In Kenya, where being overweight was once perceived as a sign of wealth and success, a drive to shed the pounds is now taking hold.

Surgical procedures and weight-loss drugs are growing in popularity, with some influencers detailing their own slimming journeys to both acclaim and criticism.

At her weight-loss clinic in the capital, Dr Lyudmila Shchukina has a fully booked schedule.

It has not always been this way for the Nairobi Bariatric Center, which she and her late husband – both from Ukraine - founded three decades ago.

When it started, the facility, which Shchukina proudly regards as a pioneer for weight-loss surgery in the country, was hardly receiving any clients.

But the clinic is now thriving, seeing 10 to 15 patients a day.

It's a "boom", the doctor tells the BBC one evening at the end of her shift.

Societal pressures may be one reason for the change.

Kenyans on social media are not known for holding back and many people, both men and women, have been insultingly told to, in the Kenyan phrase, "unfat!" after pictures of themselves have been posted online.

When political activist Francis Gaitho complained about being cyber-bullied over his weight, several people responded by telling him to "unfat".

Shchukina says that concern over both physical and mental health linked to excess weight drives patients to her doors.

She sees patients who have high blood pressure, infertility issues, diabetes, joint and back pain, while others are concerned about the overall quality of their life.

Kenyans are now "discovering that obesity is not a sign of wealth, it's about health", Shchukina says.

Health officials here have become increasingly concerned about the issue. In urban areas just over half of women and a quarter of men were described as either overweight or obese in a 2022 survey. In rural areas the equivalent figures were 39% and 14%.

However, some of Shchukina's patients are also seeking to enhance their appearance, besides their health concerns.

She says that at one time being a "big size" was considered fashionable but "now… the fashion is [to be] slim, tiny… You can see how it is changing."

Beauty expert Yvonne Kanyi says that for women the "pressure" for the "hourglass [figure] and flat stomach" was always there, although access to medical procedures was not.

Kanyi, who runs a skincare and cosmetics business and frequently speaks about beauty and entrepreneurship, says that what has changed is the celebrity culture which has now amplified the trend, "normalising medical intervention as part of maintaining a certain image".

Besides that, more women are now feeling empowered to make decisions about their body "without apology", she tells the BBC.

One of those is Naomi Kuria, a popular content creator who has had medical procedures to lose weight and enhance her looks – and is proud of the outcome.

The 27-year-old's efforts to lose excess weight began in 2024.

She started with gym workouts, but five months later, she realised she was not achieving the results she wanted. She had instead added more weight and was having "serious pain" in her knees.

Alternatives were suggested, including swimming or dieting. But she wanted speedier results.

"How long will I swim to lose a kg really?" she asks. "So I explored other quicker ways to lose weight and then I found out about Ozempic." A fellow content creator talked to her about it and she sought medical advice.

Ozempic is one of several brands, including Mounjaro and Wegovy, that are now being prescribed for long-term weight management.

It contains semaglutide, which is used in the treatment of diabetes.

The medication, administered as an injection, targets hormones that determine how quickly the stomach empties and how full a person feels, helping to regulate appetite.