Obesity and diabetes in Panama: the numbers and GLP-1 drugs

Obesity in Panama: excess weight is not the same as obesity

In Panama, the Ministry of Health (MINSA) says about 72% of adults over 18 have excess weight, meaning overweight and obesity combined³⁴. The Pan American Health Organization (PAHO) reports a nearly identical figure: 71.6% of people aged 15 and older with overweight or obesity in 2022⁶. Some headlines presented the 72% as "obesity", which is inaccurate: according to the 2019 National Health Survey of Panama (ENSPA), 36.1% of adults have obesity, as do about 10% of minors⁵. Health Minister Fernando Boyd Galindo said in January 2025 that obesity in Panama stands at 36% and that he hoped to lower it to 19% during this term⁴.

MINSA responded with the Plan to Accelerate Stopping Obesity (PADO) 2025-2030, with technical support from PAHO, the World Health Organization (WHO) and UNICEF. Its pillars include healthy food environments, limits on advertising aimed at children, packaged-food labeling and stronger primary care; the sources we reviewed give no budget or yearly numeric targets⁵. In May 2026 a specialist quoted by Telemetro spoke of 46% obesity and 50% by 2030; that is the specialist's statement, not a MINSA survey, and we do not use it as an official figure¹.

Diabetes in Panama: three figures, three different bases

Diabetes is trending upward, but the figures are not comparable with each other. PAHO lists 7.3% in 2000 and 9.3% in 2014⁶. The ENSPA 2019 analysis, published in Medicine (Baltimore) by researchers at the Gorgas Memorial Institute for Health Studies (ICGES), calculated 12.4% in adults (95% CI 10.9 to 14.05)⁸. And in May 2026 MINSA said roughly 15% of people over 15 live with type 2 diabetes, alongside 42% with hypertension¹². Years, age ranges and methods differ; MINSA did not publish the methodology behind the 15% in that statement.

The most clinically relevant ENSPA finding is control: 62.6% of people with diabetes knew their condition and only 39.6% had it controlled⁸. In other words, the system's immediate problem is not only a lack of new drugs but diagnosing and controlling with what already exists. The National Institute of Statistics and Census (INEC) of the Comptroller's Office recorded 23,206 deaths in 2024; the top five causes were malignant tumors (16.6%), ischemic heart disease (9.9%), other heart disease (8.3%), cerebrovascular disease (8.1%) and violence and accidents (7.1%)⁷. Cardiovascular disease, which diabetes and obesity worsen, takes three of those five slots.

What it costs: the Social Security Fund and households

We could not find a recent, verifiable figure for the Social Security Fund's (CSS) total spending on diabetes. The most-cited public reference dates from 2015: Dr. Fernando Castañeda, CSS national deputy director of primary care, estimated $1,200 to $1,700 per patient without major complications and $20,000 to $60,000 per patient needing an amputation; of 1,600 hemodialysis patients, 40% had diabetes as the cause⁹. This is ten-year-old data and should be read that way.

On access, CSS tender 01-2026, worth $91,979,892 for 348 lines of synthesized medicines over 15 months, covers treatments for hypertension and type 2 diabetes; the news coverage we reviewed names no GLP-1 drug¹². We also found no verifiable prices for GLP-1 agonists in Panamanian pharmacies, so we do not cite any.

What the clinical trials show

GLP-1 receptor agonists and the dual agonist tirzepatide have the strongest evidence in obesity pharmacology. In the STEP 1 trial (1,961 adults with overweight or obesity without diabetes), semaglutide 2.4 mg weekly produced a mean weight loss of 14.9% at 68 weeks versus 2.4% with placebo¹⁴. In SURMOUNT-1, tirzepatide produced 15.0%, 19.5% and 20.9% at 72 weeks depending on dose, versus 3.1% with placebo¹⁵. In SURMOUNT-5, an open-label trial of 751 adults with obesity without diabetes, tirzepatide achieved 20.2% versus 13.7% with semaglutide at 72 weeks¹⁷. In type 2 diabetes, SURPASS-2 (1,879 participants, 40 weeks) showed hemoglobin A1c reductions of 2.01 to 2.30 points with tirzepatide versus 1.86 with semaglutide 1 mg¹⁸.

Beyond weight, the SELECT trial enrolled 17,604 adults aged 45 or older with established cardiovascular disease, a BMI of 27 or higher and no diabetes; the composite cardiovascular outcome occurred in 6.5% with semaglutide and 8.0% with placebo (hazard ratio 0.80) after a mean follow-up of 39.8 months¹⁶. The weight-loss results also come with more gastrointestinal events: in STEP 1, 4.5% discontinued for this reason on semaglutide versus 0.8% on placebo¹⁴.

What GLP-1 drugs mean for Panama's health system

On December 1, 2025 the WHO published its first guideline on these drugs in obesity. The recommendation is conditional, because of limited long-term data, uncertain costs, insufficient health-system readiness and the risk of widening inequalities; it estimates they will reach fewer than 10% of those who could benefit by 2030 and suggests pooled procurement, tiered pricing and voluntary licensing¹³. For a system that still controls fewer than four in ten adults with diabetes⁸, the opportunity-cost calculation is the central debate.

Panama's regulatory framework has already shown strain. In October 2023 the National Directorate of Pharmacy and Drugs (DNFD) of MINSA warned that Ozempic is approved for type 2 diabetes mellitus, that its use for weight loss is an unapproved indication, and that shortages had encouraged counterfeits¹⁰; the details of that alert are in our analysis of counterfeit Ozempic and Mounjaro in Panama. In July 2025, DNFD director Uriel Pérez confirmed an investigation into improper promotion of Ozempic for weight loss and warned about social-media sales from addresses that did not correspond to formal businesses¹¹. For the legal framework around prescribing, see the physician's legal map in Panama, and for the pharmacological weight-management context, semaglutide for weight loss in Panama.