The growing, widespread use of a new class of “miracle” weight-loss drugs – exacerbated by massive social media hype – is causing concern among doctors and regulators worldwide, with the medical profession, particularly, worried about patients using these medications inappropriately, reports MedicalBrief.
The relatively new class of medication – GLP-1 agonists – has become a weight loss phenomenon, its results being spread not just from person-to-person, but via numerous social media platforms.
A chorus of voices is singing these drugs’ praises. Last summer, investment bank Morgan Stanley found mentions of one of these drugs on TikTok had tripled. People are streaming into doctors’ offices to inquire about what they’ve heard are miracle drugs, reports KFF Health News.
What these patients have heard, doctors said, is non-stop hype, even misinformation, from social media influencers. “I’ll have people asking for the skinny pen, the weight loss shot, or Ozempic,” said Priya Jaisinghani, an endocrinologist and clinical assistant professor at New York University’s Grossman School of Medicine.
Competition to claim a market that could be worth $110bn a year for drugmakers alone has triggered a wave of advertising that has provoked global concern among regulators and doctors. But their tools for curbing the ads that go too far are limited, especially when it comes to social media.
Regulatory systems are most interested in pharma’s claims, not necessarily those of doctors or their enthused patients.
Few drugs of this type are approved by the FDA for weight loss – they include Novo Nordisk’s Wegovy. But after shortages made that treatment harder to get, patients turned to other pharmaceuticals, like Novo Nordisk’s Ozempic and Eli Lilly’s Mounjaro, that are approved only for type 2 diabetes.
Those are often used off-label – though you wouldn’t hear that from many of their online boosters.
The drugs have shown promising clinical results, Jaisinghani and her peers say, and patients can lose as much as 15% of their body weight. Novo Nordisk is sponsoring research to examine whether Wegovy causes reductions in the rate of heart attacks for patients with obesity.
The medications, though, come at a high price, and patients typically regain much of their lost weight after they stop taking it.
Hype drives demand
But patients are not necessarily coming to doctors’ offices now because of the science. They are citing things they saw on TikTok, and seeing celebrities talking about their injections.
It leads to the questions “how come she can get it” and “why can I not,” said Juliana Simonetti, a physician and co-director of the comprehensive weight management programme at the University of Utah.
The excitement is coming also from business interests. Some are doctors promoting their venture-capital-backed start-ups.
Others are spas hawking everything from wrinkle-smoothing and lip-plumping to weight loss benefits of semaglutide, the active ingredient in Wegovy and Ozempic; their prices, often in the hundreds of dollars, are well below what consumers would pay if picking up the prescription at a pharmacy.
In the US, the FDA has oversight over ads from the pharmaceutical industry, which must acknowledge risks and side effects of drugs. But ads from people who write prescriptions don’t necessarily have the same restrictions. FDA regulations apply if the prescriber is working on behalf of a regulated entity, like a pharmaceutical manufacturer or distributor.
“The FDA is also committed to working with external partners, including the Federal Trade Commission (FTC), to address concerns with prescription drug marketing practices of telehealth companies on various platforms, including social media,” agency spokesperson Jeremy Kahn told KFF Health News.
Pharma firms run campaigns to educate healthcare professionals or raise “awareness” that may indirectly tout drugs. Novo Nordisk has an ongoing internet campaign to redefine and destigmatise how Americans think of obesity – and, left unmentioned, the drugs that treat it.
KFF Health News also found that, beyond the industry group’s examination, at least two other entities were promoting Novo Nordisk products in the United Kingdom.
Australian regulators have taken down nearly 1 900 ads since early March for improperly promoting various GLP-1 agonists, an agency spokesperson said. Novo Nordisk says it didn’t put up the ads, most of which were for their product Ozempic. The regulators are declining to say who’s involved.
Doctors are also sounding alarms about the publicity. They believe patients will be driven to use these medications off-label, obtain unreliable forms of the drugs, or exacerbate other health conditions, like eating disorders.
The drugs act in part as an appetite suppressant, which can dramatically reduce calorie intake to a concerning degree when not paired with nutritional guidance.
Elizabeth Wassenaar, a regional medical director for the Eating Recovery Centre, believes the drugs and associated advertising build-up will inadvertently trigger eating disorders.
“They’re being marketed very pointedly to groups that are vulnerable to experiencing body image dissatisfaction,” she said.
One study, published in the journal Diabetes, Obesity and Metabolism, found two-thirds of lost weight came back after discontinuation of semaglutide.
But social media users and influencers – whether with white coats or ordinary patients – are hopping on every platform to spread news of positive weight loss outcomes.
There are those, for instance, who had gastric bypass surgery that didn’t work and are now turning to TikTok for guidance, support, and hope as they begin taking a GLP-1.
Commercialism sparks concern
Some have been so delighted by their medication-assisted weight loss they have become brand ambassadors.
One woman, Samantha Klecyngier, has dropped at least 26kg since she started on Mounjaro, which she touts on her telemedicine weight loss programme, Sequence, on TikTok. She and many others who have experienced considerable weight loss since starting the medication highlight its positive impact and their improved quality of life. Now she officially promotes the company on the app.
But her story – combining a personal journey with a profit-making entity – is symbolic of another trend on social media: commercialism.
A spate of start-ups is eyeing big money matching pharmaceuticals and related support with patients. (Sequence, the company Klecyngier pitches, was recently acquired by WeightWatchers.)
Some doctors use social media to educate viewers about the drugs.
Michael Albert, chief medical officer of telehealth practice Accomplish Health, says offering information to his more than 250 000 followers has helped point patients to the medical practice. It’s received thousands of patient inquiries, more than the clinic can handle.
But there are others, like spas and weight loss centres, that offer the drugs, sometimes without much medical support, often alongside Botox and dermal fillers. Obesity doctors worry such marketing is creating unrealistic expectations.
Some spas and telemedicine operators claim to have “compounded” semaglutide. But compounding, which is when pharmacies, rather than drug manufacturers, prepare a drug, is a risky proposition, doctors caution. “The risks are enormous,” Simonetti said, warning of potential contamination from poor compounding practices. “The risks include getting bacteria, and even death.”
Weight loss clinics also frequently tout unconventional additions to semaglutide, including vitamin B12 and amino acids. Some patients incorrectly believe the former helps with nausea, Jaisinghani said; other clinics tout greater weight loss.
Novo Nordisk spokesperson Allison Schneider told KFF Health News that the company shares doctors’ concerns about compounding and that it’s begun sending letters warning “certain healthcare providers” about the related risks.
Most operators in this burgeoning industry are keen to emphasise their products’ high quality or their company’s good works, as they seek money.
Ro, a telehealth firm offering GLP-1s, said its marketing campaign in the New York City subway “aims to start an important, sometimes difficult, conversation focused on de-stigmatising obesity as a condition”.
This widespread tactic is maddening for pharma industry critics.
“They talk about trying to destigmatise obesity at the same time they’re talking about losing weight. They’re co-opting the concept,” said Judy Butler, a research fellow at PharmedOut, a Georgetown University Medical Centre project focusing on evidence-based practices for drugs. “They’re trying to sell a weight loss drug.”
See more from MedicalBrief archives:
TikTok turns diabetes drug into popular diet pill
Maintenance semaglutide injections led to continued weight loss — STEP 4
Doctors warn about ageing side-effects of diabetes weight-loss drugs
Eli Lilly tightens diabetes drug access, frustrates obese patients
SA stocks of diabetes drug drained after global weight loss frenzy