Weight loss has always been a personal and often sensitive journey. But in recent years, what was once a slow process of lifestyle change has morphed into a global rush for instant transformation. Social media feeds overflow with quick-fix solutions, from exotic injections to supposed miracle supplements, all promising radical change in weeks rather than months. In Kigali and across Rwanda, that global pressure is finding local expression in an underground market of shortcuts—some illegal, some dangerously unregulated, and many leaving a trail of unspoken harm (health hazards). At the root of this trend is frustration and impatience. People want to see dramatic results today, not a steady streak of small victories over time. They hear about Ozempic and other weight-loss drugs, or they see friends travel abroad for surgery. They believe that if something works elsewhere, it must work here. What they often don’t understand is the real human cost of those decisions. Fast results, no questions In Kigali’s bustling city centre, beauty shop proprietor Diane Akaliza has become an unexpected observer of this trend. Her shop, which sells legal skin care and slimming treatments (products), is increasingly receiving people who are looking for desperate quick fixes to weight gain. ALSO READ: Ozempic: What Rwandan officials say about diabetes, obesity drug? While most of the conversations she has with clients about radical weight loss are informal, what she hears there reflects more than cosmetic concern; it reveals a hunger for immediate transformation that borders on desperation. “People come in not to talk about eating balanced meals or joining a gym,” Akaliza told The New Times. “They come in asking where they can get Ozempic, where they can bring slimming drugs (products) from,” she says. “They say they know these things are not sold here, but they tell me, ‘I can get them from Uganda, Kenya and ask me if I can import them,” she says. Justus Ntaganda, who also deals in beauty products, says he knows these drugs can be obtained, if one has money and some of his colleagues who travel do import these products. “There are websites here where you can order these products and they are shipped to you,” he says, much as he doesn’t deal in the said products. “There are also people who can refer you to clinics in Turkey, Dubai or India. I hear it all the time,” he says. Some of the websites seen by The New Times, where Ozempic and other products can be ordered include Ubuy.com, everyone.org and bitget, which allows people to create accounts and make orders. Some clinics in Kigali also advertise the services, including Neoderma Clinic Kigali, among others. Ntaganda says most times he advises her clients not to go for those alternatives or treatments but most times people have already made up their minds. “They don’t ask about the risks. They don’t ask about what happens after,” he says. ALSO READ: Stay healthy on your way to weight loss “All they want to know is how long it will take to see results. If I mention going to a doctor, they change the subject. They just want fast results and that’s it. They don’t care about the price or the side effects. That is what surprises me most,” Akaliza adds. What Akaliza and Ntaganda describe is not merely casual curiosity. It is an underground culture where illegal or quasi-legal routes to weight loss are increasingly normalised. People talk about the availability of drugs like Ozempic across the border as if it were as common as buying flour. But unlike flour, these drugs are powerful medications with real, sometimes severe side effects when used without medical oversight. What really happens... Dr Concorde Ishimwe, Chief Medical Officer at the University Teaching Hospital of Kigali (CHUK), says the growing use of weight-loss shortcuts is deeply concerning from a medical standpoint. He warns that unsupervised use of powerful drugs and unregulated procedures exposes people to serious health risks, drawing on clinical evidence and patterns observed within hospital settings rather than individual patient management. “Medications like Ozempic and other GLP-1 drugs were not originally created for cosmetic weight loss,” Dr Ishimwe explained. “They were developed as metabolic medicines for people with type 2 diabetes. Later clinical evidence showed they could help with weight loss in very specific, controlled clinical settings,” he says. “That is a very important distinction. When they are used without proper assessment and careful monitoring, you are essentially taking a potent metabolic intervention and applying it in an environment where nobody is watching what happens to your body’s systems,” he adds. ALSO READ: Weight loss: How to maintain desired goal He is careful not to demonise the medications themselves; rather, his concern lies with how they are being used. “When someone comes in having taken these drugs by themselves, without supervision, without follow-up, without even a proper initial assessment, it is not unusual for us to see complications,” “There can be severe nausea and vomiting, dehydration, electrolyte imbalance. Without supervision, you might not notice symptoms until they become serious. And by then, you are dealing with a much bigger problem,” he observes. Dr Ishimwe points out that these medications influence how your gut and brain communicate hunger and fullness, which in itself is powerful. “But when someone with no diabetes, no obesity-related comorbidity, no baseline screening, no monitoring starts using these drugs simply because someone told them it works, they are setting up their body for a series of unpredictable responses,” he says. “The body may react in ways they are not expecting because we are not just talking about calorie counting. We are talking about metabolic regulation, hormone activity, and pancreatic function. Those are serious biological processes,” the medic adds. His concern is not hypothetical; he has seen people present to hospital after complications that grew worse over days or weeks. “Sometimes when they finally come to the emergency room, they are already dehydrated, their kidneys are stressed. Other times they are so weak they cannot take care of themselves. What was meant to be a shortcut became a crisis.” WATCH: From 130 to 85kgs: A tale of successful weight loss “These are not cosmetic interventions that can be taken lightly,” he added. “They require real medical oversight. Taking them outside that context is putting your health at risk.” Going abroad isn’t a solution In clinics in Kigali and other Rwandan health facilities, Ishimwe and his colleagues are now seeing a pattern that was rare a decade ago: patients returning from abroad after weight-loss surgeries with complications that require intensive care. “Bariatric surgeries such as gastric bypass or sleeve gastrectomy are serious medical procedures,” Ishimwe said. “They are not cosmetic ‘body sculpting.’ They change how your digestive system works, how your body absorbs nutrients,” “They require psychological preparation, nutritional planning, and lifelong follow-up. When somebody travels to a foreign country, has the surgery, and returns home without any structured follow-up or connection to a medical team, complications can spiral.” He recounts cases where patients experienced severe bleeding, internal leaks, infections, and chronic metabolic challenges linked to inadequate management after surgery. “Some come back with persistent diarrhoea. Some with vitamin and mineral deficiencies that manifest in severe ways. Some cannot keep food down. All of these are consequences of a system that was once intact, medical assessment, surgery, then long-term care, being fragmented because it was pursued as a shortcut, not a comprehensive treatment.” “The surgery is only one part of a lifelong process,” he stressed. “If you remove the aftercare that is the counselling, the nutritional monitoring, the psychological support, you are taking something complicated and leaving the person to manage it alone. That is not healing.” The fake miracle market Not all shortcuts are pharmaceutical or surgical. Perhaps the most dangerous trend Ishimwe sees is the spread of slimming products sold through informal networks, often marketed with claims of rapid fat loss and no effort required. “These products are not tested. They are not approved. They are sold through social media groups, WhatsApp forwards, pyramid-style schemes promising exponential income if you ‘sign up,’” he said. “But the people buying these products have no idea what they are ingesting. These are not harmless teas or herbs. Some contain potent substances that affect the liver, the kidneys, the heart.” He pointed to real clinical patterns. “We see weight loss, yes, but what is behind it may be dehydration, electrolyte imbalance, or organ stress. Losing weight because your body has been strained to its limit is not healthy weight loss. It is stressful. And it can lead to lasting damage.” Why people keep falling for it Counselling psychologist Leocadia Nkusikabibi says the rush toward weight-loss shortcuts is rooted less in medicine and more in psychology. “These drugs have received a lot of publicity from celebrities such as Serena Williams and Oprah Winfrey, and most of the time they only talk about the good side,” she said. “That worries me because people ignore the negative effects. When something is popular, people assume it is safe, yet they have no idea what happens behind the scenes or what medical supervision is involved.” ALSO READ: Weight loss diet that counts time, not calories She pointed out that even financially, these drugs are unsustainable. “They are extremely expensive. I interviewed a woman who had been using one of these drugs and she stopped not because she was healthy but because she could no longer afford it. That alone shows you this is not a long-term solution.” Nkusikabibi said the psychological consequences of rapid weight loss are often ignored. “People want quick results, but they don’t think about what they are losing in the process,” she says. “You lose muscle, you experience nausea, vomiting, diarrhoea. What worries me most is that people ignore the long-term effects on their bodies and their mental health,” she adds. She described the trend as a reflection of deeper self-esteem struggles. “If I were to put it in one word, I would call it lack of self-love. This is your body. You didn’t borrow it from anyone. So why would you treat it harshly just to lose weight?” Nkusikabibi says. From her professional experience, she says people cannot separate physical health from emotional wellbeing. “Human beings cannot be compartmentalised. Your emotions, your body, your mind, your nutrition are all connected. When you damage one part, the whole system suffers,” “Imagine spending so much money, going through pain, and it doesn’t work. You end up with regret and disappointment,” she observes. She also questioned society’s growing impatience. “People have lost patience. If something doesn’t work immediately, they think it is useless. Where has patience gone? People are trying to solve one problem but end up creating many more for themselves.” While acknowledging that some people have genuine medical reasons to lose weight, she stressed the importance of professional guidance. “I am not judging anyone. But even then, consult doctors, get proper prescriptions, and take the right dosage. Don’t blindly copy celebrities. You don’t know their lifestyle, their medical care, or their support systems.” “Here, people do these things alone, without follow-up,” she added. “That is dangerous. We need awareness in communities, churches, mental health centres. People should think twice before rushing into dangerous solutions.”No shortcut builds discipline. Long term effects Fitness enthusiast and entrepreneur, Ivan Munyengango believes shortcuts rob people of something far more important than a flat stomach. “When someone comes to me after trying an explosive weight-loss fix, what I see is frustration, weakness, and often lost confidence,” Munyengango said. “People chase numbers on the scale without understanding what their bodies are actually doing. It is not about weight. It is about health, strength and habits.” He emphasised the mental benefits of consistent exercise. “When you work out regularly, your brain adapts. You build discipline. You build resilience. You build neural pathways that support healthier choices. That is something a quick fix injection cannot give you. Ozempic won’t change your lifestyle habits or teach you how to move your body effectively.” WATCH: How fitness guru Munyengango is driving the ‘healthy Rwanda’ agenda Education, he says, is everything. “So many people don’t understand what sugar does, how energy balance works, how insulin responds to food. When you understand how food fuels your body, you have power. Shortcuts take that power away.” The client who learned the hard way Munyengango shared the story of a woman who came to him after losing 25 kilograms through a rapid-loss approach. “She looked thinner, but she felt beaten by the process,” he recalled. “Her energy was gone, her face sunken. She told me she thought she would feel happy once she lost the weight, but she didn’t. What she needed was a plan, not a pill. What she needed was strength, not speed.” They shifted focus to strength training and nutrition. “It took eight months, and she ended up stronger, more toned, more energetic than ever. That kind of change is real. It is slow, but it lasts.” Choosing health over haste As these trends grow, health professionals stress the need for education, regulation and accessible support. “We have to normalise seeking care,” Ishim we said. “Weight loss is a medical and behavioural process, not a cosmetic transaction. And we must push back against the idea that fast is always better.” Back to the shops, Ntaganda agrees. “People deserve honest information. They deserve to know what these things really do to their bodies, not just what influencers say online.” Munyengango echoed the sentiment. “Real health is slow. Real health is consistent. It is not something you buy in a jar or inject in a foreign clinic. It is what you build every day.” Ishimwe put it simply: “There is no shortcut worth risking your life for. Health cannot be rushed. It must be nurtured.”
