Obesity
Online UK pharmacies prescribing weight loss jabs to
people with healthy BMI
Exclusive: Calls for stricter checks after Guardian investigation
into availability of controversial drugs
Nicola Davis Science Correspondent
¥ @NicolaKSDavis
Wed 10 May 2023 14.00 BST
Online pharmacies operating in the UK are approving and dispatching prescriptions of
controversial slimming jabs for people of a healthy weight, a Guardian investigation
has found.
Some pharmacies appear to be issuing prescriptions of such medications to people
who lie about their body mass index (BMI) on an online form, In one case a reporter
was issued a prescription after accurately saying their BMI was about 20. A healthy BMI
lies between 18.5 and 24.9.
‘The findings have raised alarm among eating disorder charities, which have warned
that weight-loss medications should only be sold under the strictest conditions, Theirconcern has prompted calls for online pharmacies to employ stronger health checks
and screening for eating disorders.
Drugs originally developed for diabetes have recently been hailed as “gamechangers”
after they were found to help people reduce their weight by more than 10%, making
them a potential alternative to stomach surgery. While available to some people on the
NHS, they can also be bought on prescription through online pharmacies.
However, the medications, which are administered by injection, are controversial
because they can cause side-effects such as nausea and fatigue, and it is thought
weight loss will reverse when the drugs are stopped.
Saxenda, a brand of the drug liraglutide, has been approved for use in the UK for
certain groups of people with obesity - meaning a BMI of 30 or greater - or who are
overweight with a BMI of 27 to 30 and have weight-related health problems.
Ozempic, a brand of a similar drug called semaglutide, is licensed for diabetes but is
increasingly being prescribed “off-label” for weight loss by online pharmacies. While
legal, “off label” prescribing is done at the discretion of the prescriber.
To investigate the availability of the slimming jabs, the Guardian approached a
selection of online pharmacies from the top search results returned by Google.
On two occasions an online consultation for Ozempic - accurately filled in by a 1.7-
metre (5ft 7in) female reporter weighing 57kg (9 stone), resulting in a BMI of about 20 -
was immediately approved and dispatched by the online pharmacy Daily Chemist.
This is despite the form stating the drug should be discontinued once a patient’s BMI
fell below 27. The medication arrived by post within days.
Anumber of other online-only pharmacies contacted, including Click2Pharmacy,
Pharmacy2U and Simple Online Pharmacy, refused a prescription to the same reporter
based on her BMI, as did the online websites of the high street chemists Lloyds and
Superdrug.
Daily Chemist did not respond to a request for comment.
The investigation also found that other online pharmacies have authorised
prescriptions and sent medication to individuals who deliberately submitted incorrect
information in order to get slimming jabs.Jenny*, who has a history of disordered eating, meaning she has irregular eating
behaviours, said she had sought out the jabs after gaining 4.5kg to 6.4kg after an
operation.
“I definitely am not in the weight category to qualify for any kind of weight-loss drug
really. But I decided I really wanted the quick fix,” she said. “I could afford it”
Searching online, Jenny found a huge range of online chemists and that to obtain a
prescription for Saxenda it was only necessary to answer a few simple questions. “One
of them is: ‘What’s your weight?’ So I just added two and a half stone to my weight,
kept my height the same, my age [and] everything else the same,” she said.
To proceed with the order, applicants must allow the company, Chemist4U, the option
to contact the patient’s GP and see their summary care record. As a teenager, Jenny had
an eating disorder that was discussed with her family doctor but is not known whether
her GP was contacted after she filled out the form for Saxenda. Despite this, the
prescription arrived in the post within a couple of days.
Sasha* said she sought out Ozempic online in order to lose 6kg to 7kg of weight to.
reduce her BMI to the lower end of the “healthy” window and cut her risk of diabetes -
a disease that was common in her family.
Like Jenny, she submitted an incorrect weight to obtain a prescription from the Mayfair
Weight Loss Clinic. “I had to boost my weight to make me up to 30 BMI on this online
weight loss clinic to get it,” Sasha said. Mayfair Weight Loss Clinic did not respond toa
request for comment.
In 2019 new safeguards were introduced by the General Pharmaceutical Council
(GPhC), the independent regulator for pharmacists and pharmacies, to protect people
from the risks of buying inappropriate drugs through online providers.
In guidance for pharmacies acting at a distance, including online, the GPhC says:
“Some categories of medicines are not suitable to be supplied online unless further
safeguards have been put in place to make sure that they are clinically appropriate -
these include medicines liable to abuse, overuse or misuse or when there is a risk of
addiction and ongoing monitoring”
‘The GPhC confirmed this category included medicines used as weight loss treatments.
The guidance goes on to say medicines in this category should not be prescribed unless
the pharmacy has been assured “that the prescriber has contacted the GP in advance ofissuing a prescription, and that the GP has confirmed to the prescriber that the
prescription is appropriate for the patient and that appropriate monitoring is in place”.
‘Tom Quinn of the eating disorder charity Beat expressed concern at the findings. “The
fact that weight loss injections are apparently available online without stringent health
checks in place is very alarming,” he said.
“It can feel incredibly tempting to order weight loss injections like Ozempic as they
seem to promise fast results, but these medications can be extremely dangerous for
those with eating disorders.”
Quinn said rapid weight loss could contribute to eating disorders developing for the
first time in vulnerable people. “You can never tell if somebody has an eating disorder
based on their BMI, and it’s crucial that thorough health checks and eating disorder
screenings are in place to ensure that nobody unwell with an eating disorder is able to
access weight loss medications,” he said.
The Guardian passed its findings to the GPhC. The regulator’s director of insight,
intelligence and inspection,, Claire Bryce-Smith, said: “We take all concerns that are
raised with us very seriously and part of our role is to inspect pharmacies to ensure
they are meeting the standards we have set to protect patient safety.
“We have recently taken action to stop a small number of online pharmacies supplying
medicines being used for weight loss to potentially vulnerable people. We've also
reminded all online pharmacies that they need to follow our standards and guidance at
all times.
“These include the requirement for pharmacies to ensure they have all the relevant
patient information before making a prescription and carrying out a risk assessment to
consider the person’s wellbeing, particularly as eating disorders, body dysmorphia and
mental health issues can play a part in the reason for requesting these medicines”
Bryce-Smith said pharmacies should verify the accuracy of the information patients
provided them, for example through the use of video consultations. She added that
those accessing healthcare services should also always provide truthful and accurate
information about their health and medical history.
* Names have been changed.The free press is under attack from multiple forces. Media outlets are closing their
doors, victims to a broken business model. In much of the world, journalism is
morphing into propaganda, as governments dictate what can and can’t be printed. In
the last year alone, hundreds of reporters have been killed or imprisoned for doing
their jobs. The UN reports that 85% of the world’s population experienced a decline
in press freedom in their country in recent years.
Last week marked the 30th annual World Press Freedom Day, a day for everyone to
reflect on the importance of free expression as fundamental for all other rights. It is
also an opportunity to pledge support for independent media - because without a
robust and free press, a healthy democracy is impossible.
As you're joining us today from India, we hope you will consider marking this day by
supporting the Guardian, Despite the financial challenges plaguing the media
industry, we've decided to keep our journalism paywall-free, because we deeply
believe everyone has the right to access high-quality, fact-checked reporting. And we
maintain our independence thanks to generosity from readers all over the world,
who understand that supporting the free press is an investment in an informed and
empowered public.
Unlike many others, we have no billionaire owner - this helps us maintain the
freedom to fearlessly chase the truth and report it with integrity. Your support will
allow us to continue to work with trademark determination and passion to bring you
journalism that’s always free from commercial or political interference.
Today we ask you to power Guardian reporting for the years to come, whether with a
small sum ora larger one. If you can, please support us on a monthly basis from just
$2. It takes less than a minute to set up, and you can rest assured that you’re making
a big impact every single month in support of open, independent journalism. ThankMost viewed