Prescription-based weight management treatment has surged into the mainstream, giving more people with genuine clinical needs access to potentially life-changing care. However, the market’s growth has not been matched by consistently high standards of care. This Women’s Month, we must confront the fact that many women remain particularly vulnerable to inadequate clinical oversight, inappropriate prescribing practices, and black-market products that operate outside established medical safeguards.
Nearly seven in ten adult South African women are obese, compared to four in ten men. Women therefore account for a significant share of the weight-management market and, as a result, may face greater exposure to irresponsible medical practices and unregulated black-market options, where proper clinical support and control are virtually non-existent.
At Dr GL Vosloo Medical Practice, managed by BioWell, women make up the majority of patients seeking a holistic weight-loss and metabolic management programme, which may include prescription treatment where clinically justified. Concerningly, some patients arriving from other programmes report excessively high dosages of treatments, with scarce oversight or guidance. Others have used black-market products and later sought professional medical help after struggling to manage their treatment safely and effectively.
These experiences demonstrate exactly why prescription treatment should form part of a broader, medically-supervised programme rather than a medication-only approach. As more women seek treatment, the industry has a duty to help them understand what good clinical care and appropriate dosing practices involve, as well as how to distinguish a medically grounded programme from those built primarily around access to medication.
Not all weight-management programmes are created equal. Patients should look for a few key indicators that suggest a provider is delivering safe, responsible care:
- Screening should begin before the consultation
Before the first appointment is even scheduled, a reputable practice or physician should gather sufficient information to understand a patient’s medical history, current health status, and potential risk factors. For example, intake forms may ask about previous weight-loss treatments, allergies, pregnancy or breastfeeding status, eating habits, goals, and other information that may help the practitioner identify contraindications early.
Patients should expect this information to be reviewed before they proceed. Any omissions or concerns should be raised, while patients with possible contraindications, urgent medical issues, or conditions outside the programme’s scope should be informed and referred where necessary.
- The consultation should establish clinical need and risk
Patients should expect a thorough consultation that explores their concerns, goals, medical and treatment history, symptoms, and relevant lifestyle or health factors. It should also give the doctor an opportunity to clarify uncertainties, identify undisclosed contraindications, and assess appetite, eating behaviour, level of activity, sleep quality, and mental health.
For women, this may include menstrual health, contraceptive use, pregnancy plans, breastfeeding, menopause, polycystic ovary syndrome, hormone treatment, and previous gestational diabetes.
A medical assessment should establish whether prescription treatment is clinically appropriate, rather than being prescribed simply because a patient wants to lose weight. Relevant considerations may include body measurements, blood pressure, glucose, cholesterol, organ and thyroid function, vitamin and hormone levels, and pregnancy screening where relevant.
- Treatment decisions should be fully explained before consent
Doctors should provide a clear explanation of whether prescription therapy is appropriate, whether it should be delayed or avoided, or whether another treatment approach may be more suitable. Prescription-based medication should not be framed as the primary intervention, although it may form part of a broader programme covering nutrition, exercise, behaviour, supplementation, metabolic support, clinical monitoring, and guidance on how these elements work together.
Before written consent is given, patients should be informed about the expected benefits, potential side effects, serious risks, contraindications, alternatives, monitoring requirements, and circumstances under which treatment may be stopped. Women should also be informed about how pregnancy plans, breastfeeding, hormonal treatment, or changing health circumstances may affect whether treatment can begin or continue.
- Prescriptions should be individualised and closely monitored
Patients should be cautious of one-size-fits-all prescribing practices. Treatment should reflect the individual’s clinical needs and risk profile, using a conservative approach rather than a standard dose or automatic escalation schedule.
Ongoing follow-up is equally important. Regular check-ins should track progress, side effects, relevant eating and lifestyle factors, and any changes in health or medication use, with treatment adjusted accordingly. For women, this continuity is particularly important because hormonal, reproductive, and life-stage circumstances may change during treatment and affect how care is managed.
Women should not have to navigate a fast-moving treatment market through trial and error. By understanding the characteristics of safe, medically supervised care, patients are better equipped to make informed choices. Ultimately, however, the responsibility rests with practitioners and clinics to make ethical, medically-grounded care easy to recognise from the outset. Public trust in this treatment category will depend on how consistently the industry meets that standard.
