KUALA LUMPUR, Feb 10 — Often referred to as a ‘miracle drug’, glucagon-like peptide-1 (GLP-1) medications have seen a surge in popularity in recent years, fuelled by social media testimonials, influencer endorsements and viral before-and-after photos.

For many people, the appeal is obvious — a once-weekly injection that suppresses appetite and delivers weight loss results that typically take months of dieting and exercise.

But what began as a tightly regulated diabetes drug is now being sold — often cheaply and sometimes illegally — by unqualified providers, as GLP-1 medications are increasingly viewed as lifestyle solutions rather than serious medical interventions.

In some cases, counterfeit GLP-1 drugs are illegally marketed as authentic but instead contain harmful or incorrect ingredients, or have too little, too much or no active ingredient at all.

In fact, demand for GLP-1 therapies has grown so rapidly that the World Health Organization (WHO) issued an advisory to its members last December, warning of the spread of falsified and substandard products that threaten patient safety and public trust.

So what is the appeal of this ‘miracle drug’ that has even healthy people lining up for it?

A quick fix

Simply put, GLP-1 medications mimic a hormone released by the small intestine after a meal, effectively “tricking” the brain and stomach.

They slow digestion and stimulate insulin production, helping people feel fuller and less hungry.

Clinical trials have shown that GLP-1 medications can help patients lose weight and better control blood sugar, potentially reducing the risk of heart attacks, strokes and other serious health complications.

Because of their effectiveness in treating obesity and diabetes, the WHO added GLP-1 therapies to its Essential Medicines List for managing type 2 diabetes in high-risk groups in September last year.

However, according to the UK’s Medicines and Healthcare products Regulatory Agency (MHRA), the most common side effects of GLP-1 medications are digestive issues, including constipation, diarrhoea, loss of appetite, nausea and vomiting.

The agency has also warned that more serious risks can include pancreatitis or gallbladder problems.

Common brand names for GLP-1 drugs include Wegovy, Ozempic, Mounjaro and Saxenda.

Most GLP-1 drugs are self-administered via injection under the skin — typically in the abdomen, thigh or upper arm — either once weekly or daily, with doses ranging from 0.25 milligrams (mg) up to 2.4 mg.

Caution urged as drugs shift from treatment to trend

Locally, the growing off-label use and aggressive marketing of GLP-1 medications for quick or cosmetic weight loss — particularly among individuals who are neither diabetic nor clinically obese — has alarmed medical practitioners.

Malaysian Medical Association (MMA) president Datuk Dr Thirunavukarasu Rajoo said the drugs are intended for specific medical conditions and must only be prescribed by trained physicians following proper consultation, clinical evaluation and monitoring.

“The use of GLP-1 drugs without medical supervision, including those obtained without a valid prescription, carries potential health risks and may not be suitable for every patient, even among those with type 2 diabetes or obesity.

“MMA strongly advises the public against purchasing GLP-1 drugs online, as they risk buying counterfeit, unsafe or improperly stored products,” he said in a statement to Malay Mail.

Dr Thirunavukarasu warned that GLP-1 medications could be misused when taken without medical supervision, particularly by people using them for cosmetic weight loss rather than legitimate medical reasons.

He said the drugs are intended for long-term management of conditions such as type 2 diabetes and obesity, and should only be prescribed after doctors determine they are appropriate as part of a comprehensive care plan.

“When GLP-1 drugs are started or stopped without proper clinical assessment, follow-up and lifestyle support, patients may experience rebound weight gain and other health complications.

“This can lead to a cycle of repeated or prolonged use without addressing the underlying health issues,” he said.

He added that GLP-1 therapies should form part of a structured, long-term treatment plan that includes dietary changes, lifestyle modifications and regular medical monitoring, rather than being viewed as short-term or cosmetic solutions.

As demand for GLP-1 medications has risen in recent years, Dr Thirunavukarasu said the surge — particularly for weight loss use — had at one point put pressure on supplies, including for patients with type 2 diabetes who rely on them.

However, he added that the situation has since improved, with availability largely stabilising as supply chains adjusted and prescribing practices became more structured.

“MMA continues to emphasise the importance of appropriate prescribing to ensure patients with clear medical indications, especially those with diabetes, are able to access these medications without disruption,” he said.