Are GLP-1 weight loss drugs being dangerously misunderstood in the UAE?
The rise of self-prescribed GLP-1 use is emerging as a significant public health issue, particularly as patients attempt to manage dosing, duration, and discontinuation independently, says Dr. Ihsan Almarzooqi, co-founder and managing director of Metabolic
09 May, 2026
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As demand for GLP-1 weight loss therapies accelerates globally, the UAE is witnessing a parallel surge in interest around newer formats such as oral treatments. But with accessibility increasing, so too are concerns around misuse — particularly as prescription medications begin to appear on unregulated online platforms.
For Dr. Ihsan Almarzooqi, co-founder and managing director of Metabolic, the issue is not just regulatory — it is fundamentally clinical.
“It is not acceptable, and in the UAE it is not legal,” he says, referring to the online sale of prescription-only GLP-1 therapies such as Foundayo without medical consultation.
Metabolic (formerly GluCare.Health) announced it will provide early access to Eli Lilly’s newly approved oral GLP-1 therapy, Foundayo (orforglipron), shortly after receiving approval from the US Food and Drug Administration (FDA). The move makes Metabolic the first provider outside the US to offer the treatment, highlighting both its strategic partnership with Eli Lilly and the UAE’s growing status as a hub for advanced medical therapies. The development came after the Emirates Drug Establishment (EDE) formally approved Foundayo on April 3, making the UAE the second country globally to register the innovative drug.
The growing availability of oral GLP-1 medications has created a perception shift among patients, with some viewing them as over-the-counter solutions rather than tightly regulated treatments.
“The fact that it is now available as a pill makes it feel more like an over-the-counter product to some people. It is not. The format changed. The clinical requirements did not,” Almarzooqi explains.
In the UAE, federal law clearly prohibits the sale and purchase of prescription medications without a valid prescription issued by a licensed physician. However, enforcement challenges — particularly across digital channels — are exposing patients to unregulated access.
Beyond legality, the bigger concern is patient safety. GLP-1 therapies require detailed medical screening before prescription, including assessments of thyroid history, cardiovascular health, hormonal status, and existing medications.
“There are absolute contraindications. There are drug interactions. And there is no way to identify any of this through an online checkout,” he says.

A growing clinical concern
The rise of self-prescribed GLP-1 use is emerging as a significant public health issue, particularly as patients attempt to manage dosing, duration, and discontinuation independently.
“It is a serious problem, and I think we are only beginning to see the consequences,” Almarzooqi says.
He outlines multiple layers of risk. Patients may unknowingly fall into contraindicated categories, such as those with a history of medullary thyroid carcinoma or MEN2 syndrome. Others may misuse dosing protocols, escalating too quickly and triggering severe side effects.
“GLP-1 medications require gradual titration. Patients who escalate too quickly experience severe nausea, vomiting, and dehydration,” he explains.
Equally concerning is the lack of understanding around treatment discontinuation.
“Stopping without a maintenance plan almost always leads to rapid weight regain. Patients then blame the medication, rather than understanding that obesity is a chronic condition requiring long-term management.”
Much of the demand for GLP-1 therapies is driven by their association with rapid weight loss. However, Almarzooqi cautions that patients often misunderstand how these medications work — particularly when used without clinical guidance.
“The first is that weight loss equals fat loss. It does not,” he says.
Without body composition monitoring, patients may be losing significant muscle mass alongside fat. Studies suggest that 20 to 40 per cent of total weight lost on GLP-1 therapy can come from lean muscle, depending on lifestyle factors.
“This matters because muscle is metabolically active tissue. When you lose it, your resting metabolic rate drops,” he explains.
This metabolic shift can create a cycle of plateau during treatment and rapid weight regain after discontinuation, particularly if patients stop abruptly.
“The scale can look very encouraging while the metabolic picture is quietly deteriorating.”
A treatment, not a shortcut
Another area of confusion is whether GLP-1 therapies are fundamentally diabetes drugs or weight management treatments.
“GLP-1 receptor agonists were originally developed for type 2 diabetes management,” Almarzooqi says. “Foundayo is approved as a weight management treatment.”
This distinction is critical, as eligibility criteria, dosing strategies, and monitoring requirements differ depending on the clinical context. “What I want patients to understand is that weight management approval does not mean it is appropriate for everyone who wants to lose weight. It is a prescription treatment for people with obesity or with overweight and related health conditions.”
While patients purchasing GLP-1 medications online may have some awareness of common side effects, Almarzooqi notes that understanding is often superficial. “They understand the common side effects in broad terms… What they do not understand are the more serious warning signs that require immediate medical attention,” he says.
These include symptoms such as severe abdominal pain, persistent vomiting, or signs of pancreatitis — all of which require clinical intervention. “They also do not understand how to manage the common side effects properly… Without a dietitian involved from the beginning, patients are managing this blind.” This gap highlights a fundamental limitation of unregulated access: the absence of structured clinical support. “A disclaimer page is not clinical support.”
Why monitoring is non-negotiable
As GLP-1 therapies are increasingly used for long-term weight management, ongoing medical supervision is becoming critical.
“It is not optional,” Almarzooqi says. “These are chronic medications being used for a chronic condition.”
Long-term monitoring includes tracking thyroid function, cardiovascular health, muscle mass, nutritional status, and metabolic outcomes. Without this oversight, patients risk undetected complications.
“The longer-term safety data on some of these agents is still maturing… Patients on unregulated channels have none of this.”
He also highlights a broader systemic issue: patients purchasing medications outside regulated frameworks are effectively invisible to pharmacovigilance systems that track adverse effects. The growing accessibility of GLP-1 therapies presents a complex challenge for regulators and healthcare providers.
“The reason patients seek these medications outside clinical channels is partly cost, partly access, and partly a healthcare system that has historically underserved obesity,” Almarzooqi says.
Addressing misuse, therefore, requires more than stricter enforcement. While regulators must act against illegal online sales, healthcare systems must also improve legitimate access for eligible patients. “What is needed is a parallel response,” he explains.
This includes making treatment more affordable, reducing administrative barriers, and improving public understanding of how these therapies should be used.
At Metabolic, GLP-1 therapy is embedded within a comprehensive clinical framework designed to optimise outcomes and minimise risks.
“When a patient comes to us, they go through what we call a Metabolic Baseline,” Almarzooqi says.
This includes a full assessment of hormonal, metabolic, and cardiovascular health, followed by ongoing monitoring through physician consultations, dietitian support, and advanced diagnostic tools.
“The medication is the same. The outcome is not,” he says, contrasting this approach with self-medication.
A long-term view of treatment
Ultimately, the rise of GLP-1 therapies reflects a significant shift in how obesity is treated — from a lifestyle issue to a chronic medical condition requiring structured intervention.
“Obesity is a chronic, complex, and often relentless condition,” Almarzooqi says.
While new formats such as oral medications are improving accessibility, they also risk reinforcing the misconception that treatment is simple.
“GLP-1 medications are a genuine advance… But they are tools within a clinical framework, not solutions outside of one.”
As demand continues to grow, the challenge for healthcare systems, regulators, and providers will be to ensure that access does not come at the expense of safety — and that patients understand that the effectiveness of these therapies depends as much on the care around them as the medication itself.




























