Controversial weight loss drugs are flooding the South African market

Ozempic and Ozempic-like weight loss medications are beginning to flood the South African market, capitalising on a social media frenzy, but this success is achieved at the expense of those with type 2 diabetes. 

Danish company Novo Nordisk launched the weight loss drug Wegovy in South Africa this month, a medication with the same active ingredient as Ozempic: Semaglutide.

Ozempic is a glucagon-like peptide-1 (GLP-1) receptor agonist approved only for the treatment of type 2 diabetes in South Africa. 

The launch follows the recent market entry of Mounjaro, another GLP-1 agonist, eight months ago. 

Wegovy is one of the first of these drugs, however, to be approved in South Africa as a weight-loss treatment, second only to Sexenda which was approved in February 2025.

Semaglutide has been shown to effectively cause weight loss, resulting in a social media frenzy on the use of the drug for those purposes.

Professor Marc Blockman, Director of the World Health Organisation Collaborating Centre for Medicines Information at the University of Cape Town, told Newsday that Ozempic and Mounjaro are already commonly used off-label as weight-loss drugs in South Africa.

He expects the addition of Wegovy could start a price war in the GLP-1 agonist market, one that Novo Nordisk, as supplier of Ozempic and Wegovy, is likely to profit from.

The approval of these semaglutide medications for weight loss has led to significant economic success, and an unprecedented demand continues to strain the global supply chain.

According to Mediclinic, the surge in demand for these products, driven by the weight-loss segment, has caused severe stock shortages in South Africa, making it difficult for diabetes patients to access the medication.

Blockman further explained that South Africa has been experiencing shortages of insulin pens, as the injectable pens that diabetics use daily and those used for Ozempic, Mounjaro and Wegovy are the same. 

Manufacturers prefer to fill this device with the lucrative, trending weight loss drugs rather than diabetes medication. 

Diabetes medication supply crisis

This is an ongoing challenge, according to Blockman, who said shortages in insulin pens and Ozempic for diabetics will continue until supply can keep up with increasing demand.

“The market for weight loss has accelerated, and they’re trying to keep up with that,” he explained. 

He added that the problem will be solved only if global production of the insulin/Ozempic pens increases to meet the new demand.

In contrast, last year, Novo Nordisk, the South African Department of Health’s supplier, ceased production of easy-to-use human insulin pens, forcing the government to procure more expensive analogue insulin pens from another corporation.

Following this, the company promised to supply the South African market with more cumbersome analogue pens in June 2025, however, Medecins Sans Frontières Regional Advisor, Candice Sehoma said this is not enough.

“We welcome access to analogue insulin pens as they are the standard of care, but for them to be available for everyone, they must be affordably priced at US$1 – equivalent to 18 Rand – per pen,” she said.

“This is especially considering the cost of production for insulin pens is estimated to be as low as $0.94 per pen, including a profit.”

These types of medications are the first drugs to show significant success in treating obesity. According to the Columbia University Department of Surgery, previous medications for weight loss have yielded minimal results. 

Ozempic, on the other hand, causes an average weight loss of 15 to 20 percent. It has been proven to limit hunger and interest in food as well as control blood glucose levels. But the drug is not without its side effects.

Blockman said that, while all medications can have adverse effects, the increasing popularity of the medication has resulted in people using it without baseline testing.

“There needs to be a strict requirement that, whether using the drug on-label or off-label, there is some level of understanding about the particular patient,” he said. 

Thyroid tumors, including cancerous tumors, are a potential side effect of the medication. 

Additionally, it has been linked to pancreatitis, gallbladder problems, hyperglycemia, kidney failure, and severe stomach problems. 

The most common side effects are nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, upset stomach, dizziness, and feeling bloated.

This, however, has not curbed demand for the product. Due to its popularity and a costly development process, Wegovy, Mounjaro, and Ozempic all cost over $1,000 a month. 

Ozempic is particularly expensive, with a price tag between R2,833.93 and R3,224.99 for one injection, excluding other costs involved, according to Get Tested South Africa. 

These injections need to be administered on a weekly basis. Blockman explained that the patient has to commit to using the injectable indefinitely in order for it to be effective. 

“They work while they are being administered in terms of changing metabolic profiles and the central nervous system,” he said. 

Data suggests that when patients stop taking these medications, they will incrementally put weight back on. 

“It’s a lifelong commitment to its use. Which is why it’s so expensive.”

Newsday contacted Novo Nordisk for comment, but did not get a response by time of publication. Comments will be added if received.