Weight loss drugs should not be used to help reduce hunger cravings during Ramadan, doctors have warned.
Injectable medicines such as Wegovy and Mounjaro have surged in use across UAE hospitals as health authorities seek to tackle obesity and related health conditions such as cardiovascular disease and hypertension.
However, the drugs have also been taken off label, without prescriptions, to help people fast during Ramadan, as the powerful medications reduce appetite and hunger pangs.
Without medical supervision, they can exacerbate common side effects such as severe nausea and dehydration.
“It's safe to take GLP-1 during Ramadan, but we don’t usually start them on new patients during the fasting time,” said Dr Aswin Pankajakshan, consultant endocrinologist at Fakeeh University Hospital, Dubai.
“It's not a time to increase the dose either. If someone is steady on a dose, Ramadan is not the time to increase it.
“Common side effects are seen in 10 to 20 per cent of patients, vomiting and diarrhoea, both are dangerous if the patient is fasting.
“Dehydration can come in, and that's a problem already with fasting, so that's an issue.”
Hormone replicants
The medicines work by mimicking a natural hormone that regulates appetite, blood sugar and digestion.
By binding to GLP-1 receptors, they boost insulin release, reduce glucose production by the liver, slow gastric emptying and suppress hunger signals in the brain.
“Patients are now more aware of the importance of those medications and what they can do to their body,” said Dr Noor Naji, a consultant in obesity medicine at Burjeel Medical City, in Abu Dhabi.
“There is a huge difference between now and two years ago when those medications and the newer GLP-1 drugs were coming to this country for the first time.
“About 50 per cent of patients were taking the medication to help them fast, or for a week or two because they had a wedding and wanted to fit into a dress, have a holiday or were about to travel.
“Most of the patients who went through that phase took the drugs without prescription. They ended up having major side effects or even being admitted to the hospital for non-stop vomiting, diarrhoea or dehydration and fatigue.
“Since then, the number of people on GLP-1 drugs for this reason has come down to just 10 per cent of that medicated population.”
What advice is available?
This group of weight-loss medications has been among the most significant healthcare advances since cholesterol-lowering statins became widely used in the 1990s.
Doctors say that while understanding of their benefits and risks has improved, anyone considering starting GLP-1 treatment should wait until after Ramadan to avoid complications.
Dr Pankajakshan said clinicians were currently prescribing the drugs to five or six new patients each day. With obesity now widely classified as a chronic disease, many patients require long-term treatment to prevent regaining weight after stopping medication.
General advice for those fasting during Ramadan includes avoiding salty, fatty and sugar-laden foods and drinks.
Dr Adel Ahmad Elnaggar, a consultant in obesity management and endocrinology at Medcare Hospital, said people who need weight-loss treatment but are not yet on medication should wait until after the holy month.
“The advice is to start at least two months before Ramadan to start any weight reduction medication, mainly because of the side effects coming with the first use of this medication,” he said.
“This can affect fasting and unfortunately can lead to break the fast due to vomiting and GIT disturbance, anorexia, headache and depression.
“It is an important medication for weight reduction, to improve blood pressure, cholesterol and to control appetite and issues with obesity, but in a safe way, with very slow titration which is different from patient to patient.”
