Have weight-loss jabs become the go-to drug for disordered eaters?

Many young women who aren’t overweight are looking for a quick fix – and finding it in unregulated online stores

“The worst decision I ever made.” That’s how Lottie Moss describes the two weeks she spent on weight loss drugs. Speaking on a YouTube video titled: “My Ozempic Hell”, Moss describes the moment an A&E nurse asked her how large a dose of the drug (given to her by a friend) she had been administering. “She said, ‘oh my God, that is so not what you’re meant to be taking’. She asked how much weight I’d dropped in the last two weeks. She sent me to the emergency room.” 
Moss describes being so unwell on Ozempic (which isn’t licensed for weight loss but is prescribed off label) she couldn’t keep food or water down. “I literally had a seizure from how dehydrated I was,” she told listeners to her podcast, Dream On, this week. “Honestly, that was the scariest thing that’s ever happened to me in my life.” 
She is the younger sister of the woman who has long been followed around by her immortal line: “Nothing tastes as good as skinny feels.” In sharing her experience with the drugs that many warn have spun wildly out of control, Moss spoke of the pressure to shed huge amounts of weight in a culture that has normalised medication as a solution for anyone (of any size) wanting to become smaller. 
“All these celebrities are on it right now and it’s so hard to look at that and see these dramatic weight losses, especially for people with eating disorders and problems with eating,” says Moss, who, it should be noted, does not have an eating disorder. “It’s so hard to see that, when maybe you’re not someone who drops weight easily or you’re struggling with recovery. It’s just so not what we need right now.” 
Moss’s experience speaks to a worrying trend as anecdotal evidence indicates that more and more people are turning to weight loss drugs as a quick fix. Many of them are young women who would not be categorised as medically overweight – often, they are young women in the grips of an eating disorder. 
In the bleakest corners of the internet, where accounts encourage people to starve themselves and hashtags like “#waifchic”, “#eatingdisorderdiettips” and “#starvingmotivation” are part of the lexicon, Ozempic has become a recurring buzzword. “Starving myself isn’t enough,” writes one Tumblr user. “I need f—— Ozempic”. 
Medical professionals including Dr Vicky Price, president of the Society for Acute Medicine (SAM), raised concerns in June about how easy it appeared to be for people to access the drugs for the wrong reasons. Weight loss drugs (also known as semaglutide) are prescribed on the NHS for weight loss, but they are also available to buy from online pharmacies. A month’s dosage of Wegovy (a commonly prescribed brand of semaglutide in Britain) costs around £199. Dr Price said she was among an increasing number of medics who are now regularly treating young women suffering badly from the adverse effects of drugs they should never have been prescribed. 
“Almost every shift I’ve done recently has seen a complication from a young girl taking the new weight-loss drugs that they’ve bought from an online pharmacy,” she said. “None have been overweight. They’ve paid £100-£200 and just lied about their weight.” 
For psychologists working on the frontline of eating disorder recovery, it speaks to a growing trend in their own treatment rooms. Thomas Midgley, a registered psychotherapist and company director of The Body Image Treatment Clinic, an eating disorder clinic on Harley Street, says the acceleration in people with eating disorders accessing weight loss drugs has been striking. 
“We have seen a massive change over the last six months from none to – at present – 20 per cent of my caseload are accessing off-label Ozempic,” says Midgley. “I’m also supporting two clients to manage their urges to start [using the drug]. Its impact is significant.” 
Of huge concern to Midgley is the lack of regulation. Put simply, it needs to be much harder to get your hands on these drugs without first having a proper consultation with a medical professional. “From the clients I work with, it is incredibly easy for anyone to access this drug,” he says. “My personal opinion is that in order to access Ozempic, both an endocrinologist and the patient’s general practitioner should both assess and agree on the appropriateness of its use. This would bring in much more accountability to those prescribing and selling the drug.” 
Many of his clients are “on it because their mums are on it, and all their mum’s friends are on it, and their friends are on it”. None of them, he says, have issues with weight or diabetes. 
SAM says there is “evidence of illegal supply and fake medication”, and is encouraging healthcare professionals to file a report with the government’s regulatory body if ever a patient presents with adverse symptoms to weight loss drugs. But for many, it isn’t a case of buying these drugs from a disreputable site. Rather, it can be as simple as heading to a well known online pharmacy and fudging your answers to a basic medical form. Set your BMI at a level that would classify you as obese, don baggy clothes for the picture you’ll be required to upload, and you’re likely to find yourself with an expensive prescription. It begs the question: is this really healthcare, or is it business? 
Hope Virgo, a campaigner who was hospitalised with an eating disorder as a teenager, says she knows of many people with eating disorders “who are using weight loss drugs”. “People are after a quick fix, a solution to feeling wrong in themselves, and this is how this drug has been painted to them.” 
The ease with which people can access these drugs is deeply concerning, says Virgo, who believes pharmacies “need to be regulated and held to account for their actions”. “For me, when I was at the height of my illness, I would have taken anything to make me lose weight, as I didn’t feel like I was changing weight fast enough.” 
Meanwhile, social media “glorifies these drugs”. “People only see one side of them – not the dangers. It’s extremely worrying how they’re being used. They’re normalising eating disorder culture and making people believe that if they change something about their body then somehow they will be happy and fixed, when this isn’t the case.” 
For Virgo, the fact that they can be accessed so easily in prescription form is particularly damaging. Even if you are a weight that would never lead a GP to prescribe you a weight loss drug – and even if you have acquired a prescription by lying about your weight – a prescription may still give someone in the grips of an eating disorder the illusion that they are taking the drug legitimately. “It makes them feel safe,” she says. “But because they aren’t monitored properly on distribution, they are actually still extremely dangerous. People will do anything they can to access these drugs, so tightening regulations is essential.” 
Experts fear social media, where minimal regulations mean anyone can publicise the “success” they have had with weight loss drugs with little context for their own medical history, is playing a significant role in making Ozempic a kind of trigger word for people suffering with eating disorders. Social media “is a very strong catalyst for those with a vulnerability to developing eating disorders,” says Midgley. “Through increasing the value our society places on aesthetic aspiration, it may even cause eating disorders in those who may otherwise not develop one.” 
People suffering from bulimia are particularly vulnerable, he says. “The point of the diagnosis of bulimia is they’re desperately trying to be anorexic, but their hunger takes over, and they end up eating and bingeing. So their body’s desire to not die overrides their desire to be thin and keeps them alive.” Weight loss drugs, however, will make them “lose much more weight”. 
Anorexia is “infinitely more dangerous than the other eating disorders”, says Midgley. “And so much more difficult to treat, because once somebody’s underweight, it’s so difficult to get them to a healthy weight where they need to be, so the treatment can prevail.” He worries weight loss drugs “could end up pushing more people into anorexia”. 
Umairah Malik, clinical research director at eating disorder charity Beat, says “stringent” safety checks must be put in place along with “eating disorder screening, to ensure that those affected by eating disorders cannot access a prescription”. 
They have been hailed as wonder drugs and for some, of course, that is exactly what they are. Prof Sir Stephen Powis, NHS medical director, recently described them as “a powerful part of our arsenal dealing with obesity” which “should not be abused”. But as pictures of celebrities who have seemingly shed half their body weight continue to fill social media feeds, and “Ozempic” continues to be invoked as a weight loss solution in the darkest corners of the web, there is a growing fear that misuse of these drugs is beginning to spin out of control.