So-called “miracle weight loss injections” have recently surged in popularity as celebrities, social media influencers and business moguls credit the drug with seemingly effortless weight loss.

6 minute read

Since going viral on social media, Ozempic’s rise in popularity has been nothing short of stratospheric. The number of Ozempic prescriptions in the United States has grown by more than 5,000% since 2018, up to around 20 million in 2023. 

Weight loss injections have also become increasingly sought after in the UK. In September 2023, online weight loss service, Juniper, said it had issued prescriptions for Ozempic to more than 15,000 women for weight loss in the past 15 months.

Demand for the drug has caused the market price of pharmaceutical company Novo Nordisk, who manufacture Ozempic, to soar to more than $500 billion.

The unprecedented demand for drugs like Ozempic has led to a shortage in supply, with many patients with type 2 diabetes struggling to get their medication.

What is Ozempic?

Ozempic (semaglutide) is a type of prescription medication called a GLP-1 agonist. It is used to help control blood sugar levels in patients with type 2 diabetes and is given as a subcutaneous (under the skin) injection once a week.

How does Ozempic work?

Ozempic works by mimicking the hormone GLP-1 which is produced naturally in the body. It helps to improve blood sugar levels in people with type 2 diabetes by:

• Stimulating the pancreas to release more insulin

• Preventing the liver from releasing glucose

• Slowing down the movement of food through the intestine

Can Ozempic help you lose weight?

GLP-1 agonists such as Ozempic can help with weight loss by slowing down the rate at which food passes through your digestive system making you feel fuller for longer. It also keeps blood sugar levels stable, which may make you feel less hungry.

Ozempic was approved to treat type 2 diabetes in the UK in 2019. It wasn’t long before patients taking Ozempic for type 2 diabetes began reporting an interesting and, in many cases, welcome side effect — weight loss.

While Ozempic is not licensed for weight loss, doctors began prescribing it “off-label” to treat obesity. In 2021, Ozempic manufacturers Novo Nordisk launched a new drug, Wegovy, to treat obesity. Wegovy and Ozempic both contain the active ingredient semaglutide, but Wegovy contains a higher dose.

In September 2023, Wegovy was approved to treat patients with obesity in the UK who meet the following criteria:

• A body mass index (BMI) of 30 or more

• At least one weight-related health condition

As of 2024, Ozempic is no longer available in the UK for weight loss, and can only be prescribed to people meeting the following criteria:

• Have a BMI of 30 or above

• Have poorly controlled type 2 diabetes

• Are not suitable for treatment with diabetes drug metformin

• Do not have a personal or family history of thyroid cancer

• Do not have a personal or family history of pancreatic cancer or pancreatitis

Are there any alternatives to Ozempic for weight loss?

If you’re trying to lose weight, your GP should be your first port of call. Your GP can assess your weight, general health and medical history and offer advice about losing weight safely. This may include advice on eating a balanced diet, taking regular exercise, a referral to a dietitian or therapist, or information about local support groups.

They can also check for underlying health conditions that may be associated with obesity, such as type 2 diabetes, high blood pressure, polycystic ovary syndrome (PCOS), sleep apnoea, or thyroid problems.

In some cases, if you meet certain criteria, your GP may prescribe medication to help with weight loss.

In the UK, some medications approved to aid weight loss include:

Orlistat

Orlistat is an oral medication (capsule) that can help with weight loss by preventing around a third of the fat from your food being absorbed. This undigested fat is passed out of your body with your faeces (poo). It can aid weight loss when combined with a diet and exercise regime.

Orlistat is available on prescription from your doctor, or at a lower dose from pharmacies under the brand names Alli and Orlos. You can only buy orlistat if your pharmacist thinks it is a suitable medication for you and it must be taken under their supervision.

Your doctor may prescribe orlistat if:

• You have made a significant effort to lose weight through diet, exercise and lifestyle changes without success, and:

  • You have a body mass index (BMI) of 28 or more, and other weight-related conditions, such as high blood pressure or type 2 diabetes

  • You have a BMI of 30 or more

Liraglutide & semaglutide

Liraglutide (Saxenda) and semaglutide (Wegovy) are GLP-1 agonists that can aid weight loss by making you feel fuller and less hungry. They're taken in the form of an injection under the skin. Liraglutide is taken once a day, and semaglutide is taken once a week.

Your doctor may prescribe liraglutide if:

• You have a BMI of 35 or above, or 32.5 or above if you're of Asian, Black African, African-Caribbean, or Middle Eastern descent

• You have a high risk of heart attack or stroke

• You have non-diabetic hyperglycaemia (high blood sugar)

Your doctor may prescribe semaglutide if:

• You have health problems relating to your weight, and:

  • A BMI of 35 or more, or 32.5 or more if you're of Asian, Middle Eastern, Black African or African-Caribbean origin

  • A BMI of 30 to 34.9, or 27.5 to 32.4 if you're of Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin, and you meet other criteria for treatment by a specialist weight management service

Tirzepatide

Sold under the brand name Mounjaro, tirzepatide is a relatively new medication to aid weight loss. Like semaglutide, tirzepatide is a GLP-1 receptor agonist, but it mimics two hormones, glucose‐dependent insulinotropic polypeptide (GIP) and GLP-1.

It works by slowing down the emptying of food from your stomach, keeping you fuller for longer, sending a signal to your brain that you’re full and stimulating the production of insulin to help regulate blood sugar levels.

Your doctor may prescribe Mounjaro if you:

• Have a BMI of 30 or more

• Have a BMI between 27-30 and have a weight-related health problem

What are the benefits of weight loss injections?

Obesity is an increasing problem around the world and can lead to serious health conditions such as type 2 diabetes, heart disease, stroke, and certain cancers. It has also been linked to mental health problems including depression and anxiety.

When used correctly, and combined with a healthy diet and exercise, weight loss injections can make it easier to lose weight, increase your overall health and well-being and reduce the risk of chronic diseases.

Are weight loss injections safe?

Along with the benefits, there are risks associated with using weight loss injections.

Side effects of weight loss injections

Like all medications, semaglutide may cause side effects in some people. Most side effects are mild, but in some cases, semaglutide can cause serious, or even life-threatening side effects.

Most side effects of semaglutide are mild and improve after a few weeks. Tell your doctor if your side effects are bothering you, getting worse, or not going away.

Mild side effects of semaglutide include:

• Nausea

• Vomiting

• Abdominal pain

• Diarrhoea

• Constipation

• Burping

• Heartburn

Seek immediate medical attention if you experience serious side effects of semaglutide including:

• Skin rash, itching, hives, swelling of your face, lips, tongue, or throat — may be signs of a severe allergic reaction (anaphylaxis)

• Shaking, weakness, hunger, sweating, confusion, irritability, fast heart rate, hunger — may indicate low blood sugar (hypoglycaemia)

• Changes in your vision

• Thirst, dry mouth, feeling faint or lightheaded, headache, passing small amounts of dark-coloured urine — may indicate dehydration

• Severe abdominal pain, fever, nausea, and/or vomiting — may be due to gallbladder problems

• Heart palpitations

• Mood changes or suicidal thoughts

• Passing less urine, blood in your urine, swelling of your ankles, hands, or feet — may be signs of kidney damage

• Severe stomach pain or tenderness that may spread to your back, fever, nausea, and/or vomiting — may indicate pancreatitis

• A lump in your neck, pain or difficulty swallowing, hoarse voice, difficulty breathing — may be signs of thyroid cancer

Drug interactions

Semaglutide may interact with other medications you are taking, which can change the way they work or cause harmful side effects. Always tell your doctor about any other medications you are taking, including over-the-counter medicines, vitamins or supplements before taking semaglutide.

Contraindications

Semaglutide may not be suitable for everyone and can be harmful for people with certain medical conditions.

Tell your doctor about any medical conditions or allergies you have before taking semaglutide.

Do not take semaglutide if you:

• Are allergic to semaglutide or any of its ingredients

• Have a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia type 2 (MEN 2)

• Have uncontrolled hypothyroidism

• Are pregnant or breastfeeding

Tell your doctor if you have ever had:

• Pancreatitis

• Problems with your kidneys

• Problems with your stomach or intestines

• Diabetic retinopathy

Counterfeit medication

In October 2023, The Medicines and Healthcare Products Regulatory Agency (MHRA) issued a warning to the public about potentially fake pre-filled injection pens claiming to contain Ozempic (semaglutide) or Saxenda (liraglutide).

The MHRA has seized 369 potentially fake Ozempic pens since January 2023, as well as receiving reports from the public of fake Saxenda pens bought from unsafe sources such as the internet without a prescription. There have also been reports of a small number of people who have been hospitalised after using potentially fake weight loss medications. 

Buying prescription-only medicines such as Ozempic online poses serious risks to health. Such medications are unregulated and may be counterfeit (fake) or contain other ingredients that can be harmful to your health. In addition, buying Ozempic without a prescription means you haven’t been assessed by a doctor and the medication may not be safe or suitable for you.

Summary

Weight loss injections have soared in popularity in recent years and the trend looks set to continue as those in search of a quick fix in the battle to lose weight turn to unregulated sources such as the internet.

Though beneficial to those who need them, weight loss injections are not suitable for everyone and can have serious consequences for your health if not used correctly.

If you want to lose weight and would like to know more about medications for weight loss, make an appointment with your GP.