Users Alarmed as Platforms Issue Unexpected Blocks

Thousands of scientists, activists and policymakers will converge in Rio de Janeiro next week for the 26th International AIDS Conference, where protecting decades of progress against HIV will dominate the agenda amid steep global funding cuts.

Stigma’s legacy threatens the obesity fight

Four leading South African HIV activists – Francois Venter, Simiso Sokhela, Nzama Mbalati and Yvette Raphael – warn that the country’s past experience with HIV‑related stigma offers a stark warning for the emerging obesity crisis. The activists argue that a similar moral judgment now surrounds larger bodies, risking a repeat of those mistakes.

Obesity in South Africa is rising fast, driven by cheap ultra‑processed foods, poverty, stress and an ageing population. The result is a double burden: people living with HIV may feel judged for both a hidden infection and a visible increase in body size.

Health officials note that weight‑loss injections such as “Reta,” still in trial, are being marketed on platforms like WhatsApp, Instagram and TikTok. Prices often undercut regulated products, prompting desperate individuals to purchase illegal copies. The market thrives on false hope, fueled by stigma and a lack of safe, evidence‑based options.

What the HIV response can teach policymakers

Activists stress that HIV’s history shows prevention and treatment are not rivals; both must be pursued together. Early arguments that prevention was more cost‑effective than antiretroviral therapy delayed access to life‑saving drugs, a stance later overturned by community‑driven advocacy.

In reality, these drugs can produce dramatic weight loss for many patients, yet they remain largely unavailable through South Africa’s public health system. While ART is provided free of charge, support for ART‑related weight gain—whether counseling or medication—is missing. This gap leaves patients to manage a medical, social and personal problem on their own.

The problem is compounded by health workers who still view obesity as a failure of willpower rather than a chronic disease requiring medical care.

From a broader perspective, the lesson is clear: stigma harms, while equitable treatment saves lives. If South Africa can replicate the community‑led activism that once reshaped HIV policy, it may be able to confront obesity with the same vigor.

Proposed steps for a healthier future

Activists outline three priorities. First, regulators must crack down on illegal and unsafe weight‑loss products, providing clear public guidance on effective treatments. Second, the health department and medical insurers should integrate obesity care into existing HIV services for those most at risk, alongside stronger food‑policy measures. Third, training for HIV nurses and doctors should address weight stigma as a clinical harm, encouraging kinder, more honest conversations about body size.

Implementing these measures will require a government committed to keeping fast‑food companies out of schools and funding a food‑system overhaul that offers healthier choices. The activists point to the early success of community‑driven HIV advocacy as a model: “People living with HIV, and the organisations that stood with them, refused to be passive recipients of policy,” they wrote.

In the meantime, the illegal market for weight‑loss drugs continues to grow unchecked. Individuals turn to unverified products, often purchased through social media, exposing themselves to potential toxicity. The public health impact of this unregulated trade remains uncertain, but the risk of harm is evident.

Delegates gather in Rio, urging the application of HIV‑derived lessons to obesity.