Ozempic on the Internet
For patients, the entire GLP-1 weight-loss journey can now happen online, no doctor needed.
The New Yorker published a ranging Ozempic feature today. The most interesting part of the story, to me, was author Jia Tolentino’s experience gaining access to the drugs online for the purposes of her reporting. Here’s a relevant bit:
This past November, I created an account on a telehealth Web site that looked as though it had been designed in about forty-five minutes using stock images and a free template. I filled out a form that asked for my height, my weight, and my reason for wanting semaglutide. I entered a weight that gave me a B.M.I. of 30. This was a lie….
A few days later, I received a small cardboard box from Clearwater, Florida, in the mail. Inside was a baggie containing alcohol pads, orange-tipped single-use insulin syringes, and a vial of bacteriostatic water. Another baggie contained a two-inch vial of clear liquid—this was the semaglutide—plus a syringe with an alarmingly long needle and a single sheet of instructions for how to mix the semaglutide with the bacteriostatic water and inject myself.
This section of the story jumped out because I’ve talked to a number of patients on GLP1-based drugs, such as Ozempic or Wegovy, whose entire medication-assisted weight-loss journeys happened on the Internet, a lot like Tolentino’s reporting gimmick.
In one case, a young man in Boston turned to an online prescriber — a business that’s flourished in the US during the pandemic — and then ordered his drugs from an online pharmacy, never seeing an actual health provider, not even virtually. He started to inject solo and turned to other patients on Reddit or TikTok when he needed advice. When he lost access to a discount he’d been using for his online prescription, he turned to an online pharmacy in Canada and now gets his Ozempic shipped in from north of the border.
Other patients told me about their experiences getting the drugs at compounding pharmacies, which mix active drug ingredients with other things. (Compounded drugs are not regulated by the Food and Drug Administration, with the result that they may not have the same safety or efficacy profile as approved products.) Still other patients told me they gained access through a suite of online businesses that have recently popped up to connect people to GLP-1s, such as Calibrate. (The business model seems to be: patients pay an access fee and in return, the companies deliver a prescription, work out patients’ insurance coverage, and connect them to online coaches or health providers.) Some patients are even mixing DIY weight-loss medications after purchasing unregulated, raw ingredients online, as Stat reported.
It surely goes without saying: These experiences are all markedly different from what happened in the GLP-1 clinical trials, where participants received detailed counselling and medical supervision — as well as FDA-regulated drugs or medicines bound for FDA approval. How “Ozempic on the Internet” plays out in the coming months and years will be a story to follow: how do patients, injecting solo, fare? Do they have worse outcomes? More complications? What does all this say about our healthcare systems — their dysfunction and baked-in inequality — especially when it comes to obesity?
So far, the “online” GLP-1 patients I’ve talked to have not reported medical complications, and if they did, perhaps they would have sought the care of a nurse or doctor. But I am sure that’s not the story for everybody injecting alone, and if no one’s watching, complications may be hard to see.
You can read the New Yorker feature here.
All the best, Julia
Ps. If you’re a patient with a story about taking a GLP-1 drug — such as Wegovy, Mounrjaro, or Ozempic without medical supervision — I’d love to hear about your experience. You can contact me here, or through my Twitter @juliaoftoronto, Mastodon @juliaoftoronto@masto.ai or Facebook profiles.