Unpacking the dangers of the controversial weight loss jab

If I were to count on my hands the number of times I’ve been up way past my bedtime staring at the computer, lit up by the glare of an advert for a ‘fix’ for being fat and taking everything I had not to hit ‘purchase’, I’d run out of fingers for sure. 

As a person who’s been plus-size, mid-size, and fluctuated into all other brands of size throughout my life, I’ve surfed the dark side of the web’s waters thoroughly, from expensive diet plans to liquorice pills and appetite suppressant lollipops. All of these almost-purchases had two things in common: they happened in a moment of utter desperation caused by internalised fatphobia, and they were stopped, after some deep thought by the sobering reality that these products would actually arrive at my door once purchased, and could seriously hurt me. 

That’s why it’s a shock to see one of the products I’ve stared down on my browser is now sold in Boots. The appetite-suppressing injection –  which we won’t be naming – can now be bought, with just a quick online consultation standing between the customer and a prescription.

This particular medication – which is self-administered via injection – used to be pretty hard to come by. According to Medical Director and Obesity and Weight Management Specialist Piroska Cavell, the weight loss jab was first developed by one of the largest pharmaceutical companies in the world, Novo Nordisk, as a treatment for those with Diabetes. “However, the medication naturally suppresses a person’s appetite and causes them to lose weight. What was once considered a side effect, was quickly reconsidered to be a weight loss solution,” Cavell explains. 

“This medication is certainly not intended as a quick fix for those looking to drop a few pounds” – Piroska Cavell

In some cases, this medication can be a good thing. Cavell, who uses this treatment with some of her own patients, explains that the medication can help those who need weight loss surgery achieve a healthy weight so that they can safely undergo the surgery. “It can also be paired with a nutrition, fitness and lifestyle plan to help those with obesity achieve a safer, healthier weight generally,” she explains. 

Cavell also warns, however, that while this medication can be effective it can also “cause serious issues”. “The drug is dangerous for anyone with anxiety, heart problems, or anything like this in their family history, as the medication raises the heart rate.” It’s also inappropriate to prescribe to those with a history of disordered eating, or cases where weight gain is linked to an underlying psychological cause that needs addressing. Cavell is also concerned by Boots prescribing this medication, noting that “pharmacists are not trained in obesity or weight management specifically.”

Even if you are the intended consumer for the drug, it doesn’t always work out, and the side effects can be difficult. 24-year-old marketing assistant Amy bought the medication from the Asda pharmacy after a recommendation from her GP and a quick consultation from the supermarket. “I urgently needed to lose weight so I could have further weight loss surgery,” she shares. 

“Like so many women, I was that desperate to lose weight and this medication made me feel like I was taking things into my own hands” – Amy

“Like so many women, I was that desperate to lose weight and this medication made me feel like I was taking things into my own hands,” she says. “The most profound thing about the medication, which just makes it not worth it, is they make you feel horrible. The side effects are way scarier than, you know, being big. I was sick all the time, constipated, completely miserable and depressed, and I had very little energy.” After putting up with all of that, “my weight loss results weren’t even that good. And I really did need urgent help with my weight.”

“This medication is certainly not intended as a quick fix for those looking to drop a few pounds,” Cavell stresses. But in the wrong hands, it can be positioned that way. This isn’t the first time this injectable weight loss medication has hit headlines and stirred controversy. Back in 2019, a startup under the name Skinny Jab came under fire for promoting the same weight loss medication. Although this medication has been around since 2014, the company marketed the jabs as though it was a new method of their own making.

No longer in business, Skinny Jab looped in influencers like The Only Way Is Essex star Gemma Collins and Atomic Kitten singer and media personality Kerry Katona as ambassadors of the brand, promoting the weight loss jabs heavily as a ‘quick fix’ for those who had struggled with weight loss and keeping up with diets. Both claimed that they had lost huge amounts of weight by using the jab. 

Katona and Collins were met with uproar online, with social media users attacking them for promoting the product on their social media platforms without including trigger warnings for those with eating disorders. 

27-year-old Katie* used the weight loss jab for “all the wrong reasons” in 2018, and found it troublingly easy to get hold of. “I got the medication from Skinny Jab and I was able to lie so that I could get the jabs during the online consultation,” she tells Dazed. “The consultation was about 10 minutes long. I don’t remember them asking about family history or anything like that. They did put me on a nutrition and exercise plan and made it clear the jab would not work well on its own, but I was already a healthy weight. I know now that I shouldn’t have been able to get it at all.” Katie has since received treatment for her disordered eating, and is in recovery. 

Collins was eventually reprimanded by the Advertising Standards Authority (ASA) for not making her relationship with the Skinny Jab company completely clear in her posts. Later, Skinny Jab was found to be in breach of guidelines for not stating that the procedure is only for people with significant weight problems. 

The actions of Skinny Jab, and the influencers roped into promoting them, turned out to be completely illegal. The Medicines and Healthcare products Regulatory Agency places a ban on the advertising of any medication that is prescription-only. Businesses can only promote prescription-only medications to healthcare professionals and others who can prescribe or supply the product. So, not long after their initial launch, Skinny Jab – along with two other startups who were wrongfully promoting the same drug – was shut down by Watchdog.

For a while, it seemed like the controversial weight-loss jab had burrowed back underground, only accessible in the UK through illegal means. But in October last year, the NHS began prescribing it to patients with serious weight issues. And now, Boots, along with Supermarkets like Asda, have followed suit in their own pharmacy departments, offering a prescription to this medication after a quick online consultation.

“Visiting a pharmacist who is not trained in identifying disordered eating behaviour enables a vulnerable individual to disguise their habit and get hold of the medication” – Piroska Cavell

Unlike Skinny Jab and other startups who’ve broken the law to peddle the jab, Boots are selling the medication legally. But with Boots being the second most popular health and beauty brand in the UK and millennials making up most of their customer base, it’s arguably too easy to stumble upon the jab while shopping around for other items. “As soon as I read this my eating disorder went ‘ooooh interesting,’” as one Twitter user said. Another: “This is so fucking dangerous, just like weight loss pills or teas, this is a perfect tool for an eating disorder.”

Dazed reached out to Boots about these concerns, who said the medication “is an effective way to help patients who are clinically overweight or obese to lose weight and the medicine has a good safety profile.” In addition, they said “As with all prescription medicines, it is very important that it is only used in accordance with the directions of the patient’s prescriber.” 

But 25-year-old Samantha*, who has previously suffered from Anorexia Nervosa, says that she was able to purchase the medication from Boots, despite being a healthy weight. Speaking to Dazed, she said “I went online to order [the weight loss jab] from the Boots website. Even though my Body Mass Index [which Boots uses to determine suitability – amongst other criteria] was in the ‘healthy weight’ region, I was able to continue the purchase!”

Cavell says those with a history of eating disorders will be particularly vulnerable with this medication being readily-available. “An online consultation enables someone with a history of disordered eating to easily fake the reality of their disordered eating behaviour by not being completely truthful,” she explains. “Visiting a pharmacist who is not trained in identifying disordered eating behaviour enables a vulnerable individual to disguise their habit and get hold of the medication. And, as this medication is self administered and the dose is adjusted by the individual, abuse of the dosage is a possibility that could result in serious consequences.”

Boots say they “do not offer this medicine to patients without an online consultation and a prescription. We are also very clear with patients that, although prescription medicines like [the weight loss jab] can help, changing their lifestyle and eating habits is what will sustain a healthy weight over the long term. We provide patients with resources on how to do this.”

While Boots are not breaking any regulations, 1.25 million people in the UK are likely to have some sort of eating disorder. And, as Cavell notes, “people who want to lose weight are very vulnerable to seeing complex medications like these as a fix-all. Often their self-esteem is really low and it’s easy [to get wrapped up in seemingly simple solutions]”. Perhaps it’s a dangerous idea to place weight loss medications this invasive and complex in the same store where you get your condoms and concealer, and the weight loss jab should remain guarded by the NHS.