The use of privately purchased weight-loss drugs continues to rise, and we urgently need to talk about how they are being prescribed.
What was once a tightly regulated medical treatment pathway is increasingly delivered through remote prescribing models, raising serious concerns across the clinical and regulatory landscape.
GLP-1 receptor agonists such as semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) are prescription-only medicines that carry recognised physical risks. These are not lifestyle products. They require robust clinical oversight.
Read more: Retatrutide spike: Fake weight loss jabs surged in 2025, says new data
The General Pharmaceutical Council (GPhC) has recently strengthened safeguards requiring online prescribers to independently verify weight, height and BMI rather than relying solely on self-reported data, and to ensure appropriate two-way consultation before prescribing. This is too little, too late.
The most dangerous failure of the remote model is its inability to safeguard the vulnerable. The solution is simple, nobody should be prescribed without an in-person medical appointment first.
Eating disorders
One of the most overlooked complexities of the demand for these medications is the underlying mental health of those seeking them.
Mandatory mental health screening checks must become a requirement for prescription. There have already been too many stories of those with eating disorders being able to gain access and cause themselves further harm.
This issue is particularly pressing given existing pressures within NHS eating disorder services.
Recent national reporting highlighted adult patients in England waiting up to 700 days for treatment. Introducing large-scale, lightly regulated access to appetite-suppressing medications into this environment risks pouring petrol onto a fire.
The dangers posed by the unregulated market are even more alarming.
The MHRA has issued warnings about counterfeit and illegally supplied weight-loss pens, with reports of hospitalisation following use of products obtained outside the regulated supply chain.
Experimental agents such as retatrutide, which remains in phase 3 clinical trials and is not approved for use in the UK, have also been advertised and promoted online.
The marketing of unlicensed medicines through social media competitions and informal networks is a serious patient safety threat. The Advertising Standards Authority (ASA) has taken enforcement action against the promotion of prescription-only weight-loss injections on social media.
For vulnerable individuals, particularly those with body image concerns, such marketing is not benign. It’s an underdiscussed point on the potential benefits of a social media ban for under-16s.
Social media exposure has been consistently linked to body dissatisfaction and eating disorder pathology. The predominate algorithms on social media can significantly increase exposure to such material, reinforcing harmful cognitive patterns.
Public health messaging must balance legitimate enthusiasm for obesity and type 2 diabetes treatment with sober recognition of risk.
GLP-1 medicines represent a genuine therapeutic advance. But advances in pharmacology must not outpace advances in safeguarding.
Robust in-person clinical assessment, independent verification of anthropometric data, screening for eating disorders and mental health risk, clear informed consent, and structured follow-up should be considered baseline standards for safe supply.
The benefits of GLP-1 medicines are real. So too are the risks, particularly for vulnerable communities.
Dr Ramoo is a co-founder of eating disorder clinic Bramacare