It’s clear that there needs to be a crackdown on unlicensed sellers of weight loss drugs which are putting the health of vulnerable people at risk
Michelle first used a semaglutide ‘skinny jab’ two years ago, after a consultation with a registered nurse. But when Michelle sought another prescription this autumn, she found that the surge in demand for semaglutide had resulted in a supply shortage. Unable to access the drug via a reputable source, Michelle turned to social media.
She soon found a company on Facebook promoting products advertised as “skinny jabs and fake tan jabs”, and sent them a message asking if she could buy one of their injector pens. “They asked me no questions,” she says. “All they wanted from me was my postal details.”
Weight-loss drugs have dominated the cultural conversation in 2023. This is largely thanks to the explosion in demand for semaglutide, usually sold under the brand names Ozempic or Wegovy, both of which are manufactured by Danish pharmaceutical company Novo Nordisk. Semaglutide was originally created to treat diabetes by regulating blood sugar levels, but has since become a popular off-label treatment for weight loss due to its ability to curb hunger and slow stomach emptying.
Earlier in the year, Ozempic was largely regarded as the preserve of the elite. Hollywood actors and Manhattanites were using it. Elon Musk admitted to using it. Kim Kardashian denied using it – but rumours swirled that she, too, had dosed up to fit into Marilyn’s dress at the 2022 Met Gala. But now, semaglutide has gone mainstream, and everyone wants in: Novo Nordisk recently reported that in the first nine months of 2023, their sales grew by 33 per cent and it’s $413 billion market value now exceeds the entire GDP of Denmark. The surge in demand has been so great that it has triggered global shortages of Ozempic and Wegovy, resulting in diabetics struggling to access their medication and driving people desperate to lose weight into the arms of snake oil merchants.
It’s illegal to sell semaglutide without a prescription in the UK, but that hasn’t done much to deter sellers. “The drug has received widespread attention from the media highlighting its effectiveness at contributing to sustained weight loss, and so understandably those who do not meet the criteria [to access the drug on the NHS] but wish to lose weight want access to it,” explains Dr Simon Cork a senior lecturer in physiology at Anglia Ruskin University. “Weight loss is a multi-billion pound industry, so it is not surprising that unscrupulous individuals are cashing in on this by advertising counterfeit versions.”
Michelle says the process of buying an ‘Ozempic pen’ from an online seller was “very easy”: she simply sent the company £150 over PayPal and received the jab within two working days. “I felt a little bit apprehensive, but it did look almost identical to an Ozempic pen,” she recalls. “I didn’t listen to my gut and took it.”
Michelle soon started to feel “very disorientated, very confused” and developed a fever. “I just didn’t know what was happening around me. I felt very nauseous, very sick,” she says. 20 minutes later, Michelle’s daughter found her “slumped down” and losing consciousness. She contacted one of her mother’s close friends, who came over and immediately called an ambulance. Paramedics spent over an hour trying to stabilise Michelle, and she was taken to hospital after having a seizure. When she eventually stabilised, doctors explained to Michelle that she had not injected herself with Ozempic at all. Instead, they believed the injector pen she used had contained 14 to 16 units of insulin, causing her blood sugar level to drop dangerously low. “The doctors told me I was lucky to be alive,” she says.
“Think of your health first. I made very bad choices as I am so unhappy with my body, but now I think it’s better to be careful” – Jenna
Worryingly, Michelle’s case isn’t an isolated incident. The Medicines and Healthcare products Regulatory Agency revealed in October that since January 2023, they had seized 369 potentially fake Ozempic pens, and recent investigations have uncovered a flourishing online black market of weight loss drugs. Speaking to Dazed, another woman named Jenna says that she also had a bad experience after purchasing a week’s supply of diet pills for £45 from a company she found on TikTok. After the seller assured her the pills were “100 per cent safe”, Jenna took one.
“At first, I felt so much energy,” she recalls. “But within an hour… oh my god, things got very different.” Jenna began to feel incredibly dizzy and lightheaded and had to lie down. “I was pumping with sweat, I couldn’t speak properly,” she says. “When it wore off I threw away the tablets and messaged the lady, asking her what the hell was in them.” Jenna received no response. “People do not know what they are buying,” Dr Cork says, explaining that given the worldwide shortages, it’s unlikely that any seller would be able to procure genuine semaglutide.
To anyone who has never struggled intensely with body image issues, the idea that someone would purchase and use medication bought off social media might be difficult to comprehend. But in our aesthetics-obsessed society, people – particularly women – are socialised to view their appearance as intertwined with their self-worth. “If being beautiful is the status marker for a woman’s worth, losing weight can feel like a matter of social life and death,” explains Charlotte Fox Weber, psychotherapist and author of What We Want: A Journey Through Twelve of Our Deepest Desires. “It can feel like the most important thing in the world and can decrease an ordinary sense of risk in the willingness to try anything. Agony and misery over body shame leads to desperation and impulsiveness.” Essentially, it tracks that women are risking their health – and lives – to lose weight, considering that society has pushed them to this point.
It’s an issue that affects millions in the UK, too. Over one in six women feel negatively about their bodies while 35 per cent of all adults say they have felt “depressed” because of their body image. “A lot of women have huge insecurities about their body, and it’s just really, really sad that people are then making money off these insecurities and sending incredibly dangerous products out to them,” Michelle says. Fox Weber adds that “women are pressured to be thin and they’re then mocked for going about it in the wrong way [...] even if the drugs don’t work, compassion for people who have hoped they’ll work seems essential.”
“Women are pressured to be thin and they’re then mocked for going about it in the wrong way” – Charlotte Fox Weber
For both Michelle and Jenna, these frightening experiences have been a wake-up call. “I still have my insecurities about my body, but I feel incredibly foolish,” Michelle says. “I thought: ‘what am I showing my daughter, by taking things like that?’ It doesn’t set a good example.” Jenna adds she would urge anyone to be cautious when it comes to taking drastic action to lose weight. “Think of your health first,” she says. “I made very bad choices as I am so unhappy with my body, but now I think it’s better to be careful.”
Ultimately, though, it’s not as simple as urging people to eschew online sellers and stick to seeking out weight-loss drugs from licensed professionals. As evidenced, counterfeit drugs can be life-threatening, but using ‘real’ semaglutide is far from risk-free. It can be dangerous for anyone with a history of anxiety, heart problems, or disordered eating, and side effects can include nausea, diarrhoea, dizziness, and constipation. In rare cases, it can cause renal failure, pancreatitis and intestinal obstruction, and a top scientist has warned that it numbs people’s ability to feel pleasure and makes life “so miserably boring”. It’s also worth reiterating that it’s ultimately a drug that was created specifically for people with diabetes – not for non-diabetic people who simply want to lose a few pounds.
“The main danger comes from the risk-to-benefit ratio [...] The risks of being marginally overweight – or in some cases, not overweight but still wanting to lose weight – may not outweigh the risks associated with the drug,” Dr Cork explains. “This is particularly the case in patients who are purchasing this drug privately and who are not otherwise monitored. There is also a risk that easy access to this drug means those with body dysmorphia, for whom weight loss drugs could be very dangerous, could get hold of them.”
There’s no crystal clear, ‘binary’ distinction between safe, legitimate Ozempic and unsafe, counterfeit Ozempic. So with this in mind, perhaps it would be more useful to tackle the problem at the root and try to unpick and address the reasons why people feel compelled to risk their health just to lose a bit of weight. Evidently, there is a desperate need for a crackdown on snake oil merchants shilling life-threatening pills and jabs to innocent customers, but we shouldn’t forget that we also desperately need to crack down on our appearance-obsessed culture, too.