IMAGINE life as a slim person. For years, that was all Carol Lian (above) could do.

With her weight varying between 60kg and 67kg, she was not overly obese, but she wasn't slim.

And she desperately wanted to be - ever since she was 14 years old.

Over the years, she repeatedly went to health and beauty stores here to seek out slimming products which promised to help her achieve her goal.

None did.

Now thousands of dollars poorer, Ms Lian, 33, a magazine editor, has finally achieved her dream, but not with the help of slimming products.

She did it with exercise and sensible eating.

Now at 48.5kg, she has a body mass index (BMI) of 18.5, which falls within the healthy range.

Ms Lian told The New Paper on Sunday: "It took me a while to recognise that I am slim now. I still had the mental image of a plump person in my head."

Explaining how a recent photograph convinced her, she said with a delighted laugh: "I saw it and realised, wow, I am slim now."

That eureka moment came just a few months ago.

It was difficult for her to come to terms with her slimness because of her long and hard road she took and the many failures and disappointments along the way.

"I spent so much money buying everything which promised me a quick and easy fix to my weight issue.

After so many failures, I did not expect anything to work," she said.

She detailed some of her more memorable failed attempts. There were slimming teas and over-the-counter slimming pills.

"The slimming teas didn't work. No side effects and no other effects! The only thing I didn't try was Slim 10, because around that time the story on Andrea De Cruz cameout," she said.

Ms Lian was referring to the incident in 2002 where Ms De Cruz suffered liver failure after taking the controversial Slim 10 slimming pills.

She survived when her then fiance and now husband, actor Pierre Png, donated part of his liver to her.

Ms Lian thought that doctors could help her with prescription slimming drugs.

The first one she tried worked by preventing the absorption of fat in the intestine. "It was a bit messy," she said.

There were oily gas discharges and the frequent urgent need to go to the bathroom and increased bowel movements.

Lived in fear

She lived in fear of not "making it to the toilet in time".

"I hated (having to) go to the toilet when I least expected it. It would be very embarrassing if I could not find a toilet in time," she said.

Thankfully she did not suffer any accidents. She stopped when it did not help her to lose any weight.

She tried an appetite suppressant. To her surprise, it worked.

She lost 1kg a month and her weight dropped to 52kg. Then, inexplicably, it stopped working after about a year.

And she started gaining weight again, with side effects as well.

"My heart beat faster, I was tired during the day and I could not sleep at night," she said.

"When you want to be slim, you find that you won't care about the side effects. Very silly and dangerous, I know."

At the National University Hospital's Centre for Obesity Management and Surgery, about one in four patients seeking help for weight management would have tried over-the-counter slimming products, said Dr Asim Shabbir, a consultant.

"But with every pill we prescribe, we have to weigh the benefits versus the complications for the patient.

So if you've any doubts about any slimming products, it's best to check with a doctor," he said.

"We teach patients to lose weight by eating healthilyand exercising."

Ms Lian also tried slimming centres and multi-level marketing (MLM) health products.

"When I started working, I went to slimming centres. There were promotions in the newspapers which caught my eye. But when I went to sign up for the promotion, I realised it was a lure," she said.

For instance, the cheapest and most basic package for a 10-session promotion was $400.

"It was just to entice you. The staff would employ hard-sell tactics to get you to sign up for more and more packages. I ended up spending over $2,000," she said.

Andthey didn't work.

She also bought more than $4,000 worth of MLM health products.

"I did everything which promised me a short cut to weight loss," she said.

Everything except exercise and a sensible diet.

Finally, she stumbled on a slimming studio- cum-gym which had equipment that helped to increase one's metabolic rate with infrared smarts.

"It was exciting for me because for the first time, I would be exercising. The machines at the slimming gym helped me to burn up more calories in a shorter time. That was very motivating and made me want to do more," she said.

She signed up for a package and has since done 20 sessions.

"Between March and May, I lost 12kg," she said. She ate sensibly, cutting out some carbohydrates and fats.

"Whatever I feel like eating, I would eat. The only thing I might do is not eat so much of it. For example, if I feel like eating ramen, I would eat only half a bowl. I'll share it with someone," she said.

The exercise also made her feel more energetic.

"I feel like I'm getting rid of toxins from my body when I perspire. So I'm cleansed from the inside out," she said.

She has changed her wardrobe and watched people change their attitude towards her.

"Now my guy friends, some of whom used to tease me for being fat, treat me much better. They would open doors for me and help me carry stuff. So you see how superficial guys are," she said with a laugh.

Attracted attention

She's still unattached but said she has attracted some attention.

"A random guy came up to me and said it was his lucky day to have met me. But I didn't lose weight to meet guys. I did it for myself because I didn't like being fat," she said.

Her last kilo of weight loss was done just for her own satisfaction.

"I hadn't been under 50kg since I was 12 or 13 years old. I wanted to lose it just for myself, to prove that I could," she said.

She knows that if she loses any more weight, she will be at risk of developing nutritional deficiency diseases and osteoporosis, according to BMI figures on the Health Promotion Board's website.

However, she doesn't plan on shedding more weight.

"Now it's all about maintenance and leading a healthy lifestyle," she said.

S'poreans healthier? Fat hope

The trend of those who are overweight and obese rose from 26 per cent of the adult population here aged 18 to 69 in 1992 to 30 per cent in 1998, according to Health Promotion Board figures.

Anyone with a body mass index (BMI) above 25 is considered overweight. BMI is calculated by dividing one's weight in kilograms by the square of one's height in metres.

However, with new guidelines, anyone with a BMI above 23 is now considered overweight.

Recent studies show that many Asians, including Singaporeans, have higher body fat compared to Caucasians of the same age, gender and BMI.

These studies also show that Asians have increased risk for cardiovascular diseases and diabetes mellitus at relatively low BMI levels. In Singapore, about half of the adults with BMI of 22 to 24 have at least one cardiovascular risk factor.

The World Health Organisation (WHO) recommended that for some Asians, a BMI of 23 or higher marks a moderate increase in risk while a BMI of 27.5 or more represents high risk.

This means that in Singapore, almost half of the adults fall into the unhealthy weight category.

'Natural' slimming therapy not always safe

A study of medical records in Hong Kong revealed 66 cases where people were suspected to have been poisoned by a "natural" slimming therapy.

Eight of them became severely ill and one died. The study was published on Oct 14 in the British Journal of Clinical Pharmacology.

The researchers looked at the ingredients in the 81 slimming products these people had taken.

They found 12 different agents that fell into five categories: undeclared weight-loss drugs; drug analogues (unlicensed chemical derivatives of licensed drugs); banned drugs; drugs used for an inappropriate indication and thyroid hormones.

Said Dr Magdalene Tang, who works at the Princess Margaret Hospital in Hong Kong and is the study's author: "People like the idea of using a natural remedy because they think that if it is natural, it will be safe.

"There are two problems here. Firstly, not all natural agents are harmless and, secondly, the remedies also contain potentially harmful manufactured drugs."

She believes that fewer people would use these products if they were more aware of the potential risks involved.

According to a Health Sciences Authority (HSA) spokesman, over-the-counter health products marketed for weight reduction in Singapore should not contain potent medicinal ingredients or undeclared substances.

Some substances may cause health hazards in susceptible persons and should be used only under the close supervision of a doctor because of their potential adverse effects.

"Consumers should be wary of unrealistic claims of health products. When in doubt, consult health-care professionals. Consumers should stop using such products and seek medical advice should they feel unwell after using them," said the spokesman.

Recently, four slimming drugs were taken off the shelves following a recall in the US.

The prescription drugs - Reductil, Ectiva, Reduxade and Slenfig - contain sibutramine, which has been known to raise blood pressure or cause heart palpitations since it was licensed here in 2001.

Currently, HSA has registered five medicinal products, containing phentermine or orlistat as the active ingredient, with the approved indication for the management of obesity.

These products are regulated as either medicines which need a prescription from a doctor or as pharmacy medicines, which can be bought from a pharmacy under a pharmacist's supervision, said a HSA spokesman.

This article was first published in The New Paper.