Good morning. Canada could become the first country in the world to get generic Ozempic, so we are launching a series to explore the medical and cultural shifts in how we treat weight loss. More on that below, along with mass arrests in Iran and negotiations at the White House. But first:

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Hi, I’m Kelly Grant, a health reporter with The Globe and Mail. I’ve been reporting on Ozempic for years, and even I was stunned by the latest Canadian sales figures for the medication.

In 2025, Canadian pharmacies sold just more than $2.9-billion worth of Ozempic, a Type 2 diabetes drug that doubles as the world’s most famous weight-loss aid. Few prescription medications have cracked $1-billion in annual sales in Canada, let alone three times that.

Add in sales of Wegovy ($635.5-million), Mounjaro ($403.6-million) and Zepbound ($32.6-million) and the Canadian market for glucagon-like peptide-1 agonists (GLP-1s), as the class of drugs is known, ballooned to nearly $4-billion last year. That’s up from $2.7-billion in 2024 and $2.1-billion in 2023, according to IQVIA Canada, which aggregates prescription sales.

As this sales bonanza makes plain, more Canadians are getting on the GLP-1 train every day. Many more will board this year, when Canada becomes one of the first countries in the world to get cheap, generic Ozempic. Market exclusivity for the branded version expired Jan. 4, and everyone is now waiting for Health Canada to greenlight applications for copies from generic drug markers, likely this spring or summer.

When that happens, an injectable pen containing four 0.5-milligram doses of weekly semaglutide could drop to a base price as low as $78, down from $223 today.

We at The Globe think this shift will have major implications. We’ll be exploring them throughout the year in a new series called Skinny Inc.

We chose the name because generic Ozempic is going to be big business in Canada, as my colleague, business of health reporter Chris Hannay, lays out in compelling detail today in his story, about drugmakers’ race for a piece of the generic Ozempic market. He traces how for-profit virtual care platforms, pharmacies, and generic pharmaceutical companies are vying for a share of the Canadian GLP-1 gold rush.

In my feature story today, about how cheaper versions of Ozempic might tip the scales, I look at this rush from a different angle, widening the lens to ask: Is it a good thing that Canada will soon be awash in cheap, easy-to-access Ozempic?

Many of the physicians and patients I interviewed were thrilled at the prospect of cost being less of a barrier to a safe and effective treatment for an often-stigmatized chronic disease. On the other hand, Ozempic and other GLP-1s seem to have taken the wind out of the sails of the body positivity movement, making any shape other than skinny less socially acceptable than in the recent past.

As Deborah McPhail, a professor in the College of Community and Global Health at the University of Manitoba, told me: “Now we’re at this place where everyone’s like, ‘Well, great, now just take a drug. But what if you can’t take a drug? Or what if you don’t want to take a drug? People are worried it’s going to double or triple people’s experience of stigma.”

Over the coming months, The Globe will explore all the ways cheap Ozempic could change the world around us, from what we see in our feeds (is the era of the plus-size influencer over?) to what we put on our plates (how will GLP-1s change our relationships with food and pleasure?)

Plus, the articles are just the start of the project. We’ve also been working on a special podcast series on the business, science and cultural forces of GLP-1s that will come out on our daily podcast The Decibel. Make sure you’re following so you don’t miss it.

Along the way, we’ll ask tough questions of policy makers about how we treat obesity. Only one province, Alberta, has declared it a chronic disease. Should others follow suit? Should provincial drug plans cover semaglutide, the active ingredient in Ozempic and Wegovy, for the treatment of overweight and obesity? Right now, public plans cover Ozempic for people with Type 2 diabetes, not Wegovy, which is specifically approved for weight loss.

You’ll be hearing more from us, and we will continue to share the stories in this newsletter, too. Keep an eye out for our coverage in the coming weeks and send us your questions.

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