The centuries-long search for a miracle weight loss remedy appears to be over. Ozempic, Mounjaro and the other wonder drugs have burst onto the scene and captured the public imagination – especially on social media – by promising an easier route to a slimmer waist than the latest TikTok workout challenge. But widespread awareness and online —misinformation present dangers to patients and public health, which is proving to be a huge challenge for health professionals everywhere.
GLP-1 drugs were designed to help people with type 2 diabetes reduce their blood sugar levels by mimicking the actions of the naturally occurring GLP-1 hormone. The same hormone also slows digestion and triggers the brain to make you feel fuller after eating. Researchers soon realised that GLP-1 drugs were causing diabetic patients to lose weight – and fast. By chance, a blockbuster weight-loss medication was born.
Broadly speaking, in the Gulf, GLP-1s are prescription-only medications restricted to diabetics whose obesity is an aggravating factor for their condition. But there is evidence to suggest that some clinicians in the region are following a global trend in being overly generous with their interpretation of prescribing guidelines. There is also evidence that some pharmacists have not played by the rules at all: in November 2021, Bahrain’s medicines regulator issued a severe rebuke to pharmacists who were dispensing GLP-1s to patients who did not have prescriptions.
GLP-1s can cost between $1,000 and $2,000 per month of treatment, so only the wealthiest among us could seek to secure genuine drugs without a prescription. Unfortunately, those of lesser means might be tempted to turn to the black market in the form of an unregulated online shop, or a social media influencer peddling cheap fakes as the real deal.
Rich or poor, patients who seek to buy genuine GLP-1 drugs without a prescription or a proper treatment plan are taking a huge risk. Emergency rooms in the Gulf are reportedly seeing rising numbers of patients suffering from complications after self-administering genuine GLP-1 drugs. Indeed, this is a problem in many parts of the world. In November last year, a genuine GLP-1 drug was listed as a contributing factor in the death of a 58-year-old nurse in the UK, who had taken only two low-dose injections.
Meanwhile, the World Health Organisation has warned that social media platforms and other unregulated outlets are selling fake GLP-1 drugs that could be toxic. A woman who bought an unlicensed version of Ozempic from an Instagram influencer said she fell seriously ill and vomited blood.
There is also a broader public health concern: unregulated or lax distribution of GLP-1s means that researchers cannot collect the data they need to assess their long-term effects on weight loss patients, nor their affect on Gulf populations specifically. I am not aware of any large-scale research project of this kind in the region; indeed, we have no idea how many people in the Gulf are using GLP-1s for weight loss. In the same way that some people are genetically inclined to become obese, some may be genetically inclined to react badly to a particular medication — even one that has a strong safety record to date.
There is evidence to suggest that some clinicians in the region are following a global trend in being overly generous with their interpretation of prescribing guidelines
This is not to say that GLP-1 drugs are “bad”. It is fair to class them as wonder drugs because they are effective at reducing the appetites of overweight patients if used in tandem with diet and exercise programmes. Research supports this, and I have seen it with my own eyes in my own hospital.
Nor is it to say that GLP-1 drugs should not be used for weight-loss purposes. If safety research supports their widespread use in Gulf populations, they could be key to helping us fight the obesity epidemic in the region.
More than half of adults in GCC nations are overweight or obese. Tackling obesity is central to health policy across the region, because less obesity means people live longer and enjoy a better quality of life. It also means that pressure is relieved on health systems struggling under the enormous burden of treating the many complications caused by obesity. Reducing the number of overweight people in the GCC by 5 per cent over the next five years would save 50,000 lives and $100 billion in the subsequent decade, according to one estimate.
In my hospital in Saudi Arabia, we are seeing demand from overweight patients who want to be treated with GLP-1 drugs. Presently, we do prescribe GLP-1s but only for diabetic patients. It is a worry of mine that patients who want to use GLP-1 drugs but are not prescribed them may seek to obtain them from alternative or unregulated sources, including the black market.
Medicines regulators across the Gulf are co-ordinating efforts to regulate the distribution of GLP-1 drugs and prevent illegal sales. The region’s healthcare leaders and insurance companies are introducing guidelines to manage the prescribing and distribution of GLP-1s to ensure exercise and diet management are central to therapy. However, hospitals, primary care physicians and other healthcare providers that prescribe GLP-1s need to collaborate and collect the data that is desperately needed for crucial research.
We need to know who is taking GLP-1s, what effect their treatment has on their weight, and whether they suffer side-effects – and we need to collect this data on a regional scale. If research addresses questions about the long-term safety of GLP-1 drugs and their effects on Gulf populations, healthcare providers across the region would be able to relax prescribing guidelines to treat a wider group of patients. They would also be better positioned to subsidise these expensive medicines, ensuring treatment is available to patients of lesser means but greater need.
As patents expire on GLP-1 drugs in the coming decade, generics manufacturers will release affordable copies, cutting the cost of the drugs to patients, healthcare providers and governments alike. In other words, millions more people in the Gulf will be able to access GLP-1s in the not-too-distant future. And doctors may soon be prescribing GLP-1s for more than just diabetes and obesity: clinical trials suggest GLP-1s are effective at preventing chronic kidney disease and treating sleep apnoea, a breathing disorder. Meanwhile, tests are under way to see if GLP-1s can be used to treat Alzheimer’s disease, addiction, substance abuse, long-term infections and liver disease.
GLP-1 drugs are not just a medical sensation but a cultural phenomenon, and demand for them will only continue to rise – as will the risk to public health if access to them is not adequately restricted and data is not collected for essential research.
Quick facts on cancer
- Cancer is the second-leading cause of death worldwide, after cardiovascular diseases
- About one in five men and one in six women will develop cancer in their lifetime
- By 2040, global cancer cases are on track to reach 30 million
- 70 per cent of cancer deaths occur in low and middle-income countries
- This rate is expected to increase to 75 per cent by 2030
- At least one third of common cancers are preventable
- Genetic mutations play a role in 5 per cent to 10 per cent of cancers
- Up to 3.7 million lives could be saved annually by implementing the right health
strategies
- The total annual economic cost of cancer is $1.16 trillion
Groom and Two Brides
Director: Elie Semaan
Starring: Abdullah Boushehri, Laila Abdallah, Lulwa Almulla
Rating: 3/5
Skoda Superb Specs
Engine: 2-litre TSI petrol
Power: 190hp
Torque: 320Nm
Price: From Dh147,000
Available: Now
Dust and sand storms compared
Sand storm
- Particle size: Larger, heavier sand grains
- Visibility: Often dramatic with thick "walls" of sand
- Duration: Short-lived, typically localised
- Travel distance: Limited
- Source: Open desert areas with strong winds
Dust storm
- Particle size: Much finer, lightweight particles
- Visibility: Hazy skies but less intense
- Duration: Can linger for days
- Travel distance: Long-range, up to thousands of kilometres
- Source: Can be carried from distant regions
UK’s AI plan
- AI ambassadors such as MIT economist Simon Johnson, Monzo cofounder Tom Blomfield and Google DeepMind’s Raia Hadsell
- £10bn AI growth zone in South Wales to create 5,000 jobs
- £100m of government support for startups building AI hardware products
- £250m to train new AI models
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.”
From Zero
Artist: Linkin Park
Label: Warner Records
Number of tracks: 11
Rating: 4/5
Citadel: Honey Bunny first episode
Directors: Raj & DK
Stars: Varun Dhawan, Samantha Ruth Prabhu, Kashvi Majmundar, Kay Kay Menon
Rating: 4/5
2.0
Director: S Shankar
Producer: Lyca Productions; presented by Dharma Films
Cast: Rajnikanth, Akshay Kumar, Amy Jackson, Sudhanshu Pandey
Rating: 3.5/5 stars
Other workplace saving schemes
- The UAE government announced a retirement savings plan for private and free zone sector employees in 2023.
- Dubai’s savings retirement scheme for foreign employees working in the emirate’s government and public sector came into effect in 2022.
- National Bonds unveiled a Golden Pension Scheme in 2022 to help private-sector foreign employees with their financial planning.
- In April 2021, Hayah Insurance unveiled a workplace savings plan to help UAE employees save for their retirement.
- Lunate, an Abu Dhabi-based investment manager, has launched a fund that will allow UAE private companies to offer employees investment returns on end-of-service benefits.
Dirham Stretcher tips for having a baby in the UAE
Selma Abdelhamid, the group's moderator, offers her guide to guide the cost of having a young family:
• Buy second hand stuff
They grow so fast. Don't get a second hand car seat though, unless you 100 per cent know it's not expired and hasn't been in an accident.
• Get a health card and vaccinate your child for free at government health centres
Ms Ma says she discovered this after spending thousands on vaccinations at private clinics.
• Join mum and baby coffee mornings provided by clinics, babysitting companies or nurseries.
Before joining baby classes ask for a free trial session. This way you will know if it's for you or not. You'll be surprised how great some classes are and how bad others are.
• Once baby is ready for solids, cook at home
Take the food with you in reusable pouches or jars. You'll save a fortune and you'll know exactly what you're feeding your child.
The biog
Simon Nadim has completed 7,000 dives.
The hardest dive in the UAE is the German U-boat 110m down off the Fujairah coast.
As a child, he loved the documentaries of Jacques Cousteau
He also led a team that discovered the long-lost portion of the Ines oil tanker.
If you are interested in diving, he runs the XR Hub Dive Centre in Fujairah
COMPANY PROFILE
Name: Xpanceo
Started: 2018
Founders: Roman Axelrod, Valentyn Volkov
Based: Dubai, UAE
Industry: Smart contact lenses, augmented/virtual reality
Funding: $40 million
Investor: Opportunity Venture (Asia)
BMW M5 specs
Engine: 4.4-litre twin-turbo V-8 petrol enging with additional electric motor
Power: 727hp
Torque: 1,000Nm
Transmission: 8-speed auto
Fuel consumption: 10.6L/100km
On sale: Now
Price: From Dh650,000
Company%20profile
%3Cp%3EName%3A%20Tabby%3Cbr%3EFounded%3A%20August%202019%3B%20platform%20went%20live%20in%20February%202020%3Cbr%3EFounder%2FCEO%3A%20Hosam%20Arab%2C%20co-founder%3A%20Daniil%20Barkalov%3Cbr%3EBased%3A%20Dubai%2C%20UAE%3Cbr%3ESector%3A%20Payments%3Cbr%3ESize%3A%2040-50%20employees%3Cbr%3EStage%3A%20Series%20A%3Cbr%3EInvestors%3A%20Arbor%20Ventures%2C%20Mubadala%20Capital%2C%20Wamda%20Capital%2C%20STV%2C%20Raed%20Ventures%2C%20Global%20Founders%20Capital%2C%20JIMCO%2C%20Global%20Ventures%2C%20Venture%20Souq%2C%20Outliers%20VC%2C%20MSA%20Capital%2C%20HOF%20and%20AB%20Accelerator.%3Cbr%3E%3C%2Fp%3E%0A
The%20US%20Congress%20explained
%3Cp%3E-%20Congress%20is%20one%20of%20three%20branches%20of%20the%20US%20government%2C%20and%20the%20one%20that%20creates%20the%20nation's%20federal%20laws%3C%2Fp%3E%0A%3Cp%3E-%20Congress%20is%20divided%20into%20two%20chambers%3A%20The%20House%20of%20Representatives%20and%20the%20Senate%3C%2Fp%3E%0A%3Cp%3E-%C2%A0The%20House%20is%20made%20up%20of%20435%20members%20based%20on%20a%20state's%20population.%20House%20members%20are%20up%20for%20election%20every%20two%20years%3C%2Fp%3E%0A%3Cp%3E-%20A%20bill%20must%20be%20approved%20by%20both%20the%20House%20and%20Senate%20before%20it%20goes%20to%20the%20president's%20desk%20for%20signature%3C%2Fp%3E%0A%3Cp%3E-%20A%20political%20party%20needs%20218%20seats%20to%20be%20in%20control%20of%20the%20House%20of%20Representatives%3C%2Fp%3E%0A%3Cp%3E-%20The%20Senate%20is%20comprised%20of%20100%20members%2C%20with%20each%20state%20receiving%20two%20senators.%20Senate%20members%20serve%20six-year%20terms%3C%2Fp%3E%0A%3Cp%3E-%20A%20political%20party%20needs%2051%20seats%20to%20control%20the%20Senate.%20In%20the%20case%20of%20a%2050-50%20tie%2C%20the%20party%20of%20the%20president%20controls%20the%20Senate%3C%2Fp%3E%0A
ULTRA PROCESSED FOODS
- Carbonated drinks, sweet or savoury packaged snacks, confectionery, mass-produced packaged breads and buns
- Margarines and spreads; cookies, biscuits, pastries, cakes, and cake mixes, breakfast cereals, cereal and energy bars
- Energy drinks, milk drinks, fruit yoghurts and fruit drinks, cocoa drinks, meat and chicken extracts and instant sauces
- Infant formulas and follow-on milks, health and slimming products such as powdered or fortified meal and dish substitutes
- Many ready-to-heat products including pre-prepared pies and pasta and pizza dishes, poultry and fish nuggets and sticks, sausages, burgers, hot dogs, and other reconstituted meat products, powdered and packaged instant soups, noodles and desserts
Slow loris biog
From: Lonely Loris is a Sunda slow loris, one of nine species of the animal native to Indonesia, Malaysia, Thailand and Singapore
Status: Critically endangered, and listed as vulnerable on the International Union for Conservation of Nature red list due to growing demand in the global exotic pet trade. It is one of the most popular primate species found at Indonesian pet markets
Likes: Sleeping, which they do for up to 18 hours a day. When they are awake, they like to eat fruit, insects, small birds and reptiles and some types of vegetation
Dislikes: Sunlight. Being a nocturnal animal, the slow loris wakes around sunset and is active throughout the night
Superpowers: His dangerous elbows. The slow loris’s doe eyes may make it look cute, but it is also deadly. The only known venomous primate, it hisses and clasps its paws and can produce a venom from its elbow that can cause anaphylactic shock and even death in humans
UAE Premiership
Results
Dubai Exiles 24-28 Jebel Ali Dragons
Abu Dhabi Harlequins 43-27 Dubai Hurricanes
Fixture
Friday, March 29, Abu Dhabi Harlequins v Jebel Ali Dragons, The Sevens, Dubai
Things Heard & Seen
Directed by: Shari Springer Berman, Robert Pulcini
Starring: Amanda Seyfried, James Norton
2/5
Match info
Huddersfield Town 0
Chelsea 3
Kante (34'), Jorginho (45' pen), Pedro (80')
Last-16
France 4
Griezmann (13' pen), Pavard (57'), Mbappe (64', 68')
Argentina 3
Di Maria (41'), Mercado (48'), Aguero (90 3')
Profile
Name: Carzaty
Founders: Marwan Chaar and Hassan Jaffar
Launched: 2017
Employees: 22
Based: Dubai and Muscat
Sector: Automobile retail
Funding to date: $5.5 million
Fight card
Bantamweight
Siyovush Gulmamadov (TJK) v Rey Nacionales (PHI)
Lightweight
Alexandru Chitoran (ROM) v Hussein Fakhir Abed (SYR)
Catch 74kg
Tohir Zhuraev (TJK) v Omar Hussein (JOR)
Strawweight (Female)
Weronika Zygmunt (POL) v Seo Ye-dam (KOR)
Featherweight
Kaan Ofli (TUR) v Walid Laidi (ALG)
Lightweight
Leandro Martins (BRA) v Abdulla Al Bousheiri (KUW)
Welterweight
Ahmad Labban (LEB) v Sofiane Benchohra (ALG)
Bantamweight
Jaures Dea (CAM) v Nawras Abzakh (JOR)
Lightweight
Mohammed Yahya (UAE) v Glen Ranillo (PHI)
Lightweight
Alan Omer (GER) v Aidan Aguilera (AUS)
Welterweight
Mounir Lazzez (TUN) Sasha Palatnikov (HKG)
Featherweight title bout
Romando Dy (PHI) v Lee Do-gyeom (KOR)
Springsteen: Deliver Me from Nowhere
Director: Scott Cooper
Starring: Jeremy Allen White, Odessa Young, Jeremy Strong
Rating: 4/5
