This is deplorable. What no one has mentioned, is she continues to receive the injections, there is a chance she could become immune to the medication. If later in life she needs the medication for muscle spasms, it may not work. As a psychiatrist (went to med school & I have an MD), her daughter is a risk for developing multiple psychiatric diagnoses should her mother continue to reinforce what the little girl thinks are inadequacies with her appearance: Depression, Delusional disorder, Body Dysmorphic Disorder, Substance Use Disorders, etc...
Additionally, if her weight is not "mentioned" by others, it's coming. I suspect, unfortunately, surgical interventions could be considered before other appropriate, non invasive interventions
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It kills me to see this done to a girl, when the message we should be sending is: be happy with yourself, you are good enough.
Also, parents should not have discussions with 8 year olds regarding medical treatment. There is a reason children under 18 are not allowed to give consent... When I was 12, my parents sent me to the orthodontist, there was no discussion about if I wanted braces before.
Beyond the psychological implications, I find it hard to believe her mother has any knowledge of anatomy and in all likelihood does not know what muscle she's injecting, and god forbid this, she paralyzes the muscles used with smiling or blinking
Considering she's a single parent who only works part time, how is she financing the pagents? I'm wondering if any public assistance she receives is being diverted to financing all of this?