Danish pharmaceutical company Novo Nordisk announced last weekend that Wegovy, the weight-loss version of the company's high-profile, diabetes-control drug Ozempic, will soon officially hit the Chinese market.
It's good news for a country where the 2023 China Obesity Conference estimated that half of people in the country are overweight or obese. It's also good news for people seeking a silver bullet for weight control.
Ozempic injections of the "semaglutide" drug, available by prescription in China since 2021, have provoked much discussion over its potential abuse by people looking for an "quick fix" to eliminate unwanted blubber.
China approved use of Ozempic as a prescription drug only for treatment of type 2 diabetes, but that didn't stop people from seeking to access the drug outside official channels for weight loss.
When Wegovy was not available in China, many people turned to Ozempic, a semaglutide injection for treating type 2 diabetes, to lose weight.
That zeal was fanned by a post from Tesla tycoon Elon Musk on his X (Twitter) account. One of Musk's followers praised his new "awesome, fit, ripped and healthy" look, and he replied that his secret was Wegovy. The post soon became viral around the world, and China was no exception.
The most effective component in the drug is semaglutide, a glucagon-like peptide-1, or GLP-1, that regulates blood sugar, appetite and digestion. Normally it is produced by the small intestine, and its secretion increases after eating.
Wegovy has demonstrated an average weight loss of roughly 17 percent. The drug remains in the system for five to seven weeks after the last dose. Ozempic is believed to have a similar effect on obesity.
Gloria Zhang, a white-collar worker in Shanghai, said that after she learned about the effect of the injections, she wanted to try the drug immediately. Yet she found that Wegovy was too expensive to buy from overseas, so she turned to Ozempic as a second choice.
"Many people online said they were using it and seemed fine," she said.
Zhang said she bought Ozempic online without any difficulty.
After one injection, Zhang said she didn't suffer any apparent side effects, so she continued the injections.
The result? She lost about 1.5 kilos a month, but that wasn't good enough for her.
"I did feel that my appetite was less than before, and the constant cravings for late night snacks were gone," she said. "But I didn't lose weight as fast as I expected, given the price."
Indeed, Ozempic doesn't come cheap. A box of three injections on Alibaba's Ali Health Pharmacy online site costs 880 yuan (US$121). Buyers need only to tick a box saying they have been diagnosed with type 2 diabetes. No prescription from a doctor is required.
The box comes with instructions to administer one injection a week.
However, the comments section of the online product indicates that most buyers don't have diabetes and are buying the drug to lose weight.
"This is the third time I have bought it," commented one purchaser. "I was recently eating a bit too much, and my weight was rising again. I am hoping it will help me control my appetite."
Some netizens mentioned side effects.
"I used two injections and lost about 4 kilos in two months, yet I felt tired and sleepy almost every day," said one buyer.
Ozempic has at least 20 known side effects, including fatigue, headache, digestive system problems, kidney disease and even thyroid cancer.
Two domestic pharmaceutical companies in China – Hangzhou Jiuyuan Gene Engineering and Livzon Pharmaceutical Group – are poised to introduce Ozempic generic drugs, and almost 10 others are in the final stages of clinical trials.
However, the Fujian Province Consumers' Counsil issued a warning last week that it's dangerous to use Ozempic to control weight and said even Wegovy is not a drug for everyone.
"First, it requires use under a doctor's guidance and is suitable only for patients with a body mass index greater than 27, with at least one obesity-related complication, or for patients with simple obesity with an index greater than 30," said Sui Jian, director of the weight loss center at Fujian Provincial People's Hospital. "Otherwise, it may not be effective."
A booth promoting Wegovy at the China International Import Expo
Wegovy received a green light from China's National Medical Products Administration in June, and Novo Nordisk China initiated the application process for provincial tendering and online listing for injection of the drug.
Meanwhile, e-commerce websites have started taking reservations for Wegovy, charging about 1,600 yuan. The reservations page of Ali Health Pharmacy shows that more than 100 people have booked for the drug.
Anyone who has perused self-help bookshelves or "health" advertisements in the past decade has seen the increase of easy, quick solutions to slimming down. But, actually, there is no cure-all medicine when it comes to keeping fit.
Last month, the National Health Commission of China released new guidelines for the diagnosis and treatment of obesity, highlighting the relapse incidence among people using medication containing GLP-1. The guidelines, which quoted data from the United States, claimed that nearly all patients show varying degrees of a rebound in weight when the drug is discontinued.
"Additionally, patients with obesity exhibit different responses to pharmacological treatment, and some individuals may not achieve significant weight loss – defined as a minimum of 5 percent weight reduction – through medication," the guidelines said. "In such cases, it is recommended that the patient discontinue pharmacological treatment."
