Japan is grappling with a shortage of diabetes medications driven by a concerning global trend — the inappropriate use of these drugs for dieting purposes.

Masaaki Miyakawa, an executive board member of the Japan Medical Association, said during a news conference in late October that the organization was “deeply troubled" by the situation.

The issue is in focus as World Diabetes Day is marked on Tuesday.

A survey by the JMA of member clinics on drug shortages conducted between August and September found 308 cases where medical institutions had difficulty preparing GLP-1 drugs — common diabetes medicines — for in-hospital prescriptions. There were also 648 cases where clinics had trouble prescribing the drugs through external pharmacies.

Miyakawa said the group will work to make sure these medications are prescribed for people with diabetes, and not for healthy individuals looking to use them for dieting purposes.

Among these drugs are Eli Lilly’s Trulicity and Novo Nordisk’s Ozempic and Victoza, which are injected, and Rybelsus, which is taken orally.

The shortage primarily affects GLP-1 receptor agonists, which stimulate the body to produce more insulin and lower blood sugar levels, and are thus helpful for controlling Type 2 diabetes. The drugs also appear to have appetite-suppressing effects, contributing to a surge in demand both within Japan and globally among people trying to lose weight.

Misa Inoue, a physician and member of a medical association in Osaka, echoed concerns about the off-label use of GLP-1 drugs.

"Problems (resulting from drug shortages) are particularly serious with the diabetes drug Trulicity," she said during a news conference on Thursday addressing drug supply stability. "The drug is often used for cosmetic purposes and is not available for medical uses."

While GLP-1 drugs are covered by national health insurance when used for treating Type 2 diabetes, they are not covered when they are used solely for dieting purposes, as they are not approved for such use by the health ministry.

Miyakawa highlighted that despite ongoing awareness campaigns led by the Japan Medical Association, the Japan Diabetes Society and pharmaceutical companies, the issue persists. He said that in instances of such off-label use, some clinics have asked users to agree that they are taking the drugs at their own risk, noting that this may be making it harder for users to complain of adverse events.

On Nov. 7, three diabetes-related groups — the Japan Association for Diabetes Education and Care, the Japan Diabetes Society, and the Japan Pharmaceutical and Diabetes Society — submitted a joint request to the health ministry highlighting the need for measures to ensure a stable supply of medications. They expressed concerns about the inappropriate use of the drugs for dieting purposes among individuals who do not have diabetes.

Miyakawa noted that the use of GLP-1 receptor agonists for weight loss is linked to a ninefold increase in the risk of pancreatitis, as reported last month in the Journal of the American Medical Association. In the JAMA study, researchers from the University of British Columbia indicated that medications including Wegovy, Ozempic, Rybelsus and Saxenda are also connected to a heightened risk of serious stomach and intestinal problems.

On the social media platform X, many people openly share their personal experiences with dieting, often comparing weight-loss outcomes using various medications intended for diabetes. On the internet, advertisements by cosmetic surgery clinics offering “GLP-1 Diet” therapy are common.

Obtaining these drugs for weight loss can be a quick and simple process, with some doctors prescribing them after a short online consultation and patients getting them delivered to their homes.

Miyakawa warned that people using these drugs for dieting would not be eligible for compensation under a government-funded relief system offered to those suffering from adverse drug reactions.

The estimated number of people in Japan with diabetes as of fiscal 2019 was 11.5 million, as reported by the Japan Preventive Association of Life-style related Disease.

Researchers predict more than 1.3 billion people worldwide will have diabetes by 2050, a significant increase from a tally of 529 million as of 2021, according to a report in the Lancet medical journal. The study added that most patients will have Type 2 diabetes, which is commonly linked to being overweight.