Ozempic has become synonymous with Hollywood, where it has helped several stars lose weight, but there is a secret market booming in China.
Despite being isolated from Instagram and much of Western culture, the drug has become commonplace in Chinese internet culture, with social media stars showing off their slender physiques and promoting its effects.
It’s technically only available to diabetics with a prescription, but a “gray market” of e-commerce websites have started selling it to people who report their diabetes without a doctor’s note.
And weight loss is turning out to be big business in China.
The United States is often considered the “fattest country in the world” because 40 percent of adults have a body mass index of 30 or higher.
But the large size of China’s population means there are actually 200 million obese people there, compared to 139 million in the United States.
As in the U.S., Ozempic is only approved for the treatment of diabetes in China, but that hasn’t stopped people from buying it on websites to use it off-label for weight loss, fueling a “gray market” for the medicine.
Another 400 million are overweight in China, compared to 103 million residents who are overweight in the United States.
The resulting obesity epidemic in both countries has given rise to a multi-billion dollar weight loss industry, which has recently come to include the successful weight loss drug Ozempic.
In 2022, sales of Ozempic in China reached $2.2 billion, and analysts predict sales of the drug and others like it will reach $5.6 billion in 2031.
While in the US, there were $8.4 billion in sales of Ozempic, the weight loss drug industry is projected to grow to $100 billion by 2030.
Demand for Ozempic has increased more than 300 percent since 2020 in the United States. In China, GLP-1 drugs, which also include Wegovy and Victoza, represent a $1.7 billion market.
Ozempic is a GLP-1 agonist and contains the active ingredient semaglutide. It works by suppressing the hormones involved in hunger, keeping you fuller longer and decreasing appetite.
As in the United States, Ozempic is only approved for the treatment of diabetes in China, which is home to a much larger diabetic population: 89 million compared to 38 million in the United States.
And although most of Ozempic’s sales in China are to diabetic patients, there are still large numbers of people who buy it from websites to use it off-label to lose weight, creating a “gray market” for the drug.
Driving the surge in demand for unlabeled Ozempic in China are posts on Chinese social media apps showing users flaunting a slim physique, which they attribute to taking Ozempic.
On Xiaohongshu, an Instagram-like app, posts claim that Ozempic is a “wonder drug” that helps you lose weight “without diet or exercise.”
While doctors cannot write weight-loss prescriptions in the country, people seeking the drug for off-label use are turning to e-commerce websites to buy Ozempic.
Through these websites, people can declare that they have been diagnosed with diabetes and buy Ozempic without providing proof or using someone else’s prescription.
On some websites, people can pay as little as $140 for a month’s supply, compared to the $1,000 Americans pay out of pocket.
State media reports have claimed that the rise in popularity of Ozempic for weight loss has led to a shortage of the drug among people who are actually prescribed it to manage diabetes.
Similar medications such as Wegovy and Mounjaro are not approved for use in China, leaving Ozempic the only option for people looking to manage diabetes or lose weight without approval.
Ozempic’s maker Novo Nordisk has asked China’s drug regulator to expand the use of its semaglutide products, seeking permission to sell Wegovy in China.
While details of the application have not been revealed, industry experts believe the manufacturer is seeking permission to offer Wegovy specifically for weight loss use, as is permitted in the US.
The application is under review.
In a bid to increase supply of Ozempic and join the market with a diabetes and weight loss drug, Chinese pharmaceutical companies have begun developing their own versions, hoping new products will grow the industry in China. .
However, Novo Nordisk has a patent on semaglutide until 2026, which is the earliest Chinese companies will be able to sell their own generic brand.
In 2023, China gave the green light to its own drug, beinaglutide, which is similar to current GLP-1 drugs on the market.
A 2019 study found that the drug showed a “significant weight loss benefit” in diabetic patients.
However, it is a less potent drug and requires three injections a day, compared to once-daily products already on the market in the United States.
Before beinaglutide, Chinese drugmaker Innovent Biologics Inc. and Eli Lilly began co-developing mazdutide.
That drug It targets two receptors in the body to increase metabolic rate and the companies said in 2023 that a clinical trial showed that patients taking mazdutide lost about 19 percent of their body weight.
Obesity in China is a worsening problem, but it is not a new problem. Experts attribute the rise in obesity to greater access to energy-rich foods after the country joined the World Trade Organization in 2001 and living standards rose.
In 2017, China’s health commission began a campaign aimed at tackling obesity. The plan called for people to reduce their consumption of salt, oil and sugar.
The plan also sought to address the childhood obesity crisis in the country, which has high rates of childhood and adolescent obesity.