Novo Nordisk’s once‐weekly injectable, Ozempic (semaglutide), originally developed for type 2 diabetes, has increasingly attracted attention in Egypt, not just for its blood-sugar-lowering benefits, but for its marked weight‐loss effect too.
Clinical trials involving more than 10,000 adults led to its launch in the country in late 2021, and local specialists have hailed its ability to both control blood sugar and reduce body weight, thereby lowering cardiovascular risk, which account for more than a third of total deaths in the country, making Egypt the 15th highest country with coronary heart disease deaths in the world. For many Egyptians with uncontrolled diabetes, Ozempic has represented a breakthrough.
“The results consistently showed greater reductions in both blood sugar and body weight compared with commonly used treatments for type 2 diabetes, as well as cardiovascular benefits, in people with 2 diabetes,” explained Abbas Oraby, Professor of Diabetes and Endocrinology, Zagazig University.
Yet, as its benefits became more widely known, Ozempic’s potent effect on weight loss quickly led to off‐label use. Social media posts and testimonials all across the world have amplified its reputation as a “miracle” weight‐loss aid.
Yasser Ferro, a 29-year-old software engineer and a user of the drug, told Egyptian Streets that he first resorted to the drug after frustration with traditional weight loss approaches.
“I didn’t know how else to lose weight,” he said. “It definitely produces results, but I’m not sure if it will work in the long run. I hope that, with time, my future self can figure that out.”
He also explained that another reason for his hesitation was the drug’s limited accessibility and high cost, which made him feel that he should invest more effort into a traditional diet instead.
“I am also uncertain about potential side effects,” he added.
For others, the appeal of Ozempic is intertwined with decades of struggle.
“Ever since I became a mother, I’ve fought with my weight, both my health and my mental well-being have suffered,” Hoda Borai, a 56-year-old housewife who has battled weight issues since having her two children nearly thirty years ago, said. “I’ve tried countless diets over the years. Ozempic seems like a new hope.”
Weighing the Benefits and the Risks
Ozempic’s approved use for type 2 diabetes is well documented.
It works by mimicking glucagon-like peptide-1 (GLP-1), a hormone that increases insulin secretion and slows stomach emptying, an action that lowers blood glucose levels and contributes to a feeling of fullness.
However, the shift from diabetes management to weight loss has brought its own set of concerns. Clinical studies report that gastrointestinal side effects are common: nausea, vomiting, diarrhea, and constipation affect a significant number of users. Some research has also highlighted rarer, more serious complications, such as pancreatitis and gallbladder issues.
In addition to these medical concerns, economic factors play a role as the drug’s cost remains high for many potential users.
“The price is a major barrier,” noted Ferro. “One pen costs around EGP 5,000 (USD 100), so I have to weigh whether it’s worth the expense when a regular diet might eventually do the trick.”
This sentiment is echoed by healthcare professionals who stress that while Ozempic can yield rapid short-term weight loss, discontinuation often leads to weight regain, underscoring the need for sustained lifestyle changes.
In a 2022 study by the University of Liverpool in the United Kingdom, adults with overweight or obesity who took once‐weekly semaglutide for 68 weeks shed an average of 17.3 percent of their body weight. However, after a year without the medication and accompanying lifestyle support, participants regained roughly two-thirds, leaving them with a net loss of only 5.6 percent from their starting weight. Moreover, the cardiometabolic benefits achieved during treatment, improvements in blood pressure, lipid levels, and HbA1c, deteriorated and drifted back toward pre-treatment levels once the drug was discontinued.
Additional clinical reports highlight that while gastrointestinal side effects such as nausea, vomiting, and diarrhea are common with Ozempic, these symptoms are generally temporary and tend to resolve or diminish after the medication is stopped or the dose is reduced.
The Counterfeit Challenge
The surge in demand for Ozempic has also given rise to a parallel market of counterfeit products in countries, where the drug is not accessible. Criminal networks have exploited the drug’s high price and global popularity, distributing fake pens that may contain the wrong ingredients or incorrect dosages.
Authorities in neighboring countries have flagged the emergence of these illicit products. A Reuters investigation found that fake Ozempic pens in Lebanon have, in some cases, caused severe hypoglycemia, further complicating efforts to ensure patient safety.
In January 2024, the Egyptian Drug Authority (EDA) warned citizens against purchasing Ozempic 1 mg from unlicensed pharmacies, stating that the product in circulation is not issued by the manufacturer, Novo Nordisk Egypt. While no counterfeit batches have been officially detected yet, the authority is actively monitoring the situation regarding Ozempic 1 mg pre-filled pens.
The EDA has urged individuals who suspect a counterfeit product to report it through the authority’s hotline (15301) or official website.
Egyptian healthcare providers stress the importance of comprehensive patient awareness, advising that Ozempic should only be used with a proper prescription and continuous monitoring, especially given the potential for counterfeit products and the uncertainties about long-term outcomes.
“Ozempic is a powerful tool when used appropriately for diabetes management,” said Clinical Nutritionist and Healthcare coach Nermeen Salah. “Its weight-loss benefits are an interesting byproduct, but patients must use it under strict medical supervision. The risks, especially when patients obtain it from unverified sources, are very real.”
