Taipei, Taiwan – Ozempic is big business in China.

Last year, Danish pharmaceutical giant Novo Nordisk doubled its sales of the diabetes drug in the country to nearly $700 million – 5 percent of Ozempic's global sales.

Ozempic was approved in China in 2021 to treat diabetes, but it was its anti-obesity drug, semaglutide, that fueled demand for the drug, which many Chinese call the “internet celebrity weight-loss drug.”

Chinese influencers and vloggers have promoted the use of Ozempic on Chinese social media.

The same platforms are also the birthplace of numerous “beauty challenges” that have gained popularity over the years and in which young women in particular show off their slimness.

“Overall, 'slimness' is the ideal of beauty for women in China, and some are even willing to demonstrate and strive for it, even if it comes at the expense of their health,” Pan Wang, a lecturer in Chinese and Asian studies at Australia's University of New South Wales, told Al Jazeera.

For Wang, the increasing demand for Ozempic is no surprise.

“Today, many people in China are willing to try all kinds of methods and supplements to lose weight,” she said.

Those who want to lose weight at any cost are not just young, beauty-conscious women on social media.

China has the highest number of overweight or obese people in the world; about half of the population is overweight.

Rising obesity rates and demanding beauty standards made the Chinese market a tempting target for drug makers like Ozempic, Wang said.

“There is potential to make a lot of money.”

The pharmaceutical companies are not sitting idly by.

Novo Nordisk has applied to China's drug regulator to expand the use of Ozempic, amid speculation that the company hopes to win approval to market the drug specifically for weight loss.

The company expects its weight-loss drug Wegovy to be approved for sale in China this year.

In May, Indianapolis, Indiana-based pharmaceutical company Eli Lilly received approval from Chinese regulators for its Ozempic competitor Tirzepatide.

Chinese company Hangzhou Jiuyuan Gene Engineering, owned by pharmaceutical giant Huadong Medicine, applied for approval to sell Ozempic's first domestic competitor earlier this year.

Despite these developments, demand for weight loss drugs exceeds supply, and Eli Lilly expects demand to continue to exceed supply in 2024.

On Chinese e-commerce platforms such as Taobao, the price of Ozempic has risen to as much as 1,000 yuan ($138), twice the price of the same drug in a public hospital.

As established companies work with Chinese health authorities to increase supply, sales of counterfeit semaglutide products on the Chinese internet have skyrocketed.

“The grey market for weight-loss drugs is booming in China,” Allan Von Mehren, chief analyst and China economist at Danske Bank, told Al Jazeera.

“Weight loss drugs are a market with enormous growth potential in China.”

Due to increasing demand, competition between suppliers will not be too big an obstacle in the coming years, said von Mehren.

“Instead, the limitation at the moment is capacity,” he said.

“Whoever can invest in capacity and dominate capacity will probably end up being the one who secures the largest piece of the market.”

Von Mehren said government intervention and regulation would be crucial in determining who would build capacity in the near future and who would be excluded from the market.

“Until recently, the market was like the Wild West,” he said.

In China, people have been able to buy Ozempic without a prescription, although increasing off-label use of the drug limits its availability to diabetics.

But since last year the Chinese authorities have intervened.

In February last year, censors removed more than 5,000 posts from the social media platform Xiaohongshu about weight loss experiences attributed to Ozempic.

In March last year, police investigations into the development and sale of unregulated semaglutide products ended with a series of arrests and convictions.

Last month, six people were prosecuted for selling chocolate bars containing banned substances after a child who ate some of the chocolate ended up in hospital.

“With the approval of new drugs for the Chinese market, the Chinese authorities are likely to increase their commitment compared to the initial release of Ozempic,” said Von Mehren.

While Western products currently dominate the weight loss drug market in China, this could change with greater government intervention.

Novo Nordisk is already involved in a patent dispute brought by Huadong Medicine, the pharmaceutical giant that wants to launch a Chinese competitor to Ozempic.

In 2021, Huadong Medicine applied to the Chinese State Intellectual Property Office to revoke Novo Nordisk's patent for semaglutide in China, which was valid until 2026.

The patent was invalidated the following year, but Novo appealed the decision and a final decision from the Patent Office is still pending.

“Unless the relevant court finally decides that this patent is invalid, we will not be able to market JY29-2. [the drug similar to Ozempic] before the patent expires,” a subsidiary of Huadong Medicine said in January.

If Novo's patent is declared invalid, it could increase the supply of weight-loss drugs in China as more Chinese companies try to bring their own Ozempic equivalents to market.

On the other hand, foreign companies have long expressed concerns about Chinese companies enjoying preferential treatment in their home market.

At the World Economic Forum in Davos in January, Chinese Premier Li Qiang sought to allay such concerns, saying: “China is open for business” and there is much “potential for foreign investment.”

“Do they still primarily favor their own companies? Or are they willing to level the playing field for foreign companies?” asked Von Mehren.

“The patent dispute and the involvement of the Chinese authorities in the weight loss products market may be a small test of this.”