The arrest of a doctor and gym instructor over the alleged illegal sale of weight-loss drugs, just last week, has put Malta’s growing appetite for peptides under the spotlight.Four people were arrested two weeks ago following police raids in Marsa, Msida, Żejtun, Qormi and Marsaskala. More than 2,100 units of peptides, steroids and other substances, around €8,000 in cash and electronic devices were seized.While the four remain under investigation and have not been charged with any crime, the case raises questions that go beyond the investigation itself.The arrests have opened a window into a world that is usually difficult to see. Weight-loss drugs are booming, but alongside the legitimate medical market, a different ecosystem has emerged – one involving social media, informal sellers, gyms, private networks and products that have not been authorised as medicines.At the centre of much of the conversation is “Reta” – retatrutide, an investigational drug that has attracted enormous attention for its weight-loss potential.An investigational peptide drug is a peptide-based medicine that is still being studied in clinical trials to assess its safety and effectiveness, and has not yet been approved for marketing by regulators such as the European Medicines Agency (EMA) or the U.S. Food and Drug Administration (FDA).A quick search of the internet reveals websites selling retatrutide and a range of other peptides, highlighting how the market is no longer confined to clinical trials or conventional medical settings.Lovin Malta has reached out to several healthcare professionals as part of an investigation into Malta’s growing peptide market. Until then, here’s an overview of the facts. The weight-loss drug boomThe popularity of weight-loss drugs has exploded internationally, and with medicines such as Ozempic, Wegovy and Mounjaro becoming household names, millions of people are turning to drugs that can significantly reduce appetite and help people lose weight.Ozempic and Wegovy contain semaglutide, while Mounjaro contains tirzepatide. These medicines work on hormone pathways involved in appetite, blood sugar and digestion.In fact, many of the medicines now associated with shedding weight were originally developed primarily to treat type 2 diabetes. Ozempic and Mounjaro are used to help people with type 2 diabetes manage their blood sugar, while their effects on appetite and weight have helped propel them into the mainstream weight-loss market. Related medicines, including Wegovy, are specifically authorised for weight management.The distinction between these authorised medicines and the products being sold online is important – Not everything being marketed as a “peptide” is the same thing, and not every peptide being sold online is an authorised medicine.Malta is embracing GLP-1 drugsAt the same time as a grey market appears to be growing, Malta’s Government is preparing to make legitimate GLP-1 treatment more accessible.Malta has long struggled with high rates of overweight and obesity. According to the latest State of Health in the EU profile, Malta has the highest rates of overweight and obesity among adults and adolescents in the EU. WHO data estimates that 32.3% of adults in Malta were living with obesity in 2022, compared with a European regional average of 22.6%.In April, the then-Health Minister Jo Etienne Abela announced that around 2,000 patients with type 2 diabetes and a BMI above 40 would be offered GLP-1 medicines free of charge under a new government scheme.The initiative is expected to cost around €5 million, while the Government has indicated that it could eventually expand the scheme to people with a BMI of 35.The Minister said a specific brand had not yet been selected at the time of the announcement, as the procurement process was still ongoing.As access to approved weight-loss medicines expands, what happens to people who don’t qualify for the scheme, or who want access to newer drugs that aren’t yet authorised?Enter ‘Reta’One name appears repeatedly in online discussions about weight-loss peptides: retatrutide, or “Reta”. This drug is designed to act on three hormonal pathways – GLP-1, GIP and glucagon – and is being studied for obesity and related metabolic conditions.It is still investigational, meaning that it hasn’t gone through the same regulatory process as medicines such as semaglutide and tirzepatide. Yet products labelled as retatrutide are readily discoverable online.The drug has generated significant interest because of the weight loss seen in clinical trials. However, there is an important distinction between promising clinical trial results and an authorised medicine.The online peptide marketThe market is also becoming broader than weight loss. Peptides are increasingly being marketed online for a growing range of purposes, from hair growth and skin pigmentation to muscle development, recovery and other wellness claims. That widening market means the conversation around peptides is no longer limited to people looking to lose weight, but is becoming part of something much bigger, particularly in the online health, fitness and beauty ecosystem.A quick TikTok search – “Malta peptides” – revealed at least five pages stating to sell peptides and to message them directly for prices and information. Some products are marketed with disclaimers saying they are intended “for research use only” and are not intended for human consumption. However, for someone looking to lose weight, the distinction can become blurred.That is particularly concerning because a product bought outside the regulated pharmaceutical supply chain may carry risks beyond those associated with the active substance itself. Consumers may not necessarily know whether what they have bought contains the stated substance, whether the concentration is accurate, or whether the product has been manufactured and stored appropriately.Discussions in the local online sphere, particularly popular Facebook pages such as “Are You Being Served” (RUBS) frequently revolve around doses, results, weight loss and comparisons between different peptides.The risks aren’t only about weight lossEven authorised GLP-1 medicines are not risk-free, with common side effects including gastrointestinal problems such as nausea, vomiting, diarrhoea and constipation. More serious complications can occur, although they are less common.There is also an important question about what happens when people stop taking them.Weight-loss drugs are increasingly being viewed as potentially long-term treatments rather than short courses. Research has found that people can regain a substantial amount of lost weight after discontinuing treatment.For people using an investigational peptide outside medical supervision, however, there is an additional layer of uncertainty – They may be taking a substance whose long-term safety profile has not yet been established in the same way as an authorised medicine.Maltese commentators debated on Facebook posts relating to the drug, asking whether the colour of the liquid was supposed to be completely clear, milky white, or having a yellowish hue. Why are people buying them?The answer may not simply be that people want to lose weight quickly. For some, obesity may have become a serious health problem and conventional treatment may feel inaccessible. For others, cost may be an issue. Some may not meet the criteria for Malta’s public scheme, while others may be attracted by the promise of rapid results promoted through social media.And some people may simply want to lose a relatively small amount of weight and see peptides as an easier option than changing their diet or exercise habits.The motivations matter because they help explain why an informal market can develop even as legitimate medical treatment becomes increasingly available.What happens when doctors become involved?The recent arrests raise another important question: what role are medical professionals playing in Malta’s peptide market?There is a clear distinction between prescribing an authorised medicine to an appropriate patient and supplying an unauthorised product.But as weight-loss drugs become increasingly popular, doctors are also encountering patients who may already be using products obtained elsewhere.What should a doctor do when a patient arrives having bought “Reta” online?How should patients be monitored when taking GLP-1 medicines?And what safeguards are necessary as Malta expands access to these drugs through the public health system?These are questions we have put to the Medical Association of Malta and the Health Ministry.Is there a parallel market?Earlier this summer, Malta’s health authorities issued a warning saying that products claiming to contain retatrutide were being circulated and sold through unverified and unauthorised sources, including online platforms, social media and informal sellers.The Superintendence of Public Health and the Malta Medicines Authority stressed that retatrutide is not authorised for public use and warned that such products may be falsified, counterfeit, improperly stored or of unknown origin and quality.The recent seizure of more than 2,100 units makes the question of scale even more pressing. While the seizure points to an established supply of unauthorised products, there is currently no publicly available figure showing how widespread their use is in Malta, how many products are entering the country through online or local sellers, or how much money is changing hands. The authorities’ warning confirms that such products are reaching consumers, but it does not indicate the size of the wider marketThe questions Malta now facesWhile it is true that weight-loss medicines are changing the way obesity is treated, their growing popularity is also creating new challenges. Malta is moving towards making GLP-1 medicines available to thousands of patients through the public health system, while demand is also fuelling an online market for products outside the regulated pharmaceutical system. Recent arrests have brought that tension into sharp focus.The bigger question now is how Malta manages a rapidly growing market involving patients, suppliers, doctors, companies and regulators. As these medicines become more widely available, the focus is not only on whether they work, but on who is taking them, what they are taking and whether Malta is prepared for what comes next.We want to hear from people using peptidesAs part of our in-depth investigation into the growing use of weight-loss peptides in Malta, Lovin Malta is speaking to people with first-hand experience.If you currently use, or have previously used, retatrutide (“Reta”), semaglutide, tirzepatide or other peptides for weight loss, fitness or other reasons, we want to hear from you.We’re interested in understanding why people turn to these products, how they obtain them, how much they cost, whether they use them under medical supervision, and what effects or side effects they have experienced.You don’t need to have had a negative experience – we want to hear about the reality of using these products in Malta.If you’re willing to share your experience, please contact us at clara@lovinmalta.comConversations can be treated confidentially.•