Medical experts view GLP-1 receptor agonists as the last line in integrated healthcare strategy, with priority given to diet and exercise.
At an event a few months ago, I bumped into a former colleague I hadn’t seen for perhaps a year. A tall and naturally heavyset man, he’d always been overweight. But now, standing in front of me was a streamlined version of the person I knew. The transformation was remarkable — and I remarked on it.
“I’ve been using Mounjaro,” he told me, referring to the injectable medication used for diabetes and weight loss. “Weekly jabs, gradually upping the dose.”
Although he declined to be interviewed for this article, his dramatic success in slimming down — together with recent reports in local news outlets — led me to look into the market for weight-loss medication in Taiwan.
One such report referred to a study by the Child Welfare League Foundation in Taiwan showing that over 30% of fifth and sixth grade elementary school students were overweight or obese. This figure is 5 percentage points higher than the average among students of the same age in surveys from other countries conducted by the World Health Organization (WHO).
And according to a 2025 survey by the Taiwan Medical Association for the Study of Obesity (TMASO), more than half of Taiwanese adults aged 18 or over are overweight or obese. In that article, the association’s president, Dr. Lin Wen-yuan, highlighted culture attitudes towards obesity in Taiwan, noting that “many people believe there is nothing wrong with being fat.”
This view is supported by Dr. Chuang Hua-hai, director of the Health Promotion Center at Chang Gung Memorial Hospital and vice president of the Asian Health Literacy Association. The AHLA is an independent, multinational non-governmental organization that aims to reduce health disparities through improved access to information and better public understanding.
“Our kids are getting fatter and fatter, but a lot of people don’t realize it,” says Chuang, who has researched and published extensively on obesity and weight management. “In Chinese culture, there’s a saying: xiao shihou pang, bushi pang (小時侯胖不是胖), meaning that obesity for children is not a real thing.”
The idea, says Chuang, is that the problem will be resolved naturally, with children growing out of childhood puppy fat. “But it’s not the case,” she notes. “Studies show us that about 50% of children who are obese will become obese adolescents, and 80% of those will become obese adults.”
The WHO defines “overweight” in adults as body mass index (BMI) equal to or greater than 25, and “obese” as BMI equal to or greater than 30.
Originally developed to combat diabetes, the rapid weight-loss medications known as GLP-1 and GIP receptor agonists have been increasingly popular in Taiwan as in other markets around the world. These medications mimic gut hormones, with GLP-1 receptor agonists increasing feeling of satiety, reducing hunger signals and cravings, and slowing digestion.
Although GIP receptor agonists promote fat uptake into cells, when combined with GLP-1 — as happens in Mounjaro doses — they counterintuitively enhance weight-loss effects. “We still don’t know exactly why this is,” says TMASO’s Lin. “But the clinical results are there.”
At the same time, in a February 2026 press release, the Taiwan Food and Drug Administration (TFDA), citing a similar pronouncement from the United Kingdom’s Medicines and Healthcare products Regulatory Agency the month before, cautioned against the misuse of GIP/GLP-1 drugs. The TFDA called attention to a variety of side effects, including nausea, constipation, gastrointestinal disorders, and hypoglycemia. Cases of acute pancreatitis has also been reported, the TFDA noted, though serious instances are extremely rare.
Between January 2023 and December 2025, the TFDA’s National Adverse Drug Reaction Reporting System received 21 reports about negative reactions to GIP/GLP-1 drugs, the TFDA press release stated.
At present, some of these drugs, such as Ozempic, are covered by Taiwan’s National Health Insurance (NHI) system for type-two diabetes in very limited circumstances. Lin has warned that, from his own observations, far too many people using self-pay weight-loss jabs have questionable motivations.
“You can see from the internet, and social media, it’s often not for health but just cosmetic reasons,” he says. Because those who really might need such treatments will often balk at the price, Lin says those who have private insurance are likely to be among the main users. “A high percentage are probably wealthier people who want to look good,” he says.
While hard data is unavailable, especially as many users may be getting such drugs through unofficial channels, Taiwan seems to be following global trends in experiencing a pronounced uptick in the use of GLP-1-based therapies for weight loss purposes. Doctors, pharmaceutical companies, and manufacturers of injection devices corroborate this perception, though they emphasize that the evidence so far is largely anecdotal or derived from approximations based on sales figures.
Various medications
Weight loss medications are not a new phenomenon in Taiwan. Data exists for orlistat, a drug that blocks a class of enzymes called lipase, crucial to the digestive process. By preventing the breakdown of lipids (compounds that include fats), orlistat prevents them from being absorbed, allowing them to pass through the digestive system and be excreted. The medication reduces fat absorption by up to 30%.
A study from 2004 to 2055, showed that more than 50% of obesity patients had tried weight loss medication, with over 17% using orlistat, which continues to be sold in Taiwan under the brand name Xenical.
More than 21% had tried sibutramine, an appetite suppressant that works by boosting serotonin and other neurotransmitters. However, that medication was banned by the TFDA in 2021 due to serious cardiovascular risks. Now categorized as a Class 4 narcotic in Taiwan, it remains available in medications throughout Southeast Asia. Cases of illegal imports, which are punishable by up to 12 years imprisonment, continue to be reported in local media.
Another legal weight-management drug is Contrave, which combines naltrexone and bupropion — used to treat addiction and depression. Like the other options in this earlier generation of treatments, it is an oral medication.
“The efficacy of lipase inhibitors and existing drugs on the market wasn’t that great,” says TMASO president Lin. “With sibutramine, there were heart problems, like arrhythmia; and Contrave is not very popular — maybe 5% market share,” he notes.
In contrast, GLP-1-based therapies have shown considerably better results, leading to a corresponding surge in demand. The two major suppliers for these medications in the Taiwan market are U.S. pharmaceutical company Eli Lilly, which produces the tirzepatide-based Mounjaro, and Wegovy, a GLP-1 brand from Danish global healthcare company Novo Nordisk. With semaglutide as its active ingredient, the latter drug is essentially the same as Ozempic — also manufactured by Novo Nordisk — but with a higher dose.
“Prescription rates are going up for sure,” says Lin. “And if these drugs are used responsibly, I think [Taiwan’s healthcare] can benefit.”
Chuang of Chang Gung Hospital agrees. “As a physician who has been working long in this field, I’m very happy to see this game changer,” she says. “It’s a rapid progression in this field.”
However, both doctors emphasize that medication should be a last resort, reserved for chronic cases that have not responded to first-line, cornerstone obesity treatments such as lifestyle modification and behavioral interventions. “Diet control comes first, then exercise,” says Lin. “Last is medication, and before you consider that option, you need to consult a professional team.”
Although the TFDA, in line with WHO guidelines, stipulate prescription of GLP-1 drugs for obesity only in cases where a patient has a BMI of 30 or higher, or — for people with certain comorbidities, BMI 27 or higher — this is not a legal requirement. Too many doctors, Lin suggests, are willing to hand out prescriptions with minimal oversight.
“As it’s self-pay, as long as no one is harmed and there’s no controversy, they think it’s fine,” he says. “But there must be proper clinical assessment.”
Aside from widely reported side effects, a major issue for patients can be difficulty maintaining muscle mass while using GIP/GLP-1 drugs. Ongoing clinical studies into bimagrumab, an experimental antibody that combats muscle loss, appear to have stalled at phase two, with no guarantee the drug will make it to market.
A further challenge, highlighted by the TFDA and in local media reports, is the risk of counterfeit injection pens, which are best ineffectual and at worst potentially harmful. “For our products, there are labels on each box that allow you to check the origin of the product,” says Hans Duijf, general manager of Novo Nordisk Taiwan. “They are unique to each individual box, and we encourage patients to obtain medicines through authorized channels and follow official verification guidance.”
However, some healthcare professionals consider that such basic traceability measures are insufficient and that the TFDA should introduce stronger requirements as safeguards. In an e-mailed response to inquiries from TOPICS, the TFDA noted that it had begun working with local health authorities in 2024 on inspection programs to ensure the safety of GLP-1 receptor agonists and other medications.
“In addition, mechanisms have been established to remove illegal online sales,” a TFDA spokesperson wrote. “This includes cooperation with [U.S. tech multinational] Meta to take down non-compliant posts, working with the Taiwan Network Information Center to block illegal websites, and collaborating with pharmacist associations to strengthen online enforcement.”
Auto-injector safety
From a hardware perspective, safety is a “fundamental element,” says Sebastian Feng, general manager of SHL Medical Taiwan, a world leader in autoinjector technology with some 5,000 employees and nine facilities in Taiwan. He emphasizes that from needle depth to dosage delivery to audible feedback during use (sound cues that help guide the user through the injection process), key aspects of the device are carefully preconfigured. “Once the injection process is complete, the needle shield is designed to extend automatically, helping keep the needle covered under normal use,” Feng says. “This is a key design factor for autoinjectors, which must be easy to use, safe, and robust.”
Safety issues aside, pricing remains a barrier for many patients, says Lin. Self-pay prescriptions of Mounjaro can cost between NT$15,000 to NT$18,000 for a month’s worth of jabs in Taiwan, while the same injector pens can be purchased for as little as NT$10,500 in Japan. Taiwan’s Customs Administration permits travelers to bring up to a two-months’ worth of injection products, such as GLP-1 drugs, into the country, but there have been reports of larger amounts being smuggled in from Japan. Clinics have also reportedly obtained stock from such sources.
While Lin and other interviewees mention the pending expiry of patents this year as potentially greenlighting the entrance of local generics to the market, they emphasize that “patent thickets” — multiple overlapping patents covering different aspects of the medications — are expected to keep the original drugs tied up until at least 2030.
Duijf acknowledges the price disparity with Japan but points out that each market has unique regulation and medicine coverage and thus different pricing. Pharmaceutical companies will need to work with Taiwan’s authorities to achieve “better access,” he says.
“Today, very few people in Taiwan have access to what is one of the most transformative therapies in modern medicine,” says Duijf. “Current reimbursement restrictions are not in line with global treatment guidelines and Novo Nordisk is ready to work with authorities on how to offer what is perhaps the greatest opportunity to deliver on the ambitious Healthy Taiwan aspiration.”
Regarding the possibility of competition from local firms keen to get a piece of the pie, he says notes that patent expiries differ in different geographies. “For Taiwan specifically, those patents don’t expire until a couple of years down the road,” he says.
In the short-term, most experts see NHI coverage for GLP-1-based obesity therapies for obesity as unlikely. Nevertheless, healthcare professionals regard the drugs as a useful component in an integrated health care strategy.
Figures from the Statistics of Health Promotion and the Nutrition and Health Survey in Taiwan, both of which come from Health Promotion Administration (HPA) under the Ministry of Health and Welfare (MOHW) show obesity rates among adults in Taiwan doubling between 1993 and 2013 to 4.2%, with a 2016 survey suggesting obesity prevalence was as high as 20% by 2016. When including people in the overweight category, data shows the rates having risen by more than 5 percentage points to 50.3% according to the aforementioned findings from the TMASO.
Excessive weight is inevitably accompanied by comorbidities such as diabetes, hypertension, and cardiovascular diseases, Lin and other experts observed. For children, sleep apnoea, respiratory conditions, and abnormal physical development, including effects on height, can also be risks. Despite these challenges and the accompanying burden Taiwan’s NHI system, Lin is optimistic about some of the measures currently being undertaken to tackle the problem.
He cites the “health coins” program set for launch by MOHW last month as one example. The system, which is to be integrated into the existing NHI Mobile Easy Access app, is designed to reward behaviors such as getting vaccinations, health checkups or cancer screenings. Coins can then be used for discounts on healthcare-related services or products.
Likewise, Chuang highlights initiatives such as a multi-faceted intervention program she oversaw involving around 5,000 elementary schoolchildren. “We provided a whole package of intervention, including knowledge, behavioral change, and one-on-one, face-to-face consultations with caregivers, parents, grandparents, or whoever.”
Measures such as avoidance of sugary beverages and junk food were incentivized, yielding tangible results. Similarly impressive achievements were recorded when such programs were extended to hospital employees, with Chuang co-authoring research papers on the findings.
Most importantly, the danger of relapse after initial success is perhaps the toughest and least understood challenge, Chuang emphasizes. “Clinical insight shows that your body more or less has a memory of obesity,” she says. “So, you can lose weight, but somehow you’re not really getting rid of obesity.”
This point is echoed by Duijf. “We now know that your body is actually fighting to stop you losing weight,” he notes.
Reflecting further on this conundrum, Chuang invokes a catchy simile. “It’s like the lyrics of Hotel California, “she says. “You can check out anytime you like, but you can never leave.”
