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Off-label use of weight-loss drugs grows among non-obese users
A rising number of individuals with no medical need for weight-loss injections are using them intermittently for cosmetic purposes, despite warnings from health experts about potential risks. The trend, observed in countries like Brazil and the UK, involves drugs such as Ozempic, Wegovy, and Mounjaro-originally approved for diabetes or obesity-being obtained without prescriptions and used in cycles to maintain appearance.
Personal accounts: Quick results, recurring cycles
Gabriela, a 40-year-old Brazilian lawyer (name changed for privacy), turned to Ozempic in February 2024 after struggling to lose the last few kilograms gained during the pandemic. Weighing 76 kg at 1.69 m tall (BMI: 26.6), she purchased the injections from a Rio de Janeiro pharmacy without a prescription. The effects were immediate: her appetite plummeted, and she shed weight rapidly. "It was surreal," she said, describing how small meals left her unusually full.
Yet the results proved temporary. When she stopped the injections, the weight returned, leading to a year-long cycle of on-and-off use tied to her self-image. "When I like what I see in the mirror, everything feels easier," she admitted. Similarly, Andrew, a 49-year-old London-based food executive (BMI: 26.9), obtained Wegovy and later Mounjaro through an online pharmacy after a self-assessment. "The food noise went away," he said, noting reduced cravings and smaller portions at restaurants. Both now adjust dosing around social events-Gabriela skips doses before parties to eat freely, while Andrew times use around holidays.
Health risks of unsupervised, intermittent use
Experts warn that such off-label use-without clinical oversight or consistent dosing-poses unknown long-term risks. "We simply don't know the effects in people using these drugs purely for cosmetic purposes," said Simon Cork, a physiology lecturer at Anglia Ruskin University. Most safety data comes from obese or diabetic patients under medical supervision, noted Professor Simone van de Sande Lee, an endocrinologist. "These are not cosmetic tools," she stressed.
Common side effects include nausea and digestive issues, but rarer complications like pancreatitis or gallstones may emerge with wider misuse. Dr. Bruno Halpern, president-elect of the World Obesity Federation, highlighted muscle loss as a particular risk for slimmer users: "Slim individuals on restrictive diets tend to lose muscle more than fat. If they regain weight later, their body composition worsens." The "yo-yo cycle" of repeated weight fluctuations, he added, could increase long-term weight gain risks.
"These drugs are approved to treat conditions like diabetes or obesity-they are not cosmetic tools."
Professor Simone van de Sande Lee, endocrinologist
Psychological and physiological pitfalls
Beyond physical risks, psychological dependencies may form. Dr. Halpern observed patients equating weight loss with happiness or acceptance, only to feel like failures when weight returns post-treatment. "Your body doesn't just say, 'Great, job done,'" explained Dr. Cork. "Hunger hormones ramp up, metabolism slows, and the body fights to restore its natural set point." Patient leaflets for Ozempic, Wegovy, and Mounjaro explicitly recommend fixed weekly schedules under medical supervision-not the sporadic use seen in cosmetic cases.
Regulatory crackdowns and supply concerns
In response to rising misuse, both the UK and Brazil tightened regulations in 2025. Britain's General Pharmaceutical Council restricted online pharmacy sales, while Brazil imposed stricter prescribing rules to curb shortages and safety risks. Despite these measures, users like Gabriela and Andrew remain undeterred. Gabriela estimates spending over $2,000 on the drugs and admits, "I think I've become addicted to it." Andrew views it as a "relatively informed risk," stating, "If I cycle on and off this for the rest of my life, that would probably be OK."
Expert consensus: Chronic disease vs. cosmetic quick fix
Health professionals emphasize that obesity is a chronic condition requiring long-term management. NHS guidelines limit weight-loss drug use to two years for eligible patients (BMI ≥ 35-40, or lower with comorbidities). "Obesity isn't a temporary problem," said Dr. Halpern. "These drugs are for sustained treatment, not occasional use." Yet for users like Gabriela and Andrew, the appeal of rapid, effortless results outweighs the warnings-highlighting a gap between medical intent and real-world demand.
