Last updated on November 2, 2025
No. In Belgium, prescribing GLP-1 analogues for weight loss without meeting strict conditions is prohibited. These medicines can only be prescribed under strict eligibility criteria defined by law and enforced by the Federal Agency for Medicines and Health Products (FAMHP) to ensure patient safety and equitable access.
Why Belgium Draws the Line
GLP-1 analogues—such as Ozempic, Rybelsus, and Trulicity—were originally developed to treat type 2 diabetes. Their ability to reduce appetite and promote weight loss quickly made them popular worldwide, creating a surge in demand that outpaced supply. Belgium, like many countries, faced shortages and responded decisively: by introducing strict prescribing rules to prevent misuse and prioritize patients who need these drugs most.
The legal foundation for these restrictions lies in the Royal Decree of 9 November 2023, published in the Belgian Official Journal. This decree sets out clear conditions for prescribing GLP-1 analogues for obesity, ensuring that treatment remains evidence-based and ethically distributed.
Who Qualifies—and Who Doesn’t
Belgium’s rules are precise. GLP-1 analogues may only be prescribed for weight loss if the patient meets one of the following conditions:
- BMI ≥ 35 kg/m², or
- BMI ≥ 30 kg/m² with at least one obesity-related comorbidity, such as hypertension, type 2 diabetes, dyslipidemia, or sleep apnea.
In addition, the patient must have failed to achieve sufficient weight loss through lifestyle interventions alone. This means documented attempts at dietary changes, physical activity, and behavioral therapy before medication is considered.
The treatment must be part of a comprehensive obesity management plan, which includes ongoing monitoring of weight, metabolic parameters, and potential side effects. Prescribers must also ensure that the patient understands the risks, benefits, and the need for long-term lifestyle changes alongside pharmacotherapy.
How to Obtain a Prescription
The process is structured and involves multiple steps:
- Initial Assessment by a Specialist
The first prescription must come from an endocrinologist or a physician specialized in metabolic disorders. During this consultation, the specialist evaluates BMI, comorbidities, previous weight-loss attempts, and overall health status. - Multidisciplinary Plan
The specialist develops a treatment plan that combines medication with lifestyle interventions. This plan often includes input from dietitians, psychologists, and physical activity coaches. - Documentation and Justification
The prescriber must document the patient’s eligibility and the rationale for using GLP-1 analogues. This includes confirming that non-pharmacological measures were insufficient. - Follow-Up Prescriptions
After the initial prescription, a general practitioner may continue treatment, but only under the supervision of the specialist and in line with the agreed plan. Regular follow-up visits are mandatory to monitor progress and adjust therapy as needed.
Patients who started treatment before these rules came into effect can continue, provided they met the criteria at initiation. Those who do not qualify must taper off under medical guidance to avoid withdrawal complications.
Why Such Strict Oversight?
Belgium’s approach is rooted in two key concerns: medicine shortages and patient safety. GLP-1 analogues are in limited supply, and off-label use for cosmetic weight loss could deprive diabetic patients of essential therapy. By enforcing strict conditions, Belgium ensures that these drugs go to those who need them most—patients with severe obesity or high-risk comorbidities.
The FAMHP also warns against illegal online sales of GLP-1 analogues. Social media platforms and unverified websites often offer counterfeit or improperly stored products, posing serious health risks. Authorities urge consumers to avoid these sources and report suspicious offers.
Cultural and Practical Context
Belgium’s healthcare system emphasizes solidarity and fairness. These rules aren’t about denying access—they’re about prioritizing care and preventing harm. In a country where public health policy is deeply rooted in equity, rationing scarce medicines is seen as a necessary safeguard.
The restrictions also reflect a broader European trend. Other EU countries have adopted similar measures to manage shortages and prevent inappropriate use. Belgium’s system aligns with these principles while tailoring enforcement to national needs.
What Happens If You Ignore the Rules?
Prescribing GLP-1 analogues outside the legal framework can lead to disciplinary action for healthcare professionals, including sanctions from medical boards. Patients who obtain these drugs illegally risk severe health consequences, from incorrect dosing to exposure to counterfeit products. In addition, insurers may refuse reimbursement for prescriptions that do not comply with official criteria.
Looking Ahead
Belgium’s restrictions remain in place until at least November 2025, with ongoing monitoring by FAMHP. As supply stabilizes and new treatments emerge, rules may evolve—but for now, strict conditions are here to stay. For patients, this means working closely with healthcare providers to ensure safe, legal, and effective treatment. For prescribers, it means adhering to guidelines and prioritizing those most in need.
See more on Belgium
Sources
Limited availability of GLP-1 analogues: recommendations for medical doctors | FAMHP
https://www.famhp.be/en/news/limitedavailabilityofglp1analoguesrecommendationsformedicaldoctorsspecialists
26/10/2023
Disponibilité restreinte des analogues du GLP-1: publication d’un arrêté royal | AFMPS
https://www.afmps.be/fr/news/disponibilite_restreinte_des_analogues_du_glp_1_publication_dun_arrete_royal_reglementant_la
14/11/2023