintaining progress is hard, especially when deeper factors are at play: emotional stress, grief, postpartum changes, hormonal shifts, PCOS (Polycystic Ovary Syndrome), thyroid issues, or insulin resistance.

Globally, the same realization is gaining traction: obesity is a complex, multifactorial disease, not a willpower failure. The medical community now emphasizes personalized care, treating obesity like diabetes or hypertension. A 2025 Lancet Commission even recommended moving beyond BMI to consider metabolic health and individual context. Patients worldwide echo what South Africans say: diets alone don’t fix underlying issues. Sustainable weight loss often requires holistic approaches – nutrition, exercise, psychological support, and, when appropriate, medication or surgery.

Weight-Loss Medications: Awareness vs. Understanding

Awareness of weight-loss drugs in South Africa is surprisingly high. Mention Ozempic, and most people nod knowingly, 68% recognize it spontaneously, even though it’s officially a diabetes drug often used off-label for obesity. Mounjaro (40%) and Duromine (30%) also have significant mindshare.

But awareness doesn’t equal understanding. Misconceptions abound. Some see these drugs as “miracle fixes”, while others fear side effects or lifelong dependency. Active users tend to have a balanced view: medications help reduce hunger and support steady weight loss, but they still require lifestyle changes and come with side effects.

Social media and celebrity buzz have turned Ozempic into a pop-culture phenomenon, but nuanced facts often get lost. Many still think it’s an overnight fix, not realizing it works best alongside lifestyle changes and is intended for chronic use. Healthcare professionals worldwide are working to bridge this myth vs. fact gap, emphasizing that these drugs are tools, not cures, and using them isn’t “cheating.” It’s a legitimate medical approach to a serious health issue.

Social Media: Friend or Foe?

In 2025, social media is a major player in health decisions. South Africans scroll through transformation photos, watch YouTube “Ozempic updates,” and join Facebook groups for diet tips. About 73% use social media for weight-loss information, but trust is low. Only a third consider it even moderately reliable.

This has spurred a rise in healthcare professionals on social platforms, debunking myths and offering credible guidance. Still, scams persist, especially around high-demand medications, making skepticism essential.

The Rise of Counterfeit Products

With soaring demand for drugs like Ozempic, counterfeit products have emerged in South Africa and worldwide. Over 50% of South Africans surveyed were aware of fake weight-loss products. These pose serious risks: at best, wasted money; at worst, harmful substances. The universal advice? Only buy through reputable pharmacies with a valid prescription.

The US FDA recently ordered compounding pharmacies to stop making unapproved copies of semaglutide and tirzepatide. Europe has issued warnings about fake Ozempic pens. Pharmaceutical companies are boosting production and partnering with telehealth platforms to ensure safe access. For South Africans, vigilance is key: steer clear of “too-good-to-be-true” deals.

Barriers to Adoption

If these medications are so promising, why do many hesitate or quit? In South Africa, major barriers include:

• Side effects: 67% cite nausea and digestive issues as deal-breakers.
• Preference for natural methods: 53% want to lose weight “naturally,” fearing stigma or dependency.
• High cost: 45% struggle with affordability; medical aids rarely cover obesity treatment.
• Distrust: Concerns about long-term safety and pharmaceutical motives persist.

Overcoming these challenges will require better education, improved drug profiles, insurance coverage, and strong doctor-patient communication.

What Patients Really Want

South Africans and patients worldwide want more than a prescription. They want:

• Clear, honest information: Realistic expectations and transparent counseling.
• Personalized support: Options for in-person or digital coaching, group workshops, or hybrid models.
• Simplicity and convenience: Integrated solutions that fit daily life.
• Affordability and access: Insurance coverage, assistance programs, and cost-effective tools.
• Protection from scams: Guidance on safe sourcing and reliable apps.

Globally, these needs are driving innovation: starter kits for new patients, partnerships between pharma and digital health apps, telemedicine services, and public campaigns to reduce stigma. Digital tools, in particular, are booming; weight-loss apps average 1.5 million downloads, reflecting demand for accessible support.

Recommendations for a Healthier Future

South African findings align closely with global strategies. Key recommendations include:

• Start early: Encourage proactive screening and intervention.
• Educate honestly: Bust myths, set realistic expectations.
• Empower doctors: Provide training and resources for obesity care.
• Leverage digital tools: Use apps, telehealth, and SMS reminders for scalable support.
• Tackle affordability: Advocate for insurance coverage and explore subsidies.

These steps sketch a vision of an obesity care ecosystem that is proactive, informed, supportive, tech-enabled, and equitable.

Final Thoughts

Weight management is deeply personal, but it’s shaped by societal trends, medical innovations, and support systems. South Africans’ voices reveal a tapestry of hope, caution, and determination, echoing global sentiments. Medications like Ozempic and Mounjaro are changing the game, but they’re not silver bullets. Success lies in holistic care: honest conversations, ongoing support, and treating the whole person; not just the number on the scale.

South Africa, with its high rates and engaged public, can lead by blending cutting-edge treatments with compassionate care. The conversation is clear: rethinking weight management means changing mindsets, policies, and practices together.

Sources:

1. IQVIA Thought Leadership: Tackling Obesity
https://www.iqvia.com/locations/emea/emea-thought-leadership/tackling-obesity

2. IQVIA Blog: Outlook for Obesity in 2025
https://www.iqvia.com/locations/emea/blogs/2025/01/outlook-for-obesity-in-2025-more-than-a-transition-year

3. IQVIA Blog: Digital Solutions for Obesity
https://www.iqvia.com.kh/locations/emea/blogs/2025/01/digital-solutions-for-obesity-revolutionising-care-and-management

4. IQVIA Blog: In-depth Patient Insights
https://www.iqvia.com/locations/emea/blogs/2024/11/in-depth-patient-insights-in-obesity-highlight

5. IQVIA Blog: From Post to Prescription – Social Media & Obesity
https://www.iqvia.com/locations/emea/blogs/2024/10/from-post-to-prescription

6. IQVIA Blog: Unveiling the Global Landscape of Adult Obesity
https://www.iqvia.com/blogs/2024/03/unveiling-the-global-landscape-of-adult-obesity

7. IQVIA Report: Tracking the Evolution of Obesity Treatment
https://www.pharmalive.com/tracking-the-evolution-data-driven-insights-in-the-maturing-obesity-treatment-landscape