In January 2023, the world was abuzz with stories of a revolutionary weight-loss drug – a simple, self-administered injection that promised to transform the lives of those struggling with obesity. The click-baity headlines surrounding Ozempic, including “the skinny jab” and “Hollywood's best-kept secret”, came thick and fast.
For many, it seemed too good to be true, but for Dubai resident Sarah Nicole Rice, the rise of Ozempic and its counterpart Mounjaro was the start of a transformation she never thought possible. “Mounjaro was an absolute game-changer for my life,” she tells The National.
“My weight dropped steadily, and I've lost 25 per cent of my body weight since I started my journey two years ago. I struggled for years with every diet, every exercise, every calorie counted. You name it and I've tried it all.”
Rice is only one of millions of people who have turned to GLP-1 receptor agonists, a class of drugs that includes semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro), to not only shed kilos, but also redefine their relationship with food, health and self-worth.
Now my brain knows better when to stop eating
Sarah Nicole Rice
What began as a promising treatment for diabetes, has seemingly become a doctor-prescribed cornerstone in the battle against global obesity.
At the heart of these drugs lies glucagon-like peptide-1 (GLP-1), a hormone that is secreted in the intestines after eating, and has several functions, such as enhancing insulin secretion, slowing gastric emptying and increasing feelings of fullness by sending signals to the brain.
For Rice, the biggest effect of taking Mounjaro was “turning off the food noise and the constant chatter of what to eat”.
“It keeps me at bay when it come to eating. It's like now my brain knows better when I don't want any food and when to stop eating. There are still times when I have cravings, but I'd only want to have a tiny bit of it because I'm not really hungry.”
The science behind the hype
Large-scale clinical studies have produced compelling results, too. Early research published in The New England of Journal of Medicine in 2021 found that participants using semaglutide lost, on average, 15 per cent of their body weight over 68 weeks, which is a little more than a year.
For context, most conventional weight-loss interventions, including intensive lifestyle changes, yield average losses of five to 10 per cent.
The numbers were so compelling that in the same year, the US Food and Drug Administration approved Wegovy specifically for chronic weight management, with similar approvals following in other regions.
A more recent study by Eli Lilly and Company, the producer of Mounjaro, showed that tirzepatide demonstrated a sustained average weight loss of 22.9 per cent through a three-year treatment period.
There's been growing interest in exploring the broader effects of GLP-1 drugs beyond their use in diabetes and weight loss, too. In December, the FDA approved Zepbound (which has tirzepatide) as a treatment for moderate to severe obstructive sleep apnoea following successful clinical trials.
An integrated approach with balanced nutrition, physical activity and stress management transforms short-term success into long-term health
Dr Karima Arroud,
Wellth, Aster DM Healthcare
Another Dubai resident, Ananda Shakespeare, says she has lost about 30kg in the past 12 months that she's been on Mounjaro, with manageable side effects of nausea and occasional feelings of tiredness. Another resident, who didn't want to be named, says the drug has helped ease her struggle with polycystic ovary syndrome, and she took it based on her gynaecologist's prescription.
While the promise of these medications becomes clearer with time, the spotlight remains on their profound ability to treat obesity, a public health challenge that has long been viewed through a lens of personal responsibility, but is now understood as a complex condition.
The dangers of irresponsible use of GLP-1 drugs
While GLP-1 drugs have changed some lives for the better, their rapid rise in popularity has also exposed troubling trends in how they are prescribed. Some doctors, eager to meet patient demand, or capitalise on the buzz, now dole out these medications with minimal oversight. Some pharmacies, too, readily sell GLP-1 drugs over the counter with no doctor's prescription required.
“The problem we see in the market right now is that some people who are being prescribed these drugs have a simple goal of losing weight. While this is a primary biomarker, it can't be the only one,” says Dr Ihsan Almarzooqi, co-founder of diabetes centre GluCare in Dubai.
Potential side effects can include: nausea, diarrhoea or constipation, feeling weak or tired and vomiting. Less common but more severe effects include pancreatitis and bowel obstruction.
Lean muscle mass loss, too, has been associated with the use of GLP-1, for example, and the Dubai doctor says it's crucial to understand weight loss beyond the scales. “The average lean muscle loss on a patient being prescribed GLP-1 without lifestyle modifications can go up to 35 per cent – meaning this much of their weight loss is coming from muscle instead of fat, which can be dangerous,” he notes.
Dr Almarzooqi explains how it's important for people to seek continuous guidance when on such medications. “Doing it under no supervision or with a doctor who has no experience with it can cause quite dramatic loss in muscle, which you will find extremely difficult to regain if you're not doing the lifestyle changes in tandem.”
The irresponsible prescription and use of GLP-1 drugs not only undermines their intended purpose, but also raises concerns on shortages for the patients who rely on them.
Dubai resident Renil Cheriyan Thomas says: “There are many people who need it to keep their diabetes under control, but fail to procure a dose because they were being stockpiled by others for weight loss. There were times I had to wait up to a month to get it."
For Thomas, using GLP-1 was never about its weight-loss promise, given his latent autoimmune diabetes in adults diagnosis. In addition to insulin medication, Thomas was prescribed Mounjaro to manage his blood sugar – and he has found greater success with the combination.
The burning question: Is GLP-1 weight loss sustainable?
People using GLP-1 drugs for weight loss often transition off the medication at some point. In the US, only one in four who were prescribed Wegovy or Ozempic for weight loss were still taking them two years later, according to a Reuters report citing wide-scale analysis of pharmacy claims in the country.
The first time I was on Mounjaro, I mistakenly dropped the drug from a high dose to nothing ... but the curve is important
Ali Hashemi,
co-founder, GluCare
While details on why patients quit aren't immediately clear (some say the onerous side effects, others the cost), Almarzooqi says it's crucial to ensure the weight loss, along with other supposed results, are sustained with long-term lifestyle changes. At GluCare, patients prescribed GLP-1 drugs are enrolled in a months-long programme that includes unlimited consultations and regular body composition analysis.
Almarzooqi says this allows them to increase compliance among patients, as well as guide them in monitoring other health markers such as muscle mass retention, liver function and cholesterol levels to deliver holistic care.
“The compliance rate is generally high, at over 80 per cent, with this data-driven approach,” he says. More often than not, people who self-medicate are likely to reverse the positive results of GLP-1 drug use.
Ali Hashemi, the co-founder of GluCare and one of the early patients of his own clinic, says he learnt this the hard way. “ The danger is people are seeing these injections as like a magic needle. It's simply not that. You still have to do the hard work, as I learnt. The first time I was on Mounjaro, I got off it too quickly after hitting my goals – which means I just mistakenly dropped the drug from a high dose to nothing,” he says.
“We hadn't learnt yet at the time that the curve is important,” Hashemi adds, explaining how “the risk and rewards of these drugs change based on how long you can keep the effect. If you regain the weight after, then you've gained nothing.”
At Wellth, the integrative medicine spin-off of Aster DM Healthcare, Dr Karima Arroud emphasises that lifestyle changes "remain foundational" when it comes to weight management, and that weight loss drugs are just “tools to enhance sustainable health strategies, and are not stand-alone solutions”.
“Sustainable results depend on integrating balanced nutrition, physical activity and stress management,” she explains. “I counsel patients on adopting anti-inflammatory diets, engaging in enjoyable and consistent physical activity, and addressing psycho-social factors. This integrated approach transforms short-term success into long-term health.”
The future of GLP-1 drugs
The GLP-1 revolution seems only to have begun, with researchers and manufacturers exploring new formulations, including oral versions and combination therapies that promise even greater efficacy. There are other important questions too, such as how these drugs can be made more affordable on a global scale.
Hashemi posits that cost could be one of the biggest deterrents against the use of GLP-1 drugs. Presently in the UAE, medical insurance companies don't cover such prescriptions for weight loss, and a dose can cost up to Dh2,000 a month.
“Maybe competition will bring down the cost soon, but we don't know that for sure. What we know is that it helps in many ways, and if doctors follow the evidence and couple it with responsible prescription and supervision, it can really be a game-changer.”
At the end of the day, the real impact of GLP-1 medications isn’t just measured in clinical trials or lofty promises of future breakthroughs. Two years into her GLP-1 journey, Rice doesn't see herself discontinuing the drug anytime soon.
“My transformation so far has given me so much confidence in things like applying for a job, for example. I used to feel that people were just judging me wrongly because I was overweight, and I never want to be in that position again.”
Get Out
Director: Jordan Peele
Stars: Daniel Kaluuya, Allison Williams, Catherine Keener, Bradley Whitford
Four stars
Our legal consultants
Name: Hassan Mohsen Elhais
Position: legal consultant with Al Rowaad Advocates and Legal Consultants.
Muslim Council of Elders condemns terrorism on religious sites
The Muslim Council of Elders has strongly condemned the criminal attacks on religious sites in Britain.
It firmly rejected “acts of terrorism, which constitute a flagrant violation of the sanctity of houses of worship”.
“Attacking places of worship is a form of terrorism and extremism that threatens peace and stability within societies,” it said.
The council also warned against the rise of hate speech, racism, extremism and Islamophobia. It urged the international community to join efforts to promote tolerance and peaceful coexistence.
The bio:
Favourite film:
Declan: It was The Commitments but now it’s Bohemian Rhapsody.
Heidi: The Long Kiss Goodnight.
Favourite holiday destination:
Declan: Las Vegas but I also love getting home to Ireland and seeing everyone back home.
Heidi: Australia but my dream destination would be to go to Cuba.
Favourite pastime:
Declan: I love brunching and socializing. Just basically having the craic.
Heidi: Paddleboarding and swimming.
Personal motto:
Declan: Take chances.
Heidi: Live, love, laugh and have no regrets.
Fixtures:
Thursday:
Hatta v Al Jazira, 4.55pm
Al Wasl v Dibba, 7.45pm
Friday:
Al Dhafra v Al Nasr, 5.05pm
Shabab Al Ahli Dubai v Al Wahda, 7.45pm
Saturday:
Ajman v Emirates, 4.55pm
Al Ain v Sharjah, 7.45pm
Teenage%20Mutant%20Ninja%20Turtles%3A%20Shredder's%20Revenge
%3Cp%3E%3Cstrong%3EDeveloper%3A%20%3C%2Fstrong%3ETribute%20Games%3Cbr%3E%3Cstrong%3EPublisher%3A%3C%2Fstrong%3E%20Dotemu%3Cbr%3E%3Cstrong%3EConsoles%3A%20%3C%2Fstrong%3ENintendo%20Switch%2C%20PlayStation%204%26amp%3B5%2C%20PC%20and%20Xbox%20One%3Cbr%3E%3Cstrong%3ERating%3A%3C%2Fstrong%3E%204%2F5%3C%2Fp%3E%0A
LA LIGA FIXTURES
Friday Celta Vigo v Villarreal (midnight kick-off UAE)
Saturday Sevilla v Real Sociedad (4pm), Atletico Madrid v Athletic Bilbao (7.15pm), Granada v Barcelona (9.30pm), Osasuna v Real Madrid (midnight)
Sunday Levante v Eibar (4pm), Cadiz v Alaves (7.15pm), Elche v Getafe (9.30pm), Real Valladolid v Valencia (midnight)
Monday Huesca v Real Betis (midnight)
The Settlers
Director: Louis Theroux
Starring: Daniella Weiss, Ari Abramowitz
Rating: 5/5
The Kites
Romain Gary
Penguin Modern Classics
Where can I submit a sample?
Volunteers can now submit DNA samples at a number of centres across Abu Dhabi. The programme is open to all ages.
Collection centres in Abu Dhabi include:
- Abu Dhabi National Exhibition Centre (ADNEC)
- Biogenix Labs in Masdar City
- Al Towayya in Al Ain
- NMC Royal Hospital in Khalifa City
- Bareen International Hospital
- NMC Specialty Hospital, Al Ain
- NMC Royal Medical Centre - Abu Dhabi
- NMC Royal Women’s Hospital.
MANDOOB
%3Cp%3EDirector%3A%20Ali%20Kalthami%3C%2Fp%3E%0A%3Cp%3EStarring%3A%20Mohammed%20Dokhei%2C%20Sarah%20Taibah%2C%20Hajar%20Alshammari%3C%2Fp%3E%0A%3Cp%3ERating%3A%204%2F5%3C%2Fp%3E%0A%3Cp%3E%3C%2Fp%3E%0A
Types of policy
Term life insurance: this is the cheapest and most-popular form of life cover. You pay a regular monthly premium for a pre-agreed period, typically anything between five and 25 years, or possibly longer. If you die within that time, the policy will pay a cash lump sum, which is typically tax-free even outside the UAE. If you die after the policy ends, you do not get anything in return. There is no cash-in value at any time. Once you stop paying premiums, cover stops.
Whole-of-life insurance: as its name suggests, this type of life cover is designed to run for the rest of your life. You pay regular monthly premiums and in return, get a guaranteed cash lump sum whenever you die. As a result, premiums are typically much higher than one term life insurance, although they do not usually increase with age. In some cases, you have to keep up premiums for as long as you live, although there may be a cut-off period, say, at age 80 but it can go as high as 95. There are penalties if you don’t last the course and you may get a lot less than you paid in.
Critical illness cover: this pays a cash lump sum if you suffer from a serious illness such as cancer, heart disease or stroke. Some policies cover as many as 50 different illnesses, although cancer triggers by far the most claims. The payout is designed to cover major financial responsibilities such as a mortgage or children’s education fees if you fall ill and are unable to work. It is cost effective to combine it with life insurance, with the policy paying out once if you either die or suffer a serious illness.
Income protection: this pays a replacement income if you fall ill and are unable to continue working. On the best policies, this will continue either until you recover, or reach retirement age. Unlike critical illness cover, policies will typically pay out for stress and musculoskeletal problems such as back trouble.
Sustainable Development Goals
1. End poverty in all its forms everywhere
2. End hunger, achieve food security and improved nutrition and promote sustainable agriculture
3. Ensure healthy lives and promote well-being for all at all ages
4. Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all
5. Achieve gender equality and empower all women and girls
6. Ensure availability and sustainable management of water and sanitation for all
7. Ensure access to affordable, reliable, sustainable and modern energy for all
8. Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all
9. Build resilient infrastructure, promote inclusive and sustainable industrialisation and foster innovation
10. Reduce inequality within and among countries
11. Make cities and human settlements inclusive, safe, resilient and sustainable
12. Ensure sustainable consumption and production patterns
13. Take urgent action to combat climate change and its effects
14. Conserve and sustainably use the oceans, seas and marine resources for sustainable development
15. Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss
16. Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels
17. Strengthen the means of implementation and revitalise the global partnership for sustainable development
Rocketman
Director: Dexter Fletcher
Starring: Taron Egerton, Richard Madden, Jamie Bell
Rating: 3 out of 5 stars
WHAT%20IS%20THE%20LICENSING%20PROCESS%20FOR%20VARA%3F
%3Cp%3EVara%20will%20cater%20to%20three%20categories%20of%20companies%20in%20Dubai%20(except%20the%20DIFC)%3A%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3ECategory%20A%3A%3C%2Fstrong%3E%20Minimum%20viable%20product%20(MVP)%20applicants%20that%20are%20currently%20in%20the%20process%20of%20securing%20an%20MVP%20licence%3A%20This%20is%20a%20three-stage%20process%20starting%20with%20%5B1%5D%20a%20provisional%20permit%2C%20graduating%20to%20%5B2%5D%20preparatory%20licence%20and%20concluding%20with%20%5B3%5D%20operational%20licence.%20Applicants%20that%20are%20already%20in%20the%20MVP%20process%20will%20be%20advised%20by%20Vara%20to%20either%20continue%20within%20the%20MVP%20framework%20or%20be%20transitioned%20to%20the%20full%20market%20product%20licensing%20process.%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3ECategory%20B%3A%3C%2Fstrong%3E%20Existing%20legacy%20virtual%20asset%20service%20providers%20prior%20to%20February%207%2C%202023%2C%20which%20are%20required%20to%20come%20under%20Vara%20supervision.%20All%20operating%20service%20proviers%20in%20Dubai%20(excluding%20the%20DIFC)%20fall%20under%20Vara%E2%80%99s%20supervision.%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3ECategory%20C%3A%3C%2Fstrong%3E%20New%20applicants%20seeking%20a%20Vara%20licence%20or%20existing%20applicants%20adding%20new%20activities.%20All%20applicants%20that%20do%20not%20fall%20under%20Category%20A%20or%20B%20can%20begin%20the%20application%20process%20through%20their%20current%20or%20prospective%20commercial%20licensor%20%E2%80%94%20the%20DET%20or%20Free%20Zone%20Authority%20%E2%80%94%20or%20directly%20through%20Vara%20in%20the%20instance%20that%20they%20have%20yet%20to%20determine%20the%20commercial%20operating%20zone%20in%20Dubai.%C2%A0%3C%2Fp%3E%0A
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
German intelligence warnings
- 2002: "Hezbollah supporters feared becoming a target of security services because of the effects of [9/11] ... discussions on Hezbollah policy moved from mosques into smaller circles in private homes." Supporters in Germany: 800
- 2013: "Financial and logistical support from Germany for Hezbollah in Lebanon supports the armed struggle against Israel ... Hezbollah supporters in Germany hold back from actions that would gain publicity." Supporters in Germany: 950
- 2023: "It must be reckoned with that Hezbollah will continue to plan terrorist actions outside the Middle East against Israel or Israeli interests." Supporters in Germany: 1,250
Source: Federal Office for the Protection of the Constitution
Ashes 2019 schedule
August 1-5: First Test, Edgbaston
August 14-18: Second Test, Lord's
August 22-26: Third Test, Headingley
September 4-8: Fourth Test, Old Trafford
September 12-16: Fifth Test, Oval
