Semaglutide for weight loss: Panama's clash

A country with high demand

According to MINSA's latest national survey, 72% of Panamanians over 18 have overweight or obesity². Adult obesity reaches 36.1% (43.1% in women and 29% in men), the figure PAHO's office cited when Panama launched its 2025–2030 obesity acceleration plan³.

Against that backdrop, GLP-1 receptor agonists became the most talked-about medicine. The trials explain why: in STEP 1, with 1,961 adults with overweight or obesity and no diabetes, weekly semaglutide 2.4 mg was associated with a mean weight reduction of 14.9% at 68 weeks, vs 2.4% with placebo⁹. Panamanian endocrinologist Enrique Mendoza, former dean of the University of Panama School of Medicine, told La Prensa that GLP-1 agonists are revolutionizing the treatment of diabetes and obesity⁷.

The benefits go beyond weight. In the SELECT trial, with 17,604 adults with cardiovascular disease and overweight or obesity without diabetes, semaglutide was associated with 20% fewer major cardiovascular events than placebo (HR 0.80)¹⁰. But the effect depends on staying on treatment: one year after stopping, participants in a STEP 1 extension had regained two-thirds of the weight they had lost¹¹.

MINSA's position

In July 2025 DNFD director Uriel Pérez said MINSA was reviewing how Ozempic is being used in the country. La Estrella de Panamá's headline was blunt: "it is not a weight-loss medicine"¹. According to the report, nausea leads the reported adverse effects (75%), mostly in women¹. In STEP 1, nausea and diarrhea were also the most common adverse events⁹. And in a study using US health-insurance data, GLP-1 use for weight loss was associated with a higher risk of pancreatitis, gastroparesis and bowel obstruction than bupropion-naltrexone¹².

The other focus is how it is sold. MINSA found that these products are often sold through social media, by sellers with no physical premises¹. In 2024 the DNFD had already relayed an alert from Colombia's INVIMA on "semaglutide + vitamin B12" vials, which have no Panamanian registration, and warned that many fraudulent products are sold online, on social media and through WhatsApp chains⁵, and in 2023, amid counterfeit Ozempic detected in Europe and the Americas, it reported that Ozempic had two sanitary registrations in the country⁴. The risk of buying outside official channels has been measured: when researchers bought semaglutide without a prescription from illegal online pharmacies, the vials they received had a purity of 7.7% to 14.4% vs the 99% on the label and all contained endotoxin, and none of the Ozempic pens they ordered arrived¹³. In Europe, an EudraVigilance analysis gathered 234 safety reports linked to possibly counterfeit semaglutide, with hypoglycemia reported more often than with the genuine product¹⁴.

The region is moving the same way

In February 2026 the Pan American Health Organization issued an epidemiological alert on GLP-1s: more adverse-event reports, purely cosmetic use, and sales "through unofficial channels, including the internet and social media"⁶. PAHO asked countries to strengthen pharmacovigilance⁶. Panama is not named; the alert covers the whole region⁶. In December 2025 the WHO issued its first guideline on GLP-1s for obesity, with a conditional recommendation for long-term use in adults, except pregnant women, and warned that global demand "has fueled the spread of falsified and substandard products"¹⁵.

In the United States, the argument behind compounded semaglutide also changed: on February 21, 2025 the FDA declared the semaglutide injection shortage resolved⁸.

The underlying debate

The debate in Panama is no longer whether GLP-1s work: the trials show they do, with measured effects on weight and other outcomes⁹¹⁰. The clash is elsewhere. On one side, an obesity epidemic documented by MINSA itself²³. On the other, authorities who see growing cosmetic use, products of unknown origin and social-media sales¹⁵⁶.