Can you take Ozempic while fasting during Ramadan? UAE experts weigh in

Dubai: More people than ever are arriving at Ramadan with an Ozempic prescription in hand, hoping that combining the holy month's natural calorie reduction with a powerful appetite suppressant will deliver faster results.

It is an understandable impulse. But doctors across the region are urging caution, pointing out that what seems like a clever shortcut can quickly become a health risk if it is not managed carefully.

Ozempic, the brand name for semaglutide, was originally developed to treat type 2 diabetes. It works by copying a hormone your gut naturally produces after eating, one that slows down how quickly food leaves your stomach, makes you feel full sooner, and helps your body manage blood sugar levels. A related drug called tirzepatide works in a similar way. Both have become widely used for weight loss, and both raise specific concerns during Ramadan.

The core effect of these injections is appetite suppression, and under a normal eating pattern, that is exactly what makes them useful. During Ramadan, however, reduced hunger can quietly become a problem.

Dr Azeem Irshad, Specialist in Internal Medicine at Aster Clinic Al Nahda, explains the risk: "During Ramadan, appetite suppression may lead to individuals eating too little at Suhoor or skipping it entirely because they don't feel hungry. This can result in fatigue, dizziness, dehydration, headaches, and reduced concentration during fasting hours."

When someone is already fasting from dawn until sunset, the last thing they need is to feel so full that they skip Suhoor or pick at a small portion at Iftar and call it enough. Eating too little across two meals is not the same as healthy fasting. The body needs enough fuel to function, and when it does not get it, the signs show up quickly.

For people with diabetes who are also taking blood sugar-lowering medicines, the situation becomes more complex. Dr Kingini Bhadran, Specialist Endocrinologist at Aster Clinic Al Qusais, notes that "fasting already places physiological stress on the body. When combined with medication-induced appetite reduction, patients may unintentionally consume too few calories or insufficient fluids between Iftar and Suhoor, leading to fatigue, muscle loss, and worsening digestive symptoms."

There is also a risk of blood sugar dropping too low, which can cause shakiness, weakness, and confusion, particularly in people taking more than one diabetes medication.

There is also a more specific concern for those with existing diabetic eye disease, a condition where long-term high blood sugar damages the tiny blood vessels at the back of the eye. Dr Irshad points to research suggesting that rapid shifts in blood sugar levels, rather than low blood sugar alone, can be associated with temporary changes in the retina. During Ramadan, when dietary patterns shift and blood sugar can fluctuate more than usual, careful monitoring is essential.

"Appetite loss alone should never be the goal of treatment. Sustainable weight loss depends on metabolic balance, adequate protein, fibre, micronutrients, sleep quality, and physical activity, not simply eating less."

Not necessarily, and this is where individual assessment becomes so important. Doctors are clear that routine dose reduction is not required for everyone. Dr Irshad explains: "Patients who are stable on their current dose and tolerating it well can usually continue without adjustment, provided they maintain adequate hydration and balanced nutrition." However, those who have recently started the medication or are still in the period where their doctor is gradually increasing the dose week by week may benefit from pausing that increase and holding at a lower dose for the duration of Ramadan.

What is essential is that any decision about dosing is made with a doctor before Ramadan begins, not improvised midway through the month.

Dr Bhadran is direct on this point: "It is essential that anyone taking Ozempic consult their physician before fasting. Individual assessment is important, and patients should be monitored for persistent nausea, vomiting, severe weakness, or symptoms of low blood sugar."

Nausea, bloating, acid reflux, and constipation are among the more common side effects associated with these medications. Under a typical eating schedule, these are often manageable. During Ramadan, when all eating is concentrated into two main windows, they can become much more noticeable.

A large, heavy Iftar meal is one of the main triggers. Dr Irshad advises that patients should eat slowly, consume smaller portions, and avoid overeating after breaking the fast. Anyone experiencing persistent vomiting, severe abdominal pain, or signs of dehydration should seek medical review.

Breaking a long fast with rich fried food and oversized portions puts significant stress on a digestive system that is already processing a powerful medication.

Alongside prescription medications, there is a booming market in over-the-counter slimming products: herbal mixtures, detox teas, appetite-suppressing supplements, and beauty treatments promising rapid results. All three specialists flagged these as a serious concern, particularly when combined with prescription injections.

Dr Bhadran is emphatic: "Appetite loss alone should never be the goal of treatment. Sustainable weight loss depends on metabolic balance, adequate protein, fibre, vitamins and minerals, sleep quality, and physical activity, not simply eating less."

Dr Amir Firouzjaei, General Practitioner and Chinese Medicine Practitioner at Wellth by Medcare, adds that many of these products "may disturb gut motility, cause constipation or bloating, increase heart rate or anxiety, and mask true nutritional needs."

The problem is increased during Ramadan. Many unregulated slimming products contain substances that speed up your heart rate, others that force your body to flush out water as urine, and some that contain undisclosed pharmaceutical ingredients. All of these increase the risk of dehydration during an already demanding fast. Combined with prescription weight loss injections, they can amplify side effects and lead to dangerous imbalances in the body's minerals and a shortage of the vitamins your body needs to function.

The good news is that Ramadan, approached thoughtfully, can genuinely support healthy weight management.

At Iftar, break the fast gently:

Avoid fried foods, heavy pastries, and sugary drinks. As Dr Firouzjaei notes, "they promote weight gain despite reduced daytime intake," and sweetened juices and specialty coffees often contain far more calories than people expect.

All three doctors agree: skipping Suhoor is a mistake. Dr Irshad is clear: "Skipping Suhoor is strongly discouraged."

A good Suhoor should be built around foods that release energy slowly across the fasting hours:

This combination keeps hunger manageable, protects your muscle mass, and helps your body stay steady throughout the day.

Hydration is where many people fall short, and appetite-suppressing medications make this even more important. Dr Bhadran is clear: "Hydration between Iftar and Suhoor is critical."

Here's what you need to remember:

Ozempic and medications are clinical tools. Used correctly and under medical supervision, they can safely support weight management during Ramadan. The problems arise when they are treated as a cosmetic shortcut, combined with unregulated products, or used without proper nutritional support.

As Dr Firouzjaei puts it: "Using Ozempic purely for cosmetic weight loss, especially during prolonged fasting, requires medical supervision."

Ramadan offers a genuine opportunity to build better habits around food, eating more mindfully, choosing nourishing ingredients, and stepping away from the habit of excess. With proper guidance and realistic expectations, it is entirely possible to fast well, feel well, and take meaningful steps towards better long-term health.

If you are taking weight loss medication and planning to fast this Ramadan, the most important step you can take is a conversation with your doctor before the month begins.

Areeba Hashmi is a trainee at Gulf News.