Speaker 1: Now, health matters with Daniel Martin.
Speaker 1: Welcome into Health Matters right here on CN A 938.
Speaker 1: I'm Daniel Martin. And you heard about it on the
Speaker 1: news this week on health matters how the Singapore Food
Speaker 1: Agency has come up to say that it's detected
Speaker 1: banned substances in three detox slimming food products sold online. Yes.
Speaker 1: Our good friend Serman has been found to be amongst
Speaker 1: the ingredients in two of these products and these are limo,
Speaker 1: a detox slimming sachets and Limo s detox slimming sachets.
Speaker 1: We've talked about this over the years ever since Sabin
Speaker 1: was banned,
Speaker 1: we have talked about it every now and then popping
Speaker 1: up some of these food items. Why does it keep
Speaker 1: doing that? Let's find out more about what we need
Speaker 1: to understand when it comes to Subbu mean as we
Speaker 1: encounter this latest banning, we're joined on today's edition by endocrinologist.
Speaker 1: Doctor Ben, who's from endocrinology. Doctor. Welcome back. I wish
Speaker 1: under better circumstances. Why do we keep hearing about sub? Ok,
Speaker 1: let's start with the basics. Remind everybody
Speaker 1: what is
Speaker 1: mean?
Speaker 2: Well, see, but was a drug that was introduced in
Speaker 2: the late 19 nineties. It was introduced as a weight
Speaker 2: loss therapy. And so let's start by saying it was
Speaker 2: a very effective weight loss therapy and how it works
Speaker 2: is that it works within what we call neurotransmitters. So, ultimately,
Speaker 2: these are little chemicals that we
Speaker 2: crete and one is the, one of the neurotransmitters. It
Speaker 2: works on a serotonin. We might have heard of it
Speaker 2: before is a mood hormone. And what it does is
Speaker 2: that Cine affects serotonin. So it suppresses our appetite. So
Speaker 2: we don't want to eat so much but more dangerously,
Speaker 2: it affects what we call norepinephrine or a derivative of adrenaline.
Speaker 2: And we know adrenaline, it makes our heart go faster.
Speaker 2: And one of the effects of the mean is increases
Speaker 2: our metabolic rate, our heart goes faster. We produce more
Speaker 2: heat and therefore people who take a mean actually lose weight.
Speaker 2: The concern about it was in 2010, there was a
Speaker 2: study looking at the effectiveness of sub and the dangers
Speaker 2: of sub Bruine. And the problem with that is that
Speaker 2: this study confirmed that anyone who took a dram,
Speaker 2: although you lost weight, you are at increased risk of
Speaker 2: developing heart disease and stroke. So because of that, the
Speaker 2: drug was stopped. And then in most countries are all
Speaker 2: across Asia Europe and the US, including Singapore. So
Speaker 1: why does it keep popping up and turning up in
Speaker 1: all these weight loss Sachs and products that we keep
Speaker 1: hearing about it in the news all the time? A,
Speaker 1: I think because it's just like you said, it was
Speaker 1: effective in that purpose. So, maybe that's why we find
Speaker 1: it bleeding into all these products.
Speaker 2: Yeah, I think. Absolutely right. 222 components. I think the
Speaker 2: most important thing is you hit the nail on the head.
Speaker 2: It works. The problem is with cam is very good
Speaker 2: at reducing weight and many times we don't see the
Speaker 2: increased risk of heart disease and stroke, isn't it? You know,
Speaker 2: because of course, it doesn't affect everyone, but there's an
Speaker 2: increased risk. So many people, especially the
Speaker 2: younger people, there's this thing called invincibility bias, isn't it?
Speaker 2: You know, I think when we were all a bit younger,
Speaker 2: it'll never happen to me is that kind of attitude
Speaker 2: that we have. Therefore, what they see is a, I'm
Speaker 2: losing weight. Therefore, it must be fine and all these
Speaker 2: side effects don't apply to me at all. So there's one.
Speaker 2: So there's a demand, the other one as well is
Speaker 2: for such an established drug which has been along for
Speaker 2: a
Speaker 2: while. The compounded ingredients are known. What I mean by
Speaker 2: that is that it's very possible for someone with basic
Speaker 2: facilities to construct this drug. So you don't need to
Speaker 2: really go any detail, this the ingredients and the method
Speaker 2: of preparation is quite available. So if you have some
Speaker 2: pharmacological knowledge and so forth, you can potentially make it,
Speaker 2: but that comes with the danger as well. See I mean,
Speaker 2: I know some of the medications we have are, they
Speaker 2: can be costly. But one of the reasons why they
Speaker 2: are a little costly is because they are standards involved.
Speaker 2: There's hygiene. There's the fact that if you're taking 1001
Speaker 2: g of Panadol, you are getting about 1 g of Panadol.
Speaker 2: The problem with many of these things is that how
Speaker 2: much are you actually
Speaker 2: getting? And is there some quality control or are there
Speaker 2: any contaminants within the drug itself that can be causing problems?
Speaker 1: Why are people willing to take the risk to the
Speaker 1: point where it could have a very well known impact
Speaker 1: on your heart disease and stroke risk of other cardiovascular
Speaker 1: diseases is the root cause. The fact that just so
Speaker 1: many people and you've encountered many patients in this field
Speaker 1: as well. Doctor,
Speaker 1: there are so many people that just need to and
Speaker 1: want to lose weight the fast way.
Speaker 2: Absolutely. I mean, if you look at it, statistics, there
Speaker 2: was an IPSOS study done around the pandemic time. Shocking, well,
Speaker 2: not shocking, more than half of Singaporeans want to lose weight. 55%
Speaker 2: of us want to lose weight. And the problem is
Speaker 2: I think for all of us who have tried to
Speaker 2: lose weight before we are not always successful. In fact,
Speaker 2: most of us are not. And as due to a
Speaker 2: variety of reasons, we
Speaker 2: power lifestyle changes, availability of food and so forth and
Speaker 2: I suppose the attraction of a drug, listen or what,
Speaker 2: what is promised to the, to the consumers, all you
Speaker 2: need to do is pop in this drug and you're
Speaker 2: going to lose weight magically is very, very attractive. And
Speaker 2: when someone takes this drug and they actually lose weight,
Speaker 2: then they say, all right, this is, this is working
Speaker 2: and I think is all the delivery as well.
Speaker 2: The what is not highlighted to many people is the
Speaker 2: potential side effects and how dangerous this is. I mean,
Speaker 2: I think for the purpose of the discussion, the supplements
Speaker 2: that were banned, I am not sure whether s to
Speaker 2: mean was actually even mentioned in the ingredients. And so
Speaker 2: many people may have been thinking they were taking natural
Speaker 2: ingredients and so forth and clearly they didn't know what
Speaker 2: was inside.
Speaker 1: That's the thing.
Speaker 1: So that's part of the problem. I was gonna ask like,
Speaker 1: how come it's so easy for people to get access
Speaker 1: to this? And then you realize it's being marketed in
Speaker 1: these things that seem to be natural, healthy, inoffensive people
Speaker 1: don't think of it as medication when it's a weight
Speaker 1: loss shake and so on and so forth is not
Speaker 1: the problem when it comes to online medication. I know
Speaker 1: some people that log on to like I herb and
Speaker 1: really buy supplements and magnesium and potassium and stuff like that,
Speaker 1: an actual medication. But this is like hidden medication in
Speaker 1: a way.
Speaker 2: Absolutely. And I think the issue is all to do
Speaker 2: with messaging, isn't it? At the end of the day?
Speaker 2: You know, I'm not against supplements in general. I always
Speaker 2: say that there should be a reason on why you
Speaker 2: take the supplements. But I think we have to be
Speaker 2: very cautious. I mean, we are lucky in Singapore that
Speaker 2: the mainstream media
Speaker 2: holds a great influence on people. But there's a huge
Speaker 2: number of people who listen to social media, all the
Speaker 2: things that is happening in Tik Tok and so forth.
Speaker 2: And the problem is the messaging that's going through here
Speaker 2: can be quite misleading. People saying that, you know, if
Speaker 2: you think this is all natural is all safe, but
Speaker 2: you lose weight with no side effects at all.
Speaker 2: I think that that's where the concern is, isn't it
Speaker 2: that ultimately people are attracted to these options and not
Speaker 2: really understanding that there is no easy fix to weight
Speaker 2: reduction that ultimately, you know, that there are always, there
Speaker 2: are things to their potential side effect even to supply
Speaker 2: themselves. And we have to be aware of this and
Speaker 2: there has to be some regulation involved. The problem with
Speaker 2: the internet and so forth and availability of online products
Speaker 2: is that you don't get that the ability to search
Speaker 2: something to sell something online is very, very difficult to regulate.
Speaker 1: Yeah, exactly. Well, I'm just, I'm so tired of seeing
Speaker 1: weight loss shakes and there's so many of them online
Speaker 1: and
Speaker 1: I'm just so tired. I mean, I can understand meal
Speaker 1: replacement shakes and stuff like that. But can you honestly say,
Speaker 1: as a doctor, have you ever seen a meal, a
Speaker 1: weight loss shake that actually works, which doesn't have medication inside. It.
Speaker 1: Probably not.
Speaker 2: Right.
Speaker 2: I mean, I think that the principle when you talk
Speaker 2: about weight loss shakes and so forth,
Speaker 1: counter to the counter productive.
Speaker 2: Yeah. I mean, at the end of the day, let's
Speaker 2: be very clear. No matter what you're taking, as far
Speaker 2: as weight loss is concerned, you need to put out
Speaker 2: more than you put in from an energy perspective. You know.
Speaker 2: So I suppose the meal replacement, if you are not
Speaker 2: eating the ch and you're taking a meal replacement that
Speaker 2: should work. You know, even when it comes down
Speaker 2: to any form of therapy, whether medication or surgery, the
Speaker 2: principle is the same, you need to put out more
Speaker 2: than you put in and if you can't, and that
Speaker 2: comes at some kind of cost to the human body
Speaker 2: is not going to be some, I'm just going to
Speaker 2: take this. Everything is just going to happen. I'm going
Speaker 2: to sit down, I can eat what I like and
Speaker 2: do what I like and I'm going to lose weight
Speaker 2: and that hasn't happened in my experience and I wish
Speaker 2: that there was, but there clearly isn't.
Speaker 1: We will talk later on a little bit about what
Speaker 1: actually works when it comes to a medical approach to
Speaker 1: weight loss, but very quickly, can I touch base in
Speaker 1: terms of you mentioned, these might be added and they're
Speaker 1: working and that's why these are working. But then some
Speaker 1: people may think, but I look at the ingredient list,
Speaker 1: why like I don't see listed down there because you
Speaker 1: bought this thing online and who knows where it's from
Speaker 1: because it's not necessarily hs a approved, you're not necessarily
Speaker 1: gonna a recognize or be necessarily see
Speaker 1: as an ingredient. Correct. Absolutely.
Speaker 2: Right. And this is again, where regulation comes in. I
Speaker 2: think it's so important that, you know, we, we need
Speaker 2: some kind of protection. We don't know everything, isn't it
Speaker 2: and how things are marketed, how things are put in together.
Speaker 2: We are not, we are not always private that information. And,
Speaker 2: you know, I mean, it's good that this was detected
Speaker 2: but the FSA can't pick every single thing in the
Speaker 2: market that's available, test every
Speaker 2: everything and then make it safe for consumption. I probably
Speaker 2: hundreds and thousands of things in the market today. And,
Speaker 2: you know, this was picked up very diligently, but probably
Speaker 2: because more and more people were starting to use it.
Speaker 2: But I'm quite certain that if we, you and I
Speaker 2: started looking for now on the internet, we'll probably find
Speaker 2: it
Speaker 1: exactly. If we just, I just did a simple search
Speaker 1: before this interview on weight loss shakes. And there were
Speaker 1: so many that turned up on my Ecommerce platform. In fact,
Speaker 1: so I gotta ask you building on that, how can
Speaker 1: we protect ourselves from unknowingly consuming subtrain? We didn't start
Speaker 1: out wanting to
Speaker 1: and then you just end up doing it by mistake.
Speaker 1: How can we protect
Speaker 1: ourselves?
Speaker 2: I mean, I think that the solution is actually more
Speaker 2: straightforward than anything but the is the execution. I think
Speaker 2: we have, first of all, we have to be very
Speaker 2: cautious where we get our information and where our sources
Speaker 2: of supplements from. I think that ultimately there has to
Speaker 2: be regulation
Speaker 2: and the tips to learn is this, if you start
Speaker 2: going to these websites, which promise you everything, you're going
Speaker 2: to lose weight, you're not gonna have any side effects
Speaker 2: and and shockingly is working, something is wrong. Ultimately, we
Speaker 2: have to be very cautious again where we get our
Speaker 2: information and get something from an approved site if necessary,
Speaker 2: speak to your doctor, your diet, your qualified dieticians and
Speaker 2: so forth. Because these are the sources that are correct.
Speaker 2: And more importantly, they are the ones that are safe.
Speaker 2: The problem is that many of us we want natural,
Speaker 2: we want a natural way of losing weight. I can
Speaker 2: understand that, but it's difficult. And ultimately, when we are
Speaker 2: promised some natural supplement, we tend to go for it.
Speaker 2: So it's all to do with messaging and listening to
Speaker 2: the right sources, I think, and not believing everything you
Speaker 2: see or hear So,
Speaker 1: should we be using medication as
Speaker 1: part of the weight loss
Speaker 1: journey?
Speaker 2: I mean, I think there are very many effective weight
Speaker 2: loss medications out there today. I think there are many,
Speaker 2: many scientifically proven safe methods of losing weight. The problem
Speaker 2: is when it comes down to such a general question,
Speaker 2: the answer depends. I'll give you a simple scenario. General,
Speaker 2: I imagine you have person a he's overweight, he's got
Speaker 2: heart failure, he's got diabetes. You got arthritis of the
Speaker 2: knees and all of this
Speaker 2: is caused by his weight. Clearly, he needs medication or
Speaker 2: surgery because he has very advanced disease versus the other
Speaker 2: guy who's a little overweight blood pressure a bit high
Speaker 2: and he's got nothing else. Then you ask yourself, does
Speaker 2: he really need medication to lose weight because he needs
Speaker 2: to lose a kilo, 2 kg and he will actually
Speaker 2: get benefit from that. Then you think because they even
Speaker 2: the ones that are approved for weight loss, which have
Speaker 2: been shown to improve heart disease and so forth
Speaker 2: and they are safe. There are side effects, nausea being
Speaker 2: very common, gastrointestinal side effects. And you ask yourself, is
Speaker 2: it really worth risking a young man or woman with
Speaker 2: virtually no disease, exposing them to this drug? And we
Speaker 2: know that many of these medications we try to stop,
Speaker 2: but we can't. So we are potentially putting a young person,
Speaker 2: minimal complications on a weight loss drug versus someone who
Speaker 2: clearly will benefit from it
Speaker 2: because he's got so many other issues. So I think
Speaker 2: that with reducing medication, very useful, very effective but choosing
Speaker 2: a the right patient for it and that's, and that's
Speaker 2: something we need to, the doctor needs to talk to
Speaker 2: the individual, isn't it? You know, because it's very easy
Speaker 2: for us to say, eat less exercise more, not everyone
Speaker 2: can do it. So, so I think it has to
Speaker 2: be an individualized approach. But you do see the complexity
Speaker 2: here between the two people
Speaker 2: already. It's difficult to find the right balance here. But
Speaker 1: do the current weight loss medications have the same risks
Speaker 1: as sibutramine where it could also ironically affect your heart
Speaker 1: disease as well as stroke risk.
Speaker 2: No, certainly not with the body of scientific evidence. Now,
Speaker 2: I think that they are safer in the sense that
Speaker 2: they don't cause stroke and heart disease. You will never
Speaker 2: be approved at the moment. By the end of it,
Speaker 2: it does have side effect, you know, and the common
Speaker 2: side is again, gastrointestinal nausea, that sort of thing is common,
Speaker 2: but there's no end organ damage is in reversible damage
Speaker 2: such as heart disease and stroke. So I think that
Speaker 2: even every drug that you put in your mouth, whether
Speaker 2: it's for pain relief, whereas for blood pressure, whereas for
Speaker 2: weight loss, there are side effects and we have to
Speaker 2: be clear on that. And with any drug, we have
Speaker 2: to balance the benefits. What we hope to achieve from
Speaker 2: the drug and the potential risks of the drug and
Speaker 2: that has to be balanced very, very closely clearly
Speaker 2: in the in the line of sub to mean, yes,
Speaker 2: we know weight loss is good as offers that weight loss.
Speaker 2: The problem is that it's then counterbalance with that significant
Speaker 2: increased risk of heart disease and stroke and clearly that
Speaker 2: balance is unacceptable
Speaker 1: just to end us off. Truly. I think what you
Speaker 1: said earlier on resonates, which is the fact that this
Speaker 1: is a very well known compound. It's gonna be quite
Speaker 1: easy for people at manufacture and synthesize. We're probably gonna
Speaker 1: see it turn up in online items
Speaker 1: every now and then. I've been talking about it for
Speaker 1: years on the show and it just keeps popping up
Speaker 1: the bottom line is where the first line of defense
Speaker 1: because facing the ecommerce world, it's about us in terms
Speaker 1: of what don't look for the miracle drink and obviously
Speaker 1: be keenly aware about something that's too good to be true,
Speaker 1: especially when it comes to weight loss.
Speaker 2: Absolutely. And I think the important thing is my best
Speaker 2: advice would be, as you say, if it sounds too
Speaker 2: good to be true is probably not true. Second of all,
Speaker 2: be very aware, I mean, that the source,
Speaker 2: especially when you talk about medication or supplementation that causes
Speaker 2: weight reduction, there is no easy fix. So if something
Speaker 2: seems too easy, it's probably, it's probably too easy. And
Speaker 2: I think the sources of information that we get from
Speaker 2: social media and all that very attractive the way they
Speaker 2: do things nowadays. Absolutely incredible.
Speaker 1: We, I did a story in some of the reviews
Speaker 1: are being written by A I now.
Speaker 2: Oh,
Speaker 2: that's amazing. So you see that, so the problems you
Speaker 2: can't really trust everything you see
Speaker 2: online. So I think coming to the mainstream sources of
Speaker 2: information is very, very important and relying on the professionals
Speaker 2: such as your health care provider, your gp's your specialist.
Speaker 2: Those are the ones I think you probably need to
Speaker 2: put your trust in rather than someone who's posing on
Speaker 2: Instagram or Tik Tok. And we don't really know whether
Speaker 2: they actually, they say what they are, what they say,
Speaker 2: what they mean, or they're advertising, what we think they
Speaker 2: are advertising.
Speaker 1: Absolutely. And also what you're saying is
Speaker 1: listening to health matters and any show I do because
Speaker 1: 18 years of running, that's the health professional. Hey, doctor,
Speaker 1: thank you so much. Appreciate your time today. Doctor, be
Speaker 1: endocrinologist from endocrinology, reminding us about the dangers of Sebum.
Speaker 1: Now it's just popped up in two more weight loss
Speaker 1: shakes that have been identified by the Singapore. The S
Speaker 1: fa actually, you can read about it on CN A
Speaker 1: dot Asia. Now, we know of course, a little bit
Speaker 1: more about how we can protect ourselves against unknowingly consuming sin.
Speaker 1: It's health matters. I'm Daniel Martin. Thanks for joining me
Speaker 1: before making any decisions. Based on the information in our program,
Speaker 1: please consult a medical professional.