Just 12 months ago, Pakistani father of two Sarosh Sohail was facing an anxious year of ill health caused by obesity as he struggled to shift weight from his 163kg frame.
Plagued with high blood pressure and cholesterol, sleep apnoea and Type 2 diabetes, Mr Sohail was struggling to balance his health with family life and a career in TV production.
But after trying a batch of medications aimed at those with diabetes to help weight loss, he has never looked back and is now an astonishing 72kg lighter.
Mr Sohail now hopes more people with serious weight problems can benefit from changes to the way expensive drugs such as Mounjaro and Ozempic are prescribed.
“I had to fight with my health insurers to get Mounjaro approved because they said it was for cosmetic purposes, rather than health benefits,” said Mr Sohail, who has lived in Dubai for a decade.
“The reality is, it has been life changing. As soon as I started on Mounjaro, my craving for food just stopped. Initially the weight loss was really nice, about eight to 10kg in the first month.
“Then, of course, it reduced to 4kg to 5kg a month. My weight now is between 91kg and 93kg.
“Initially, because I was obese, the insurance covered the cost of medication – but only until October when my weight got down to about 100kg.
“Since then I have had to pay for it myself, which is about Dh1,750 ($476) a month for four injections.”
Health benefits
The heath problems associated with his obesity have all but disappeared, and he is also more patient with his family.
Despite the huge weight loss, Mr Sohail's target is to drop to 85kg.
“My portion sizes have really gone down,” he said.
“I could easily finish two 200g steaks at a time. Now, I can hardly finish one, and have gone from three meals a day to two.
“I used to see food and crave for it. Now I don't feel hungry at all.
“I strongly recommend obesity is considered a disease and that insurance should cover it. It is not a cosmetic thing.”
Dr Sushum Sharma, a lifestyle disorder specialist at Saudi German Hospital, who treated Mr Sohail, said: “Mr Sohail had visited multiple doctors without losing much weight before for various treatments.
“Most of my patients have lost 20kg to 25kg, but somehow this patient had exceptional weight loss.
“He was very careful with his diet and lifestyle and responded very well to the medication.
“Insurance depends on what type it is and will only clear if the patient has diabetes, so he qualified for it to be covered this time.
“If you lose weight, you will have control of your diabetes, but it is a mixed bag on how much weight is lost.”
The drugs, commonly called glucagon-like peptide 1 (GLP-1) agonists, not only improve blood sugar control but can also lead to weight loss.
The medication mimics the action of a hormone called glucagon-like peptide 1.
As someone eats, blood sugars rise so the drug stimulates insulin production to lower those levels, which helps control Type 2 diabetes.
Although not entirely clear how GLP-1 drugs lead to weight loss, doctors do know they curb hunger and slow the movement of food through the body, making you feel full faster, and for longer.
From my perspective, there should be no boundaries to treat patients and I think costs can be a huge boundary for many
Prof Bart van Wagensveld,
bariatric surgeon
The kind of drugs used by Mr Sohail have surged in popularity in recent months.
Semaglutide, under the brand name Wegovy, is registered for weight loss in the UAE, rather than Ozempic, which is registered for Type 2 diabetes, while Tirzepatide is used under the brand name Mounjaro in the UAE. It is prescribed for the treatment of diabetes and obesity.
According to data compiled by Universal Drugstore, an international prescription referral service, between August 22 and July 2023, there were 151,400 searches on Google in the UAE for the drug Ozempic, one of the most popular GLP-1 agonist class of drugs.
Data was collected using Google Keyword planner, to see how many times each term was searched in the UAE.
Similar weight-loss drugs were also sought by people in the Emirates, with 48,000 searches for Metmorfin, 47,200 searches for Saxenda, 20,480 for Tirzepatide and 18,660 for Wegovy.
Profits for Novo Nordisk, the Danish drug manufacturer behind Ozempic and Wegovy, a drug with similar properties, surged by more than 45 per cent to about $5.7 billion (Dh20.9 billion) in the first half of 2023, due to global demand.
Prof Bart van Wagensveld, a bariatric surgeon and obesity expert at the Weight Management Unit at NMC Royal in Khalifa City, said the new drugs have revolutionised the way medics tackle obesity.
“Bariatric surgery is the longest standing treatment, with excellent results and it's a safe treatment,” he said.
“But with the new medication, we now have a new weapon.
“Before the introduction of the GLP1 agonist drugs, medication wasn't effective.
“Now we see very good results that are getting close to those of bariatric surgery.”
Monthly expense
Monthly costs for emaglutide products such as Ozempic are about Dh1,700 a month, or Dh20,000 for a year.
Bariatric surgery typically costs between Dh25,000 and Dh30,000 for a one-off procedure and follow-up care.
The UAE currently ranks fifth in the world, with about 28.4 per cent of the country classed as obese, according to the Worldwide Obesity Index.
Only the Pacific Islands of Nauru, Kiribati and Tuvalu – and Kuwait – have a higher obesity risk score, that also considers physical inactivity, diabetes and the number of people who are overweight.
While GLP-1 drugs do carry side effects, they are usually mild and include gastrointestinal symptoms such as nausea, abdominal discomfort, diarrhoea or constipation.
“There is one contraindication, such as thyroid cancer in the family, otherwise you can use it on a very broad scale,” Dr van Wagensveld said.
“Obesity is a chronic disease that needs lifelong treatment.
“Insurers do not always cover these costs of medication yet, but they should.
“From my perspective, there should be no boundaries to treat patients and I think costs can be a huge boundary for many.”
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What sanctions would be reimposed?
Under ‘snapback’, measures imposed on Iran by the UN Security Council in six resolutions would be restored, including:
- An arms embargo
- A ban on uranium enrichment and reprocessing
- A ban on launches and other activities with ballistic missiles capable of delivering nuclear weapons, as well as ballistic missile technology transfer and technical assistance
- A targeted global asset freeze and travel ban on Iranian individuals and entities
- Authorisation for countries to inspect Iran Air Cargo and Islamic Republic of Iran Shipping Lines cargoes for banned goods
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.”
The Travel Diaries of Albert Einstein The Far East, Palestine, and Spain, 1922 – 1923
Editor Ze’ev Rosenkranz
Princeton
The Florida Project
Director: Sean Baker
Starring: Bria Vinaite, Brooklynn Prince, Willem Dafoe
Four stars
SHOW COURTS ORDER OF PLAY
Centre Court (4pm UAE/12pm GMT)
Victoria Azarenka (BLR) v Heather Watson (GBR)
Rafael Nadal (ESP x4) v Karen Khachanov (RUS x30)
Andy Murray (GBR x1) v Fabio Fognini (ITA x28)
Court 1 (4pm UAE)
Steve Johnson (USA x26) v Marin Cilic (CRO x7)
Johanna Konta (GBR x6) v Maria Sakkari (GRE)
Naomi Osaka (JPN) v Venus Williams (USA x10)
Court 2 (2.30pm UAE)
Aljaz Bedene (GBR) v Gilles Muller (LUX x16)
Peng Shuai (CHN) v Simona Halep (ROM x2)
Jelena Ostapenko (LAT x13) v Camila Giorgi (ITA)
Jo-Wilfried Tsonga (FRA x12) v Sam Querrey (USA x24)
Court 3 (2.30pm UAE)
Kei Nishikori (JPN x9) v Roberto Bautista Agut (ESP x18)
Carina Witthoeft (GER) v Elina Svitolina (UKR x4)
Court 12 (2.30pm UAE)
Dominika Cibulkova (SVK x8) v Ana Konjuh (CRO x27)
Kevin Anderson (RSA) v Ruben Bemelmans (BEL)
Court 18 (2.30pm UAE)
Caroline Garcia (FRA x21) v Madison Brengle (USA)
Benoit Paire (FRA) v Jerzy Janowicz (POL)
Dubai Creek Open in numbers
- The Dubai Creek Open is the 10th tournament on this year's Mena Tour
- It is the first of five events before the season-concluding Mena Tour Championship
- This week's field comprises 120 players, 21 of which are amateurs
- 15 previous Mena Tour winners are competing at Dubai Creek Golf and Yacht Club
The past winners
2009 - Sebastian Vettel (Red Bull)
2010 - Sebastian Vettel (Red Bull)
2011 - Lewis Hamilton (McLaren)
2012 - Kimi Raikkonen (Lotus)
2013 - Sebastian Vettel (Red Bull)
2014 - Lewis Hamilton (Mercedes)
2015 - Nico Rosberg (Mercedes)
2016 - Lewis Hamilton (Mercedes)
2017 - Valtteri Bottas (Mercedes)
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What can victims do?
Always use only regulated platforms
Stop all transactions and communication on suspicion
Save all evidence (screenshots, chat logs, transaction IDs)
Report to local authorities
Warn others to prevent further harm
Courtesy: Crystal Intelligence
Global institutions: BlackRock and KKR
US-based BlackRock is the world's largest asset manager, with $5.98 trillion of assets under management as of the end of last year. The New York firm run by Larry Fink provides investment management services to institutional clients and retail investors including governments, sovereign wealth funds, corporations, banks and charitable foundations around the world, through a variety of investment vehicles.
KKR & Co, or Kohlberg Kravis Roberts, is a global private equity and investment firm with around $195 billion of assets as of the end of last year. The New York-based firm, founded by Henry Kravis and George Roberts, invests in multiple alternative asset classes through direct or fund-to-fund investments with a particular focus on infrastructure, technology, healthcare, real estate and energy.
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Director: Jon M Chu
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Rating: 4/5
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Fatherland
Kele Okereke
(BMG)
Europa League group stage draw
Group A: Villarreal, Maccabi Tel Aviv, Astana, Slavia Prague.
Group B: Dynamo Kiev, Young Boys, Partizan Belgrade, Skenderbeu.
Group C: Sporting Braga, Ludogorets, Hoffenheim, Istanbul Basaksehir.
Group D: AC Milan, Austria Vienna , Rijeka, AEK Athens.
Group E: Lyon, Everton, Atalanta, Apollon Limassol.
Group F: FC Copenhagen, Lokomotiv Moscow, Sheriff Tiraspol, FC Zlin.
Group G: Vitoria Plzen, Steaua Bucarest, Hapoel Beer-Sheva, FC Lugano.
Group H: Arsenal, BATE Borisov, Cologne, Red Star Belgrade.
Group I: Salzburg, Marseille, Vitoria Guimaraes, Konyaspor.
Group J: Athletic Bilbao, Hertha Berlin, Zorya Luhansk, Ostersund.
Group K: Lazio, Nice, Zulte Waregem, Vitesse Arnhem.
Group L: Zenit St Petersburg, Real Sociedad, Rosenborg, Vardar
