In a global health concern, Japan is currently facing a shortage of diabetes medications due to the inappropriate use of these drugs for weight loss purposes. Masaaki Miyakawa, an executive board member of the Japan Medical Association, expressed deep concern during a news conference in late October about the rising trend of healthy individuals using diabetes drugs for dieting.
The issue gains prominence as World Diabetes Day is observed on Tuesday.
A survey conducted by the Japan Medical Association (JMA) between August and September revealed 308 cases where medical institutions encountered difficulties in preparing GLP-1 drugs, common in treating diabetes, for in-hospital prescriptions. Additionally, there were 648 instances where clinics faced challenges in prescribing these drugs through external pharmacies.
Eli Lilly’s Trulicity, Novo Nordisk’s Ozempic and Victoza (injected), and Rybelsus (taken orally) are among the drugs affected by the shortage. GLP-1 receptor agonists, which stimulate insulin production and lower blood sugar levels, are crucial in managing Type 2 diabetes. However, their appetite-suppressing effects have led to an increased demand globally from individuals seeking to lose weight.
Physician Misa Inoue, a member of a medical association in Osaka, voiced concerns about the off-label use of GLP-1 drugs, particularly highlighting issues with Trulicity, which is often used for cosmetic purposes instead of medical reasons.
While GLP-1 drugs are covered by national health insurance for treating Type 2 diabetes, they are not covered for dieting purposes, as the health ministry has not approved them for such use.
Despite awareness campaigns by the Japan Medical Association, the Japan Diabetes Society, and pharmaceutical companies, off-label use persists. Some clinics even ask users to acknowledge the risks associated with off-label use, potentially making it harder for users to report adverse events.
On November 7, three diabetes-related groups—Japan Association for Diabetes Education and Care, Japan Diabetes Society, and Japan Pharmaceutical and Diabetes Society—submitted a joint request to the health ministry, urging measures to ensure a stable supply of medications. They expressed concern about inappropriate drug use for dieting among non-diabetic individuals.
Miyakawa emphasized the health risks, citing a ninefold increase in the risk of pancreatitis associated with the off-label use of GLP-1 receptor agonists, as reported in the Journal of the American Medical Association (JAMA) last month. The study linked medications like Wegovy, Ozempic, Rybelsus, and Saxenda to a heightened risk of serious stomach and intestinal problems.
Social media, particularly on platform X, witnesses individuals openly sharing experiences with using diabetes drugs for weight loss. Online, cosmetic surgery clinics frequently advertise “GLP-1 Diet” therapy.
Obtaining these drugs for weight loss has become simple, with some doctors prescribing them after brief online consultations, and patients receiving deliveries at their homes.
Miyakawa cautioned that individuals using these drugs for weight loss are not eligible for compensation under the government-funded relief system for adverse drug reactions.
As of fiscal 2019, an estimated 11.5 million people in Japan had diabetes, according to the Japan Preventive Association of Lifestyle-related Diseases. Researchers predict a substantial increase in the global diabetes population, exceeding 1.3 billion by 2050, with Type 2 diabetes becoming more prevalent, often linked to being overweight, as reported in the Lancet medical journal.
