In the Gulf, a growing scramble for Ozempic and other weight loss drugs


BEIRUT — “A lot of you have been asking, ‘Lubna, talk about your experience with Ozempic.’ Well, I’m going to drink my coffee and talk about it in full,” Saudi TV presenter Lubna Abdulaziz told her 150,000 followers on Snapchat last year.

After consulting with her doctor, she said, she was prescribed Ozempic. “For a month I was taking 0.25 [milligrams], and it had little effect on me,” she said, but after upping her dosage to 0.5 mg, she started to notice results.

Then, all of a sudden, she said, “It was cut off from the market.” She had to switch to 1 mg because it was the only dose available, she said, but started experiencing stomach pains and constipation.

Abdulaziz is one of many in the Persian Gulf region who have come to rely on Ozempic and similar medications to lose weight. As in the United States and other parts of the world, soaring demand has triggered shortages and calls for greater regulation.

Insurers clamping down on doctors who prescribe Ozempic for weight loss

Over the past year, Ozempic has become a global game changer in the weight-loss industry. The drug, which is injected using a pen needle, was developed as a treatment for Type 2 diabetes, but it is increasingly being prescribed off label to those who want to control their food cravings and shed pounds without major surgery.

On social media, morning talk shows and in glossy celebrity profiles, patients have shared their inspirational weight-loss journeys. Ozempic and its sister drug Wegovy — which contains the same active ingredient and is specifically designed for weight loss — have generated record profits for their maker, Denmark-based Novo Nordisk, which says it relies on the discretion of doctors to prescribe them.

Ozempic is now surging in popularity in the oil-rich region, where obesity rates are among the highest in the world — driven by near-universal access to cars, punishing heat that keeps people indoors and the increasing prevalence of processed foods. Thirty-one percent of men and 44 percent of women in the United Arab Emirates live with obesity, according to the Global Nutrition Report, while in Qatar, the figures are 36 percent for men and 46 percent for women.

“The trend is going more and more for the pharmacological weight-reduction medications,” said Adil Sajwani, a family medicine consultant physician in Dubai who prescribes Ozempic and similar drugs “on a daily basis,” following U.S. Food and Drug Administration guidelines. Because of this new trend, “the rate of bariatric surgery is going down worldwide and even here in the UAE,” he said, referring to gastric bypass and other weight-loss surgeries.

Ozempic works by slowing digestion, Sajwani explained. Food normally takes about six hours to leave the body, but when Ozempic is administered, “food stays more in your stomach, so you feel full.”

These weight-loss drugs were initially developed for Type 2 diabetes, and now they could become one of the biggest-selling in pharmaceutical history. (Video: Luis Velarde, Brian Monroe/The Washington Post)

These new drugs are significantly more effective than past obesity medications, according to a growing body of clinical evidence. A study published in the New England Journal of Medicine in 2021 found that, on average, they led to a 15 percent reduction in body weight.

Sajwani posts videos on TikTok and Instagram to advertise his services, which he credits with helping to attract new patients: “50 percent of my patients are now for weight management,” he said.

In Qatar, supply chain issues have led to a shortage of Wegovy, so doctors have started prescribing Ozempic off label, according to Ola Al Tai, operations and pharmacy manager at Al Tai Medical Center in Doha.

“Understandably, in the face of the soaring demand, the mother company, Novo Nordisk, has been unable to keep up,” she said. “This, coupled with shipment delays and limited quantities assigned to the licensed distributor in Qatar, has resulted in a nationwide shortage.”

Al Tai said this has caused “extreme distress for diabetic patients. Many complain of driving around looking for the drug in multiple pharmacies.” Some have had to switch to other drugs, she said, and are struggling to deal with a new set of side effects.

Supplies also ran low in the UAE last year. “People were fighting to get Ozempic,” Sajwani said, though he noted that the situation improved after Mounjaro, another diabetes drug that is being used off label for weight loss, was introduced in the country.

A 40-year-old man in the UAE told The Washington Post he started taking Mounjaro recently, sharing his story on the condition of anonymity for fear of repercussions of speaking to foreign media. He quickly lost six pounds and has “not felt hungry at all,” he said. His wife and his mother-in-law are also taking it and have been pleased with the results.

But he has had to travel to Saudi Arabia to find the drug, and is taking it without a prescription, part of a trend that has raised concerns in the medical community.

Patients grapple with side effects of popular weight-loss drugs

The UAE, like the United States, runs under a federal system, meaning each emirate has its own set of regulations. In the two largest emirates, Dubai and Abu Dhabi, patients need a prescription before they can buy Ozempic. In the five other emirates, it is sold over the counter.

“You can go to Sharjah and buy Ozempic without a prescription, but if you go to the same pharmacy chain in Dubai or Abu Dhabi, they will ask for a prescription,” Sajwani said. This means many people in the UAE are taking the drug without medical supervision, he said, and may be unaware of the side effects. “It can cause severe nausea for them, some gastrointestinal complications,” Sajwani noted, “but usually it’s temporary.”

Novo Nordisk says gastrointestinal side effects are mild to moderate and are well-recognized.

Other potential side effects are more serious, said Joseph El-Khoury, a psychiatrist in Dubai, because the drug acts on the central nervous system.

“If you have a psychiatric condition and you want to take this medication, definitely do it under medical supervision,” El-Khoury said.

Al Tai agreed, saying medical research hasn’t been able to keep pace with the explosive popularity of new weight-loss drugs. “This medication was not intended for those at an average weight, nor was it tested and studied within that group,” she said.

Consulting with a physician during treatment “is vital,” she added.


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