Economic Observer reporter Zhang Ying

(1)

During the morning rush hour, Chen Jun fainted on the subway. After drinking a bottle of cola handed by a passenger next to him, he tried to stand up, but his legs were weak and he quickly fell down again, so he had to sit on the ground.

At this awkward moment, fear struck him, 'I am the backbone of the family, with two elderly people above me and a very young child. I dare not die, nor can I bear to die.'. From then on, he made up his mind to lose weight.

Chen Jun is 44 years old and has worked in an Internet factory for many years. When he was a child, he had a well proportioned figure, and it wasn't until his second year of high school that he began to gain weight. After working, he became increasingly overweight. At the age of 34, with a height of 1.75 meters, he weighed 85kg, which is medically considered overweight. By the age of 43, his weight had exceeded 95kg.

The weight gain brought Chen Jun not more anxiety caused by appearance, but physical pain.

Firstly, the quality of sleep deteriorates. When the weight reaches 95kg, it becomes particularly difficult for him to fall asleep. He prepares to fall asleep at midnight and can only fall asleep at two or three in the morning. Deep sleep only accounts for about ten percent of his sleep time, and he often experiences breathing pauses during sleep.

Working at a desk for a long time during the day can cause discomfort in the heart and an increase in heart rate. I usually feel physically weak, especially in summer. A slight movement can make me sweat profusely, and I may gasp for breath on the stairs. On the day he fell on the subway in 2025, he only slept for two or three hours. After waking up, he rushed to work without breakfast and was already sweating profusely when he squeezed onto the subway.

Obesity also affects sexual activity. Chen Jun said, "I will feel terrible, my physical condition is obviously not good, I have no mood, and I have no desire.

He also pays special attention to comparing himself with the parents of other classmates. Sometimes when he participates in the kindergarten parent-child sports meet, he doesn't run as flexibly as other parents and feels like he hasn't set a good example for his children.

48 year old Xu Yong, a senior executive of a listed company in the south, decided to lose weight only when his body was showing signs of weakness.

As early as 2020, with a height of 1.7 meters, his weight had already reached 86kg, but he did not realize that he belonged to the obese group and still frequently participated in social gatherings, eating and drinking heavily, and ordering mostly meat. In 2022, after undergoing gallbladder surgery, he was informed by a gastroenterologist that his blood pressure was abnormal for unknown reasons. After diagnosis and treatment by a general practitioner, he was advised to lose weight. In 2023, he experienced another blockage in his cardiovascular system. After undergoing stent surgery, the cardiologist once again advised him to lose weight. In 2024, he was hospitalized again due to a follow-up examination after cardiac stent surgery.

Being hospitalized due to illness for three consecutive years made him wary of health risks, and he thought, 'It's over, I won't live to be 50 years old anymore.'. Especially when he was hospitalized in the cardiology department, he found himself the youngest patient in the ward, with almost all of his other patients being elderly.

In contrast, Ding Hongliang's weight loss reasons are not as urgent. He is 32 years old this year and has no other physical abnormalities except for obesity. He lost weight mainly due to his appearance.

Ding Hongliang is an only child who grew up in Beijing and is loved by his elders. His grandmother often cooks meat for him. He gained some weight in elementary and middle school. In college, he was 1.82 meters tall and weighed 110kg, making him the fattest boy in his class. Obesity makes him somewhat insecure, especially when he hopes to date. He found that due to obesity, he would show off when wearing thin clothes in summer, which made him particularly embarrassed despite his delicate mind.

In his senior year, he lost weight from 110kg to 85kg through high-intensity exercise and dieting. Not only did he lose weight, but he also became more confident. However, due to difficulties in perseverance and busy work schedules, his weight has been fluctuating between 85kg and 98kg in the past decade.

Because I have enjoyed the feeling of losing weight before, now as long as I exceed 95kg, I want to lose weight. ?Ding Hongliang also mentioned that his girlfriend has a very fit body, which is why he has been losing weight in the past two years. He hopes to be more compatible with his girlfriend in terms of body shape.

(II)

Ding Hongliang claims to be a guinea pig of weight loss pills. Since 2024, he has used two types of weight loss needles and is planning to use a third one this year.

At the beginning of 2024, he began to use Smeaglutide, a drug developed by Novo Nordisk, a Danish pharmaceutical company, which will become the world's "drug king" in 2025. At that time, this drug was not approved for weight loss in China, and almost no one used it around. However, Ding Hongliang saw a large number of people using it abroad, and he bought it on the Internet platform to inject himself - to inject needles into his stomach.

In the first week of using semaglutide, he lost 10 pounds, and after using it for two months, he lost nearly 20 pounds in total. After stopping the medication for two months, the weight rebounded to its original value.

In October 2025, he switched to a domestically produced weight loss needle - Masidide developed by Xinda Biotech (01801. HK), and lost 20 pounds in two months of use. During these two months, he ate very little food every day. One loaf of bread was enough for breakfast and lunch, and he didn't eat dinner. Besides losing weight, he also spent less money on meals

However, as the duration of drug withdrawal extended, his appetite gradually recovered. Now, after stopping the medication for three months, his weight has rebounded by 15 pounds.

During the use of weight loss pills, Ding Hongliang hardly exercised and, as usual, spent most of her time playing games after work. Apart from eating less due to medication reasons, her lifestyle did not change much. He analyzed that it is precisely because of this that when drugs are stopped or become resistant, weight will quickly rebound.

Chen Jun has tried various weight loss methods. At the age of 34, he lost weight from 85kg to 74kg in three months by strictly controlling his diet and cupping. This weight loss method is effective, but the disadvantages are the painful process, social impact, and the need for sufficient time.

In those three months, he only ate soybean milk and eggs for breakfast, beef, skinless chicken legs, fish and shrimp and other low-fat foods for lunch, and cucumber and tomato for dinner. Like an ascetic, he eats differently from his family, destroys the family atmosphere, and cannot eat together with colleagues in the company, seriously damaging social interactions

Cupping to lose weight is not easy either. Chen Jun described himself as lying there like a salted fish, with thirty or forty pots all over his body. He had to pull out his back after pulling out the front, which took an hour at a time.

After fainting in the subway, he decided to use semaglutide. At that time, Chen Jun knew that Musk had used semaglutide and had also read medical science on the internet. For Chen Jun, compared to self dieting and regular exercise, weight loss pills are a more feasible way. After becoming a senior executive, socializing became inevitable. He often had to drink and have meals at night, and it was already 10 o'clock when he got home from work. He also had to spend time with his family and children, and had almost no time to insist on high-intensity exercise.

He believes that the physiological burden of using weight loss needles is significantly lighter, and "hunger is a particularly big obstacle on the road to weight loss. You won't feel hungry when getting an injection, and going for a run or workout won't be so uncomfortable. Within 5 months of using a weight loss needle, he reduced his weight from 95kg to 82kg, and his sleep quality, blood pressure, and other physical aspects improved significantly.

The main reason why Xu Yong chose to use weight loss needles to lose weight is that his previous weight loss methods encountered bottlenecks.

Before using weight loss pills, Xu Yong had tried to lose weight through exercise and controlling his diet, but every time he reduced to 78kg, he couldn't continue and could easily rebound to 82kg-83kg. And after using the third dose of tilpotide, his weight quickly broke through the bottleneck.

Xu Yong was also the first person in his social circle to start getting weight loss injections. At first, he felt very lonely because there was no one to communicate with and he didn't want his friends to know that he was taking weight loss pills. "I was afraid that after taking them, I wouldn't be able to lose weight and it would be embarrassing," he said.

Tilpotide is a drug developed by the American company Eli Lilly, which, like semaglutide and mescalin, can control appetite. "When I had my first injection, I didn't feel hungry without eating all day. When I saw my favorite braised pork in the evening, I couldn't eat half of it. Later, even my favorite sea urchin dumplings had a strange smell. After two or three mouthfuls, I felt full, and then I would feel nauseated." Xu Yong recalled.

Since August 2025, Xu Yong has received a total of 12 doses of tiltrotide, with doses of 2.5mg for 4 doses, 5mg for 4 doses, and 7.5mg for the final 4 doses. The weight decreased from 79.8kg to the lowest point of 68.5kg, a total weight loss of nearly 23 pounds. After discontinuing the medication, there was a slight rebound during the Chinese New Year period, currently maintaining around 70 kilograms.

In addition to losing weight, Xu Yong also found that his decades long fatty liver had disappeared, and almost all other indicators of his body had returned to normal.

While taking medication, Xu Yong also insists on exercising. Now he does strength training every morning and then spends 40-50 minutes running. In terms of diet, his breakfast and lunch are almost only eggs, milk, and protein powder, and he eats dinner normally.

However, not everyone has the same effect as Xu Yong when using tilpotide. Chen Jun has also used tilpotide, but this drug did not significantly suppress his appetite.

(3)

The process of using a weight loss needle is not perfect.

Many men encounter opposition from their families when using weight loss injections at the beginning, and their families are mainly concerned about the side effects of the medication. Chen Jun's wife believes that using this medication may cause harm to the body, and she hopes that Chen Jun can stick to exercising twice a week like herself, so as to maintain a good physique.

When she saw Chen Jun experiencing diarrhea during use, her opposition became even more intense. On the National Day of 2025, the whole family went on a trip to Dalian. Chen Jun suffered from severe diarrhea for seven days, and he described his condition as worse than death.

Ding Hongliang also encountered a similar situation, whether using semaglutide or mesidogrel, his digestive system became particularly fragile, resulting in severe vomiting and diarrhea. His girlfriend believes that Ding Hongliang's current weight is normal and there is no need to deliberately lose weight.

Chen Jun observed that it is common for male colleagues to face opposition from their wives when using weight loss pills. Some people store medicine in the company refrigerator to avoid family conflicts.

Someone is in a dilemma, 'My wife urges me to run every day, but I am too tired to run and it is difficult for me to persist. It is also difficult for me to control my diet by myself. I want to take medication, but she doesn't allow it.'.

Another point of concern for many men is whether weight loss injections will have an impact on sexual desire.

Recently, a plastic surgeon in South Korea posted on Twitter that GLP-1 weight loss drugs such as semaglutide and tilpotide not only suppress appetite, but also inhibit other desires and impulses, including the desire to love someone. This post quickly attracted over 7 million readers. Some people in China are also confused about this.

In the interview, different interviewees gave varying answers. Ding Hongliang's experience is that obesity itself does not have an impact on sexual desire, but during the period of taking weight loss pills, sexual desire will indeed decrease significantly, and it will gradually recover after stopping the medication.

Chen Jun's experience is exactly the opposite. Due to the positive feedback that weight loss brings to his body, his mood has significantly improved, and his sexual abilities and desires have been enhanced.

Zhang Fang, Deputy Chief Physician of the Endocrinology Department at Peking University People's Hospital, introduced to the Economic Observer that very few male obese patients have raised sexual concerns with doctors. "This is a more secretive demand. In fact, simple obesity mainly affects the appearance (such as abdominal hypertrophy leading to visual penis shortening), but if accompanied by diabetes or dyslipidemia, it will indeed lead to problems such as decreased sexual ability by interfering with microcirculation and autonomic nerves."

Regarding the question of whether weight loss drugs will reduce sexual desire, Zhang Fang explained that the drugs themselves do not directly affect sexual function, but it should be noted that "satiating and indulging in sexual desire" has scientific basis. When you are in a state of drug-induced hunger, your body limits its reproductive function in order to survive. Once your weight reaches the standard and enters a stable period, many people may feel more energetic due to their lighter and healthier body

(IV)

In people's general impression, those who pursue weight loss are mostly women. However, according to Zhang Fang's observation, the proportion of men and women seeking treatment at weight loss clinics is very similar. Nevertheless, approximately half of the weight loss drugs currently available on the market are purchased through non hospital channels, so the proportion of patients in hospitals may also deviate from the overall population. The male interviewees interviewed by the Economic Observer all chose to buy medicine on the Internet platform.

An interesting phenomenon observed by Zhang Fang is that there is indeed a certain difference in the motivation for weight loss between men and women: women pursue the ultimate, and even some slim girls may come to request medication, while men tend to be more Buddhist and rarely come for a slim figure. Weight loss to a certain extent is sufficient, and many men lose weight out of clear health demands, such as abnormal blood sugar, blood lipids, uric acid, etc.

Zhang Fang suggested that obese and overweight patients can choose weight loss methods based on their BMI (Body Mass Index, which is an indicator of the degree of body weight loss, calculated as the square of weight/height). Overweight patients with a BMI between 24-27 are likely to be obese due to low physical activity, and it is best to focus on strengthening exercise as it is more closely related to the cause; Obese patients with a BMI greater than 27 should primarily focus on dieting, as the main cause of this condition is overeating.

If patients with a BMI greater than 27 find it difficult to control their weight through adjusting their diet and exercise, they can try using medication or even surgery to restrict their eating. ?Zhang Fang said that if medication is chosen for treatment, it is generally recommended to use it for a long time. If the medication is interrupted in the middle, there is a greater possibility of rebound, such as stopping the medication immediately after reaching the standard, which can easily cause a rebound.

He does not recommend people to blindly use weight loss drugs, as he himself is a case of not being suitable for using GLP-1 type weight loss drugs. Due to the extremely fragile digestive system, he experienced severe stomach acid reflux after taking a medication - when he slept, the acid water surged upwards, causing him to wake up, and sometimes the acid water rushed into his nasal cavity and even caused nosebleeds.

From the perspective of side effects, Zhang Fang introduced that gastrointestinal reactions such as diarrhea are known to be common side effects. People with particularly sensitive gastrointestinal tract or rapid weight loss may also have risks such as gallstones, pancreatitis, and liver abscess.

We encourage scientific weight loss because there is very clear medical evidence that there are no truly healthy overweight people, "Zhang Fang reminded. Obesity itself is considered a disease.

(At the request of the interviewee, Chen Jun and Xu Yong are given pseudonyms in the article)