Online World Poses Outsized Headache Over Unapproved Weight-loss Drug

On a video post on social media, a 32-year-old man who asked to be identified as Parab from Kedah comes on screen, fills a hypodermic needle with liquid from a vial and injects his belly. He then flexes for the camera. 

In the captions, he calls the drug – which he identified as retatrutide in another post – a “game changer” for his quest to lose weight and be healthier. 

Retatrutide, an experimental weight-loss drug developed by the United States (US) pharmaceutical giant Eli Lilly, is still in the development stage and has not been approved for sale or use anywhere in the world, including Malaysia. And yet, sales of retatrutide, called reta for short, have been front and centre in the news and in social media for months. 

The reta that is being sold online, despite having the label ‘For Research Use Only,’ is not part of any clinical trials run by Eli Lilly. It is an unlicensed and unapproved drug produced by unknown sources.

While there have been many news reports of illegal reta-users almost dying in Malaysia, Australia and other countries, the narrative on social media has been markedly different. Many netizens have been gushing over its efficacy, chronicling their weight-loss journey and happily demonstrating how to use it. 

Several social media posts included information on where and how to purchase vials of the unlicensed version of the drug, which international news organisations, US authorities and Eli Lilly say are mostly produced in China. Placing ‘For Research Use Only’ label on the vials allows sellers to exploit a loophole in the US that allows a pharmaceutical product to be sold as a lab reagent but not a drug for human consumption. The unlicensed drug is also available on e-commerce platforms in Malaysia and elsewhere.

Parab said he knew the risks of using an experimental and unapproved drug but added he had researched the manufacturer.

“I am more afraid of being hospitalised because of diabetes,” he told Bernama via WhatsApp. When he first started, he was 110kg. He is now 76kg.

He added he was confident that the reta he uses and sells is safe as it is manufactured in the US.

While technically illegal, what Parab is doing is tapping into a thriving online black market that is faster and reaches more people before health authorities can take action.

“Now, with just one TikTok account, the content can be viewed not only across Malaysia but also by Malaysians living abroad,” said Mohd Zawawi Abdullah, former Director of Pharmacy Enforcement, Ministry of Health (MoH), at an event organised by Novo Nordisk with the Ministry of Health, Pharmacy Enforcement Division, Malaysian Medical Association, Malaysian Pharmacists Society, and Communications and Multimedia Content Forum of Malaysia last week.

(From left to right) Moderator Dr. Shazril Shaharuddin (left), Malaysian Medical Association President Dr Sivanaesan Letchumanan, President Malaysian Pharmacists Society Honorary Prof Amrahi Buang, and recently retired Director of Pharmacy Enforcement, MOH Mohd Zawawi Abdullah (right) speaking at the "Unknown Sources: Know the Source Before You Trust the Promise" forum held recently in Kuala Lumpur. --supplied photo

ANTI-FAT FAD

One does not have to dig deep to see why Malaysians are willing to risk their health to take an unapproved and unregistered weight-loss drug.

Malaysia is the second most obese country in Southeast Asia. The Ministry of Health’s National Health and Morbidity Survey (NHMS) 2024 found that 23.1 percent of Malaysian adults are classified as obese, up from 21.8 percent in 2023. The number of obese and overweight Malaysians combined is 53.6 percent.

Obesity carries a higher risk of metabolic and cardiovascular diseases.

As of 2024, the prevalence of diabetes among adults in Malaysia is 21.1 percent, according to the International Diabetes Federation. Ischaemic heart disease, a condition in which narrowed arteries reduce blood flow to the heart, remained the leading cause of death in Malaysia, accounting for 13 per cent of all deaths in 2025, according to government data.

Since weight-loss drugs Ozempic, WeGovy and Mounjaro hit the public consciousness beginning in 2024, demand has outstripped supply a few times in Malaysia. On top of the aesthetic benefits that accompany these drugs, retatrutide, which is reportedly even more effective than current drugs on the market, has only become more appealing for people seeking to increase their weight loss.

Retatrutide, targets three hormone receptors compared to single hormone receptor agonist (Ozempic) or double-hormone receptor agonist (Mounjaro), which makes weight loss more effective. Serious side effects include gallbladder disease, pancreatitis and kidney damage.

The black market retarutide has the same active ingredient as Eli Lilly’s product, but the fact that it is produced by unknown manufacturers in unknown conditions, with no quality control whatsoever, can turn the risk deadly.

DANGERS

Doctors have reported cases of patients almost dying after taking bootleg retatrutide.

Senior Consultant Interventional Cardiologist Dr Onn Akbar Ali told Bernama that a few months back, he was called in to resuscitate a patient who developed complications after undergoing surgery for a gynaecological condition. The patient had been taking illicit retatrutide and did not inform her doctor.

“Post-op, she became acutely ill because that medication needed to be stopped a week before the surgery because that medicine paralyses your stomach,” he said.

“But (if your) stomach (doesn’t work) after the operation means that you will keep vomiting. You will keep vomiting, and you will develop a lot of metabolic complications of that medication.”

He added she almost died due to the stress of the surgery on the body, exacerbated by the drug’s effects.

Senior Consultant Interventional Cardiologist Dr Onn Akbar Ali shared with Bernama that he had had to resuscitate a patient who developed complications related to taking bootleg Retatrutide. --fotoBERNAMA (2026) COPYRIGHT RESERVED

In Malaysia, there have been other reported cases of complications due to illicit retatrutide. In Johor, a doctor reported that a 24-year old bride-to-be  had to be placed in an induced coma after developing severe inflammation and high heart rate, and a 36-year old man who had to be admitted to the hospital for a few days for severe dehydration, acute kidney injury and other issues.  No deaths linked to the drug have been reported so far.

However, the United States isn’t as lucky. Two deaths were reported to the FDA, suspected to be due to unregistered retatrutide. In July, a 41-year old woman suffered a heart attack, and a 49-year old woman died from severe dehydration, malnutrition and cardiac arrest in September. Doctors noted the retatrutide was from unreliable sources.

On its US website, Eli Lilly warned the public against taking the drug in a press statement issued in August.

“What is being sold on the black market is not a medicine – it is entirely unverified, unapproved and not worth the risk," said Dr. David A. Hyman, Eli Lilly's chief medical officer. 

The company has filed lawsuits in the US against businesses, including online sellers, pharmacies and spas. It also called for drug regulators in other countries, customs agencies, social media platforms, credit card companies and others to stop enabling the sale of the experimental drug.

At the forum Unknown Sources: Know the Source Before You Trust the Promise held last week, Zawawi said registered drugs meant the National Pharmacy Regulatory Authority has evaluated its safety, quality and efficacy.

“That is why we insist on the use of registered medicines. Once a medicine is registered, we assess it in terms of its safety, quality and efficacy. We do not want them to claim that a product contains Tongkat Ali when, in reality, it contains something else,” he said.

ACTION

In recent months, perhaps in response to the rash of reports of adverse events involving reta, the MoH has stepped up enforcement action and public awareness campaigns to warn the public and social media users. There is no way to determine how large the black market is for retatrutide but an indication of its popularity can be seen in its seizure numbers.

On Nov 2, Health Minister Datuk Seri Dr Dzulkefly Ahmad told the Dewan Rakyat that retatrutide share of its seizure was much bigger than other weight-loss drugs.

 “From 2025 to September 2026, a total of 12 raids related to Retatrutide were conducted, resulting in the seizure of 697 units worth RM341,000.  Retatrutide is a drug that, I would say, is not yet included in our formulary.

“The Pharmacy Enforcement Division also detected the illegal sale of Ozempic (which contains the active ingredient Semaglutide). From 2025 to September 2026, seven raids involving the product were conducted, resulting in the seizure of 62 units worth RM64,170,” he said.

According to data shared at the forum, the MoH has conducted 47 raids up to September 2026, seized unregistered drugs worth RM771,517. At the same time, 827 product listing on e-commerce platforms have been taken down and 1,637 enforcement action taken.

Malaysia has seized 130,678 illegal pharmaceutical products worth RM3.15 million while 2,294 online links associated with illegal pharmaceutical sales were blocked and removed from January to October this year. The Pharmacy Enforcement Division (BPF) also inspected 497 postal packages, leading to the seizure of 49 packages containing illegal pharmaceutical products valued at RM766,721. 

Mohd Zawawi Abdullah, Director of Pharmacy Enforcement, MOH. -- supplied photo

Zawawi, who recently retired from the MoH, said the authorities had received 5,653 reports involving unregistered medicines as of Oct 31. The BPF has seized products worth an estimated RM64 million in connection with these cases.

“Last year, the figure stood at RM70 million, while this year it has reached RM64 million. It may seem substantial, and I believe we could potentially hit RM80 million by the end of this year,” he added.

He also said the division is constantly monitoring social media, e-commerce platforms and online activities for illegal sales and promotions, including influencers involved in such activities, as well as to prevent smuggling of unregistered drugs into the country. 

He noted influencers have played a significant role in peddling unregistered anti-obesity drugs online.

“(They’re) on our radar,” he told Bernama, advising influencers to read up on guidelines for promoting pharmaceutical cosmetic products online. Influencers may also face legal action under the Medical Advertisement Act for promoting such products.

However, he said the ministry was not keen to take legal action against influencers as court cases would take too long to settle, adding that influencers were not the main problem in the supply chain. 

“But, behind the distribution of counterfeit, unregistered and fake medicines, there are individuals operating larger syndicates. These are the people we want to track down. We are not so much interested in targeting influencers, but rather in identifying those behind these operations and finding out who they are,” he said.

COST OF LEGITIMACY

Eli Lilly is expected to apply for approval early next year, and investor reports do not expect any issues. Once the FDA approves the drug, approval from regulatory agencies in other countries will likely follow suit.

When that happens, Parab would like to take the approved and licensed retatrutide. But he does not expect to be able to afford it based on the prices of weight-loss drugs available on the market in Malaysia now.

“I first started with Ozempic, but it was extremely expensive. Reta is a little cheaper and works faster,” he said, adding that he hoped the Malaysian government would also approve generic versions of retatrutide at the same time.