Underweight or pregnant, doctors don't discriminate when prescribing Mounjaro
Reports show the weight-loss drug is being prescribed outside stated guidelines, including to underweight patients, pregnant women and children, contributing to an increase in adverse events.
An AI-generated image shows an underweight woman on a scale and a dose of obesity drug Mounjaro.CHATGPT
At 167 centimeters (5 feet 6 inches) tall and 51 kilograms (112 pounds) light, an office worker going by the name Kim has been feeling dizzy and pain even from the lightest touch. Her body frequently trembles, and she was forced to take days off from work because she was so sick.
Yet, she's still not willing to give up on her 5 milligram weekly dose of the magical obesity drug, Mounjaro.
“They prescribed it without asking any questions,” Kim, in her 30s and underweight, said. She has been taking the drug for four months now. “It interferes significantly with my daily life, but when I go back for another prescription and the doctor asks if I’m O.K., I just say 'I’m fine' and the appointment is over in 10 seconds.”
The following are details on Mounjaro from the Ministry of Food and Drug Safety’s drug information service.
For pregnant women and women of childbearing potential, data on the use of the drug during pregnancy are very limited. Tirzepatide, the active ingredient in Mounjaro, showed reproductive toxicity in animal studies. The drug should not be used during pregnancy, and treatment should be discontinued if pregnancy is detected during treatment or if the patient wishes to become pregnant. Women of childbearing potential are advised to use contraception when starting treatment with the drug.
For pediatric patients, the safety and efficacy of the drug in patients under 18 have not been established.
As Mounjaro surges in popularity, reports of adverse events are mounting amid an increase in prescriptions issued outside the drug’s prescribing criteria. The drug has even been prescribed to pregnant women and children, warranting tighter oversight of prescriptions.
A total of 1,261 adverse events involving Mounjaro were reported during the 11 months from its domestic launch in August last year through June this year, according to data that Rep. Baek Jong-hean of the People Power Party received from the Ministry of Food and Drug Safety. Of those, 916 cases, or 72.6 percent, were reported this year.
The figures are based on reports from medical professionals and other sources, meaning the actual number of adverse events is believed to be higher.
Despite the large number of reported adverse events, prescribing criteria are frequently not followed in clinical practice. Glucagon-like peptide-1 (GLP-1) obesity drugs such as Mounjaro and Wegovy are intended for patients with obesity who have a body mass index (BMI) of 30 or higher, or overweight patients with a BMI of at least 27 but below 30 who have a weight-related condition such as high blood pressure.
“They tell you at reception that they will check your weight, but once you enter the consultation room, the doctor barely even looks at the scale,” a woman in her 20s said outside a clinic in Jongno District, central Seoul, on Sept. 18. The clinic is widely known among people seeking Mounjaro.
LEE JEONG-MIN
“Sometimes doctors prescribe obesity drugs to patients who do not need them simply because the patients ask for them,” said a doctor in their 30s who previously worked at a cosmetic clinic. “The doctor essentially becomes a drug vending machine.”
Another major issue is that records also show that Mounjaro was prescribed to pregnant women and children.
There were 325 prescriptions for pregnant women and 110 for children under 13 from the drug’s domestic launch in August last year through July this year, according to data from the Health Insurance Review and Assessment Service obtained by Baek’s office. However, the data were collected during the prescribing and dispensing process and do not establish whether the patients actually took the drug.
The Ministry of Food and Drug Safety firmly warns that Mounjaro should not be used during pregnancy. Its safety and efficacy in pediatric patients under 18 have also not been established.
“Given that there is insufficient safety data on the effects on a fetus, a pregnant woman using an obesity drug is essentially conducting a clinical trial on herself,” said Oh Sang-woo, a professor of family medicine at Dongguk University Ilsan Hospital.
LEE JEONG-MIN
The Ministry of Food and Drug Safety is working to revise its regulations with the aim of designating Mounjaro, Wegovy and other drugs as medications with potential for misuse or abuse this month. Once designated, the drugs will carry warnings about the risk of misuse or abuse.
Still, medical professionals worry that simply adding a warning without separate sanctions will make it difficult to prevent indiscriminate prescribing.
“If prescriptions were issued and the drugs administered to pregnant women and children, that would be a serious problem,” Baek said. “We need to review basic prescribing principles and put effective measures in place to prevent the possibility of misuse and abuse in the first place.”
This article was originally written in Korean and translated by a bilingual reporter with the help of generative AI tools. It was then edited by a native English-speaking editor. All AI-assisted translations are reviewed and refined by our newsroom.
