SINGAPORE: The mother of a 20-year-old competitive bodybuilder, who died from the toxic effects of a banned weight-loss drug, raised questions about how her son obtained the illicit substance at the conclusion of a coroner's inquiry on Friday (Oct 16).
Police were unable to establish the source of the drug, dinitrophenol, during investigations for the coroner's inquiry. The youth's mobile phone could not be unlocked, and no trace of the drug was found in medication and substances seized from his home.
"The fact is that there are youth in Singapore who can get such and be given such (illicit drugs) even despite authorities' best efforts, and that would be something that continues to affect our family," the mother said tearfully in court.
She said she hoped "that no other life should be lost due to such illicit drugs that continue to be around us".
She also questioned whether her son had been "encouraged" or "made" to take the drug while preparing for a bodybuilding competition, and said he was "under tremendous pressure to keep to a certain weight and a physique".
After the mother said she wished to give the police a statement with further evidence on this, the coroner's court made arrangements for her to do so at a later date.
State Coroner Adam Nakhoda noted that the coroner's inquiry could thereafter be reopened if necessary to consider further evidence.
Coroner's inquiries are to establish the circumstances that led to a death, and are not supposed to ascribe liability. The mother was addressing the court after being asked if she had any questions as the next-of-kin present at the delivery of the coroner's findings.
The police do not suspect any foul play in the youth's death. Judge Nakhoda on Friday found that the death was a substance-related accident.
BODYBUILDING EFFORTS
The deceased youth, who cannot be named due to gag orders protecting his identity imposed by the coroner's court, died at Tan Tock Seng Hospital on Dec 22, 2024. He was a polytechnic student at the time of his death.
The final cause of death was dinitrophenol toxicity. Dinitrophenol is a substance listed under the Poisons Act. It is used as a weight-loss agent, but is prohibited due to concerns of toxicity. It has been banned for human use in the United States since 1938.
The youth had dreams of becoming a professional bodybuilder, and his mother had plans to help open a gym for him to run so he could excel at his chosen path, according to the coroner's report.
He was noted to be extremely disciplined in what he ate when preparing for bodybuilding competitions, Judge Nakhoda said in the findings.
However, during a clinic visit in August 2024, he reported issues with uncontrollable binge-eating that he attributed to the stress of competition preparations. He asked for and was prescribed weight-loss medication, which was not linked to the toxic substance.
Months later, in the early hours of Dec 22, 2024, he was hospitalised after experiencing heart palpitations, difficulty breathing, feverishness and excessive sweating.
His condition deteriorated in the hospital and he suffered a cardiac arrest, with resuscitation efforts ending after 40 minutes. He was pronounced dead the same morning.
After his death, a fatal amount of dinitrophenol was detected in toxicology tests.
Judge Nakhoda found that it was probable the youth had taken dinitrophenol shortly before he died, as the substance was found in a sample of stomach contents taken after his death, and in the hospital, he showed symptoms of having consumed the drug.
The youth had also told hospital staff that he had taken "fat burners", although there was no evidence the staff knew it was dinitrophenol.
Judge Nakhoda said it was uncertain whether the youth himself knew he had taken dinitrophenol, since no evidence of it was found in substances seized from his bedroom.
Since dinitrophenol is not allowed for clinical use in Singapore, the drug is only available illicitly, said the state coroner.
He added that while the sale and use of dinitrophenol is banned in several countries, it is still sold clandestinely online under different names, with the promise of fast weight loss.
He also noted that 34 types of medication and substances were seized from the youth's bedroom and kitchen of his family home. These included prescription medication for conditions like breast cancer, high blood pressure, high cholesterol and asthma.
There was no evidence that the youth suffered from any of the conditions these medicines were meant to treat.
Judge Nakhoda cited a medical report on the medication and substances found in the youth's home, in which doctors observed that bodybuilders aim to develop a muscular physique with a "shredded" appearance.
This requires increasing muscular mass while reducing body fat, and bodybuilders are known to engage in the "off-label" use of medicines to accelerate this, the medical report stated.
Another class of substances is then used to address the adverse effects arising from the "off-label" use of the medicines, said the doctors.
The doctors also said it was known that bodybuilders were highly vulnerable to muscle dysmorphia.
Judge Nakhoda said the youth's immense drive, dedication and discipline in his chosen sport of bodybuilding was undeniable.
"It is a profound tragedy that someone so full of potential passed away so young," he said.