Increase in demand for weight loss jabs means black-market alternatives are on the rise—and they're proving life threatening

By now, you'll likely have seen drugs Ozempic and WeGovy circulating on your social media. Rumours that celebrities had been using the injections to lose weight initially began after Kim Kardashian lost 16 pounds to fit into one of Marilyn Monroe's historically significant dresses for the Met Gala in May.

Dubbed "Hollywood's skinny jab", the drugs were initially developed for the treatment of type 2 diabetes, yet in recent months, have been prescribed in the US and UK for weight loss. They've since become one of 2023's most talked about topics, with searches for semaglutide, the active ingredient in Ozempic, at breakout on Google.

The debate about whether the drugs should be used for weight loss purposes rages on, with many qualified medical professionals maintaining that not enough long-term, clinical research has been carried out on the side effects of the drug.

The drug works by lowering your blood sugar levels and slowing down the rate at which food leaves your stomach, reducing appetite and inflammation. That said, its sharp rise in popularity led to global supply issues, even creating a shortage for diabetes patients in the UK.

As a result, many illegal and unregulated versions of the drugs have been popping up on the black market, labelled as 'diet kits'. It's been reported that unregulated Ozempic is being sold over the counter in beauty salons in both Manchester and Liverpool.

Just this month, in a sad twist, a new BBC report has uncovered that black-market sales of the drugs are seriously harming some of the women taking them, resulting in damaging and sometimes life-threatening complications.

According to the BBC, after purchasing unregulated semaglutide illegally online, Maddy*, 32, ended up in A&E vomiting blood. "I was extremely ill, bed-bound, vomiting," she told the publication. "I was throwing up all night, to the point where I was throwing up stomach acid, blood, [and] white foam. I thought I was dying - I was literally crunched over, bawling my eyes out to my mum."

Here, we explore the rising trend, plus ask: are black-market weight loss injections ever the answer? Below, we chat with three professionals for their take.

How is the online black market cashing in on weight-loss jabs?

According to Lesley Blair MBE, CEO and Chair of the British Association of Beauty Therapy and Cosmetology, online markets have been given an ideal set of circumstances to cash in on the weight loss drugs, including a lack of regulation, loopholes currently governing both products and supply channels, and demand outstripping regulated medical supplies. 

"This makes this a perfect storm for the black market," she shares. Ian Budd, a pharmacist at Chemist4U, agrees, adding that black-market sellers are taking advantage of growing demand with unlicensed, unregulated variants of legitimate treatments. "While these providers may advertise guaranteed results, the reality is that their medications are unregulated, untested and come with a long list of serious concerns," he continues. 

GP and online medical adviser for Prescription Doctor Dr Giuseppe Aragona also points out that many of these alternatives are counterfeit and may include substances claiming to boost metabolism or aid in fat loss that, in reality, have no scientific backing. "[Criminals] can take advantage of people seeking quick fixes by providing unregulated and potentially dangerous products," he continues.

Why are people turning to the black market?

As we've touched on above, global supply chain issues and shortages mean many who are already taking Ozempic have felt they've had to take matters into their own hands.

That said, it only prays on the vulnerability of those who genuinely require the medication. "The cost, shortages of medication, and sometimes arduous process of being able to access the medication legally through the right medical channels leaves these people disillusioned, desperate and with the belief they have no option but to go elsewhere," Blair reflects.

Why are black-market weight loss injections so dangerous?

The most obvious danger of taking a black-market weight loss jab is that no matter what you're told or where you buy it, you won't truly know what's in it. As Budd highlights, there’s no way of knowing what you’re putting into your body. "If you’re lucky, you may receive a medication that has the active ingredient you’re expecting, but you have no idea what it’s been made with or how strong the dosage you receive will be," he warns. It's important to note that licensed weight loss injections like Wegovy and Saxenda meet strict regulatory guidelines that mean that you'll get the right dosage for you and won’t be surprised by any unexpected ingredients.

Similarly, these black-market medications could be filled with dangerous ingredients. "Even if these medications come with an ingredient level, there’s no way to know whether this is accurate - anyone can type out a label, after all," he continues. "Injecting these unknown substances into your body could leave you with serious side effects, with some reports revealing that patients have been left hospitalised."

Black market weight loss injections also often neglect the fact that injectables should require medical oversight, shares Blair, not to mention ongoing monitoring from a professional who is qualified to both administer and manage complications while taking into consideration the medical history of the individual.

BABTAC has long advocated for further regulation of certain advanced procedures including injectables and products, and campaigns to make sure those who are fully legally able and qualified to administer these are doing so. "This way, medical practitioners are qualified to manage any complications that could arise," she continues. 

What side effects have people seen from buying these black market drugs? What are the risks, and can it result in death?

While the BBC article reports severe vomiting and the patient "throwing up stomach acid, blood, and white foam," Budd points out that patients who have fallen prey to these unregulated injections have reported other gastrointestinal side effects, too. 

The issue with this is, that if left untreated, these can leave you seriously unwell, dehydrated, and malnourished. "If you have serious allergies, you could also be putting yourself at risk of anaphylactic shock, as you have no way to tell whether the ingredients you’re injecting will cause a severe allergic reaction," he continues.

Another thing to consider - you'll have no reassurance of how these black-market medications have been prepared. They might not have been created in sterile conditions and you have no guarantee that the needle you’re provided hasn’t been used before. "These factors could leave you vulnerable to infections or even at risk of serious conditions like HIV," he warns. 

Aragona adds that the side effects of black market weight-loss drugs can vary widely as the composition is often unknown. "People have reported adverse reactions such as increased heart rate, high blood pressure, insomnia and gastrointestinal issues," he shares. And, in some extreme cases, these substances can be life-threatening, potentially leading to heart attacks, strokes, or other severe complications, he goes on to warn.

So, why as a society are we all so fixated on quick-fix weight loss solutions?

This one's more complicated and is deeply rooted in societal pressures and culture. As Blair points out, sadly we live in a society that demands instant results with little effort. "We're constantly provided with unrealistic objectives based on the fake perception of perfection that much of social media and the digital age encourages," she continues. 

Budd agrees, adding that in a world dominated by social media, it’s easy for people to fall into the trap of body envy. "While some celebrities and influencers may be happy to keep it real, the rise in popularity of photo editing apps has made it difficult to tell whether the photos you’re seeing online are realistic," he reflects. "When your timeline is flooded with these edited images, you naturally begin to compare yourself to the people you see online, often unfairly and with a sense of impatience to see results of your own."

In his opinion, these unrealistic standards for body image seem to be fuelling the demand for weight loss treatments. "But while medications like Wegovy can be necessary for those who are at risk of developing weight-related illnesses, like type 2 diabetes, they are not a quick fix or a way to lose a few pounds before a holiday."

What are the red flags when looking to buy weight loss products?

With so many weight loss products on the market, it can feel like a minefield knowing where to start. That said, it's critical to make sure you're purchasing a product that's safe, confirm all three experts. "If you're unsure of a product, do seek professional expert advice from your doctor," recommends Blair. 

Do note, as well: for prescription-only products such as semaglutide, it's a legal requirement for medical oversight in order to obtain it. "If there isn’t any, that should be a red flag immediately," she goes on.

Budd advises that legitimate prescribers will have their credentials listed in registers provided by the General Medical Council (GMC) or General Pharmaceutical Council (GPhC). "Both online and local pharmacies should also be registered with the GPhC, and details of their credentials should be made readily available," he adds. If you can’t find any information about the person who is trying to sell you weight loss medications on these lists, don’t part with your money and do not take anything they give to you, he warns.

Aragona recommends using the following checklist if you're considering buying a weight loss product:

• Lack of regulation: Be wary of products that are not approved or regulated by relevant health authorities.
• Overstated claims: If a product promises miraculous results with little effort, it's likely too good to be true.
• Hidden ingredients: Products with undisclosed or proprietary blends may contain harmful substances.
• Unrealistic before-and-after photos: Manipulated or exaggerated images can be used to deceive consumers.
• No scientific backing: Genuine weight-loss products typically have scientific studies supporting their efficacy.

Bottom line: weight loss is a highly personal and nuanced matter, and what works for you won't work for the next person. 

That said, all three professionals we spoke to for this piece maintained the same opinion: unless you have a medical condition, the best way to lose weight is via a healthy, active and balanced lifestyle. Black-market weight loss jabs will only risk your health long term and, best case scenario, act as a risky quick fix.