From Italy to Greece and Portugal, off-label use of GLP-1 drugs such as Ozempic and Munjaro for weight loss has created a booming private market and brewing public health dilemma.
Within just a few years, Europe witnessed an unprecedented change in how one class of drugs (so-called GLP-1 receptor agonists) are recognized and used. Originally developed for the treatment of type 2 diabetes, these injectable drugs currently fuel the billions of euro weight loss industry due to private demand, social media hype and regulatory gaps. The new “weight loss hysteria” began in the United States. There, drug prices remain the highest, but people are still willing to pay $1,300 a month without insurance coverage. The trend is currently exploding in Europe, not limited to people with medical conditions or obesity, but it is spreading to those seeking a new approach to coping with the beach. But how much will we pay for the body of our European dreams?
Italy: Ten times more expenditure
The Italian private market for GLP-1 drugs exploded in 2024, with global anti-obesity drug spending reaching 26 billion euros, an increase of more than 10 times compared to 2020. According to the Pharma Data Factory (PDF), private spending on GLP-1 agonists went from 2023 million euros to over 115 million euros in 2024.
This surge comes from an increasing trend. This is an off-label use of antidiabetic drugs for weight loss. As such use is not currently covered by Italian National Health Services, most of the spending comes directly from the patient’s pockets.
However, there is a policy level movement. Recent Act No. 741, which officially recognizes obesity as a chronic disease, could pave the way for future reimbursements under Italian Insurance Level Care (LEA) provisions. However, for the time being, prescriptions are usually limited to experts, and in many cases, evidence of a high mass index or diabetes-related condition is required.
Greece: high demand, strict rules
This phenomenon is reflected in Greece, with anti-obesity drug usage rising 82.5% in 2024, with total expenditures of 93 million euros. Ozempic’s popularity has skyrocketed, and the market has since expanded to include Mounjaro, which was introduced in November 2024.
Despite consumer enthusiasm, Greek regulations are one of the strictest in Europe. Prescribing these drugs for obesity is technically prohibited except in cases that are life-threatening. Doctors need to prescribe them to prove a diagnosis of diabetes, making legitimate weight loss prescriptions almost impossible through official channels.
However, the rigidity of the regulations does not slow underground momentum. With Mounjaro’s sales now reaching 12,000 units per month, the 23% drop announced by Pharmaserve-Lilly in February is expected to further accelerate the spread of other drugs, whether legal.
Portugal: No refund market
In Portugal, the weight loss drug phenomenon is newer, but not so intense. In the first four months of 2025 alone, Portuguese consumers spent nearly 20 million euros on GLP-1-based injections such as tilzepatide (Munjaro) and semaglutide (Wegovy).
Over 10,000 tilzepatides were sold in just two months of 2024, but Wegovy, introduced in April 2025, earned 6,800 units of sales in a month. With each of the 244.80 euro wegovy injections, this trend shows no signs of slowing down.
Ozempic is not officially approved for weight loss, but it continues to be widely used off-label. Its popularity led to a shortage of pharmacies and forced the National Medical Office of Medicine to approach the National Drug Supervisor in cooperation with the European Medicine Administration.
Refunds are still a fixture. Despite growing interest and usage, Portugal remains unsubsidized for anti-obesity injections, with all costs being borne by individuals. This is motivated by the culture of influencers and the transformation of celebrities.
Spain: Market On Fire
According to data shared by consulting company IQVIA Digital ConfidentialityIn the Spanish pharmaceutical market, weight loss drug sales exceeded 484 million euros in 2024. This is a 65% increase from 293 million euros in 2023.
However, despite this surge, the Minis Steel Committee on drug and health products prices has not publicly tracked particularly anti-obesity drug spending. Known: Spain’s overall retail drug spending is 412 euros per person, 21% below the EU average of 500 euros, according to the 2024 Drug Expense Report.
In Spain, the prices of publicly reimbursed drugs are set by the Ministry of Health, and obesity drugs must be prescribed and supervised by experts. This regulatory barrier is intended to ensure proper use, but also limits access, especially as policies rise faster than they adapt.
Germany: Increased demand, limited access
In Germany, demand for weight loss drugs such as Wegovy and Mounjaro is rising rapidly. These GLP-1 drugs cost up to 300 euros a month, and for most people, the bill comes out of their pocket.
By law, the German public health insurance system excludes drugs that are purely used for weight loss and classifies them as lifestyle treatments. However, an exception has appeared. In early 2024, authorities were able to qualify for a refund for Wegovy, but only if obesity poses a serious cardiovascular risk.
Despite these restrictions, the market is booming. Sales of German GLP-1 drugs are expected to more than double by 2030, reaching more than 700 million euros. More than half of the adult population is overweight, and there is growing pressure for policymakers to expand access. For now, there is a continuing debate between costs and public health that these powerful new drugs should benefit from.
Poland: Easy access via telehealth
While some countries have restricted access, Poland offers surprisingly open availability. Ozempic will be refunded for diabetic patients (PLN 121.25/€28 discount), but depending on the physician’s assessment, it can also be obtained through telehealth after remote consultation, and remote consultation, with the exception of diabetes.
The total price of Ozempic is PLN 404 (94 euros), and demand is high and drug recognition is growing as a rapid track for weight loss.
France and the UK: Controlled Refund Passes
France has launched a formal review that could lead to a refund of Munjaro in cases of limited obesity, but for now neither Murjaro nor Wegoby are covered by the public system.
In contrast, the UK NHS covers both drugs and qualifications are limited to patients referred to specialized weight management services. Wegovy was made available via the NHS in 2023, and Mounjaro was rolled out in 2024 under the Structured Program.
All of Europe, the public healthcare system faces an increasing dilemma. Originally designed to manage chronic diseases like diabetes, these systems are now strained by a surge in demand for weight loss drugs like Ozempic, Wegovi and Murjaro.
Obesity is increasingly recognized as a chronic condition, but regulations and reimbursement policies are struggling to keep up. This discrepancy has created a shadow market where people who have no official diagnosis pay their own out-of-pocket pay. And buying some of these medications is actually as easy as buying a detox tea. You have to lie and click to pay. And rather than praying that what comes through the post is authentic.
