Ketone buildup from rapid fat breakdown poses serious health risks

Ketoacidosis cases reported even in people without obesity or diabetes

Cheaper drugs bought in Japan without prescription raise safety concerns

[Reuters/Yonhap]
[Reuters/Yonhap]

The Japan Society for the Study of Obesity has issued a warning about the side effects of obesity and diabetes drugs, drawing attention amid a growing trend in South Korea of buying Mounjaro and similar medications cheaply and without a prescription in Japan — a practice nicknamed "Sushijaro," a portmanteau of "sushi" and "Mounjaro."

According to Japanese media reports Sunday, the society recently released a statement warning of health risks as the use of drugs such as Mounjaro and Wegovy for weight-loss purposes has increased.

The society said rapid weight loss through these medications can cause ketone bodies — byproducts of fat breakdown — to accumulate in the body, triggering side effects including vomiting, abdominal pain and fatigue. It particularly flagged the risk of ketoacidosis, a potentially life-threatening condition in which excessive ketone buildup lowers blood acidity below normal levels.

"Cases of problems such as ketoacidosis have recently been reported even in people without obesity or diabetes," the society said, highlighting concerns about the misuse of obesity and diabetes treatments.

The society also urged anyone who develops symptoms linked to increased ketone levels while taking Mounjaro or similar drugs to stop the medication and seek medical attention immediately.

In Japan, adverse event reports tied to off-label use of Mounjaro have been mounting.

Of the roughly 950 adverse event cases involving Mounjaro reported to Japan's Pharmaceuticals and Medical Devices Agency from when the drug went on sale in 2023 through Sept. 22, 35 involved side effects that occurred after the drug was used for dieting or cosmetic purposes rather than its approved indications.

Mounjaro is an obesity and diabetes treatment that in principle requires a doctor's prescription, but in Japan it can be obtained through "free medical care" — private consultations not covered by national health insurance — for cosmetic weight loss. The drug is also classified in Japan as a type 2 diabetes treatment and managed directly by the government, making it relatively cheaper than in South Korea and other neighboring countries.

As a result, the "Sushijaro" trend — buying Mounjaro in Japan through purchasing agents or other channels — has gained popularity.

Obesity drugs used for dieting or cosmetic purposes can cause serious side effects, and the ease and low cost of obtaining them abroad underscores the need for authorities to act.


carrier@heraldcorp.com