GLP-1s in Japan: What You Need to Know Before You Start
“The base pharmacy stopped my GLP-1 — What now?”
It’s a story I am hearing more often these days.
A SOFA civilian walks up to the military treatment facility (MTF) pharmacy window, expecting a refill of their weekly GLP-1 injection — only to be told it’s unavailable. Confused and frustrated, they ask, “Can I get this off-base?”
If this sounds familiar, you’re not alone. Across Japan, U.S. service members, families, and civilians are facing new barriers to accessing GLP-1 medications like semaglutide (Ozempic®, Wegovy®) and tirzepatide (Mounjaro®, Zepbound®).
I know how unsettling that feels. These medications have helped countless people regain energy, lower blood sugar, and finally see progress after years of trying. So let’s walk through what’s going on—and what your safe next steps can look like here in Japan.
What GLP-1 Medications Are — and How They Work
GLP-1 receptor agonists mimic a natural hormone that helps control appetite, digestion, and insulin response. Originally developed for Type 2 diabetes, these medications have transformed how we manage obesity and metabolic health.
They work by:
Slowing stomach emptying, helping you feel full longer
Reducing appetite and cravings
Improving blood-sugar regulation
Supporting cardiovascular health and blood-pressure stability
Research from the American Heart Association and leading journals shows that when used correctly, GLP-1 therapy can reduce heart-disease risk and support long-term wellness when paired with consistent medical oversight.
Why MTF Pharmacies Changed Their Policies
Beginning in 2024, Department of Defense (DoD) and MTF pharmacy guidelines were updated to limit GLP-1 dispensing to certain diagnoses — primarily Type 2 diabetes.
GLP-1 receptor agonists were originally developed for diabetes, but they’ve become some of the most effective tools we have for weight management and heart health. Over the last two years, demand has skyrocketed in the U.S. and around the world. Unfortunately, the supply hasn’t kept up for a myriad of reasons from supply-chain issues to regulatory delays to the proliferation of rampant off-label use.
MTF pharmacies (along with the rest of the world) have had to make tough choices about how to allocate their supply. The change isn’t simply about cutting SOFA civilians off from care. Still, for many, it’s been disruptive and stressful—and likely, pharmacy access for SOFA civilians will continue to be restricted.
That’s why it’s important to have a local medical home that understands your situation and can help you safely continue your care in Japan.
Costs and Coverage — What to Expect in Japan
Off-base access is possible, but pricing and coverage vary.
Here’s what to know:
Price variation: GLP-1 medications are sourced from multiple places affecting the cost of them. While the Japanese government puts a cap on prices for the national health insurance system (which you cannot access on SOFA status), it does not regulate the self-pay market. Suppliers to self-pay patients usually charge much more than the national health insurance price. Hence, you will see price variation in the pricing that reflects differences in sourcing, business models and the level of services offered with the medication. Some places may only prescribe the medication with minimal or no follow-up. Some places may have no physical presence in Japan so are ill-equipped to manage your health comprehensively. Torii Health provides ongoing primary care, screening for other co-morbid conditions and works with US insurance as possible.
Insurance:
Foreign Service Benefit Plan (FSBP) currently covers eligible members for GLP-1 management in Japan. They have been the least restrictive from my experience.
TRICARE, BCBS, and Aetna coverage varies and may require prior authorization.
Safety: Avoid compounded or imported versions from unverified sources — these may not meet FDA or Japanese regulatory standards and can pose serious health risks. Telehealth-only providers in or outside of Japan are not recommended as in-person follow-up may be needed along with local coordination of care and coordination of care. Weight loss is not just about one medication - it really warrants a comprehensive lens of one’s health.
Screening Before You Start — Safety First
GLP-1 therapy isn’t one-size-fits-all. Before starting, a comprehensive medical review is essential. Ongoing follow-up is also critical for dose adjustments, side effect management and tackling co-morbid conditions that can come up like high blood pressure, high cholesterol or sleep apnea.
At Torii Health we recommend:
Baseline labs to assess kidney, liver, and thyroid function
Full medical history review
Co-morbidity screening for diabetes, gallbladder disease, sleep apnea, and thyroid issues
Medication review to detect interactions or contraindications
This process also aligns with guidance from Mozaffarian et al., American Journal of Clinical Nutrition (2025), which emphasizes the importance of baseline assessment and lifestyle counseling in achieving safe, sustained weight management.
The Role of a Medical Home
Starting or restarting GLP-1 therapy is not just about getting a refill — it’s about building continuity. Your medical home is the anchor for that care.
A medical home provides:
Ongoing monitoring of weight, labs, and medication response
Side-effect management and dosage adjustments
Holistic guidance on nutrition, sleep, and physical activity
Long-term planning to sustain progress
At Torii Health, we take pride in being Your Medical Home in Japan. Our English-speaking clinicians coordinate every aspect of your care — from initial evaluation to prescription support and follow-up. Whether you’re transitioning off-base or just need continuity, we’re here to help you stay safe and on track.
Moving Forward Safely
If your base pharmacy has stopped your GLP-1 refill, don’t panic — and don’t turn to unverified online sources. There’s a safe, guided path forward.
At Torii Health, we offer:
Evidence-based GLP-1 management with proper screening and follow-up
English-speaking providers who understand U.S. and Japanese health-care systems and insurance
Coordination with FSBP and other US insurers
Holistic support that combines medication with lifestyle coaching
You’ve already taken a big step toward better health. Now it’s about building the right support around that progress. Stay tuned for Part 2 next week where we’ll cover Nutrition.
Torii Health — Your Partner in Safe, Sustainable Weight Management
📍 Telehealth across U.S. bases in Japan and physical location near Camp Zama
🕘 Appointments available Monday–Saturday
📅 Book your consultation today www.toriihealth.org/appointments
References
Mozaffarian D. et al., American Journal of Clinical Nutrition (2025). “Comprehensive baseline assessment and lifestyle support in GLP-1 therapy.”
American Heart Association (2024). Scientific Statement on Obesity Management and Cardiometabolic Health.
FDA (2024). “Guidance for Safe Use of GLP-1 Medications.”
DoD Pharmacy Operations Division (2024). “MTF Policy Update: GLP-1 Medication Access.”
