WHO warns about fake medicines for weight loss, says could lead to health risks

The WHO said these medicines are shown to suppress appetite in addition to lowering blood sugar levels and are therefore being increasingly prescribed for weight loss in some countries.
(FIle Photo)
(FIle Photo)

NEW DELHI: The World Health Organisation (WHO) has issued a global warning about fake versions of popular weight-loss and diabetes medicines, saying these could pose risks to people's health.

The world health body said it had received several reports of fake semaglutide - the active ingredient in Novo Nordisk's Wegovy and Ozempic - in all geographic regions of the world since 2022.

Also known as "skinny jab", Ozempic is used for the treatment of type 2 diabetes.

After the fake medicines were found to be in circulation in many countries, the WHO, in its first official notice Thursday, warned that they could pose a danger to health.

WHO said authorities had seized fake batches of the drug in the UK, Northern Ireland, Brazil and the US.

Drug maker Eli Lilly & Co. has also said it is "deeply concerned" about growing online sales and social media posts involving fake or compounded versions of Tirzepatide, the active ingredient behind its drugs Mounjaro and Zepbound. 

It said that off-label use of the medications has gone up, leading to shortages.

(FIle Photo)
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The company also said these medicines are for severe diseases and not approved for cosmetic weight loss. The company said it was the only "lawful supplier" of those drugs.

It also said they do not provide Tirzepatide to compounding pharmacies, wellness centres, or online retailers. The Indianapolis-based company further highlighted that these fake versions are "never safe to use."

In its advisory, Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products, said, "WHO advises healthcare professionals, regulatory authorities, and the public to be aware of these falsified batches of medicines."

"We call on stakeholders to stop any usage of suspicious medicines and report to relevant authorities".

The semaglutides, including the specific brand product that has been falsified, are prescribed to people with type 2 diabetes to lower their blood sugar levels.

Semaglutides also reduce the risk of cardiovascular events.

Most semaglutide products must be injected under the skin weekly, but they are also available as tablets taken by mouth daily.

According to Dr Rajeev Jayadevan, former president, Indian Medical Association (IMA) Cochin, Ozempic, for which the WHO alert has been issued, has not been officially launched in India yet. “Therefore, it is not available in our country,” he said.

Ozempic is an injectable high dose form of Semaglutide, a GLP-1 agonist which was used initially in the control of diabetes, for which it is authorised in India at a much lower dose in tablet form, under the trade name Rybelsus by Novo Nordisk.

It costs approximately Rs 300 per tablet and is meant to be used only for diabetes in India. It is not authorised as a weight loss pill in India, he added.

However, injectable forms such as Ozempic that are sold in Western nations contain a higher dose of the same preparation, semaglutide. The injectable medication is used for weight loss, and is extremely expensive, he further added.

At higher doses, semaglutide is known to cause weight loss, but also certain side-effects that go with it, which include loss of appetite, bloating and, in very rare instances, paralysis of the stomach. "It is concerning that fake products are being made of these relatively new medications. If people use such products and develop complications, it will not only affect their health, but also the trust people have in the healthcare system," he told this paper.

Dr Rishikesh Desai, Senior Consultant Department of Medicine, Sir Gangaram Hospital, Delhi, said they are using oral form of semaglutide in India which is approved by the Drugs Controller General of India (DCGI). "We don't have any confirmation that fake versions are available in India."

The WHO said these medicines are shown to suppress appetite in addition to lowering blood sugar levels and are therefore being increasingly prescribed for weight loss in some countries. They added that they have been seeing an increased demand for these medicines and reports on falsification.

"These falsified products could have harmful effects on people's health; if the products don't have the necessary raw components, falsified medicines can lead to health complications resulting from unmanaged blood glucose levels or weight," the WHO said.

"In other cases, another undeclared active ingredient may be contained in the injection device, e.g. insulin, leading to an unpredictable range of health risks or complications," it added.

Semaglutides are not part of WHO-recommended treatments for diabetes management due to their current high cost. The cost barrier makes these products unsuitable for a public health approach, which aims to ensure the widest possible access to medicines at the population level and to strike a balance between the best-established standard of care and what is feasible on a large scale in resource-limited settings.

Also, there are more affordable treatments available for diabetes, with similar effects to those of semaglutides on blood sugar and cardiovascular risk.

WHO is currently developing a rapid advice guideline on the possible use of GLP-1 RAs, including semaglutides, to treat obesity in adults and as part of a more comprehensive model of care.

The term GLP-1 RAs stands for glucagon-like peptide-1 receptor agonists, which include semaglutides. These are a class of medicines used for diabetes treatment to lower blood sugar and support weight loss.

The WHO said that to protect themselves from falsified medicines and their harmful effects, patients using these products can buy drugs with prescriptions from licensed physicians and avoid buying medicines from unfamiliar or unverified sources, such as those that may be found online.

"People should always check the packaging and expiration dates of medicines when they buy them, and they should use the products as prescribed. In the case of injectable semaglutides, patients should ensure they are stored in the refrigerator," it advised.

It added that the WHO Global Surveillance and Monitoring System (GSMS) has been observing increased reports on falsified semaglutide products in all geographical regions since 2022.

The drug maker said they did not make any product marketed as tripeptide that isn't Mounjaro or Zepbound and is not approved by the U.S. Food and Drug Administration.

Novo Nordisk has also issued similar warnings about its medications.

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