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Ten people die after agonising reaction to weight loss jabs

Ten people die after agonising reaction to weight loss jabs

Daily Mirror26-06-2025
MHRA says users of jabs such as Wegovy and Mounjaro reported inflamed pancreas - which can cause agonising abdominal pain - before their deaths as a major investigation has been launched
A probe has been launched into why ten people died after reporting a severe side effect to weight loss injections.
The Medicines and Healthcare products Regulatory Agency (MHRA) has launched an investigation after hundreds of users reported problems with their pancreas. The regulator's 'Yellow Card' scheme will now ask anyone who reports pancreatitis after taking the appetite-suppressing jabs to provide a DNA sample. It comes after Government ministers and some health leaders have called for the injections to be more widely available to tackle Britain's obesity epidemic and targeted at areas of high unemployment to help get people back to work.


Professor Matt Brown, chief scientific officer of Genomics England, which will also run the study, said: "GLP-1 medicines like Ozempic and Wegovy have been making headlines, but like all medicines there can be a risk of serious side effects. We believe there is real potential to minimise these with many adverse reactions having a genetic cause.'
Weight loss jabs slow digestion and reduce appetite by mimicking hormones which regulate hunger and feelings of fullness. They are designed to act like one of these hormones, known as glucagon-like peptide 1 (GLP-1).
Last year it was reported that Susan McGowan was the first Brit believed to have died after taking weight loss injections. The 58-year-old took two Mounjaro injections before her death in September. Susan's death certificate listed multiple organ failure, septic shock and pancreatitis as the immediate cause. It was believed to be the first confirmed death linked to a GLP-1 injection but it is not known whether her case was reported to the Yellow Card scheme.
Pancreatitis is inflammation of the organ located behind the stomach that aids in digestion and blood sugar regulation. It can cause sudden, severe abdominal pain, often radiating to the back. Other symptoms are nausea, vomiting, fever and a rapid heartbeat.
The Yellow Card scheme is the way anyone can report to the MHRA if they have had an adverse reaction to a drug. The MHRA data shows:

181 reported cases of acute and chronic pancreatitis linked to Mounjaro. Five of these people died
113 cases of acute and chronic pancreatitis linked to semaglutide - branded as Ozempic for diabetes and Wegovy for obesity - and one person died
116 users of the weight loss jab Saxenda reported having pancreatitis and one died
Exenatide, known by its brand names Byetta and Bydureon, was linked to 101 similar reactions after which three died
These cases are not confirmed as being caused by the medicines but the person who reported them suspected they were.

It comes after data released from the MHRA under Freedom of Information laws found there had been a total of 111 "suspected adverse drug reactions with a fatal outcome" up to May 2025. Responding to a freedom of information request from Chemist + Druggist, the MHRA added: "Underlying or previously undiagnosed illness unrelated to the medicine can also be factors in such reports."
However the latest data release focuses on fatal cases where side effects affected the pancreas.
Dr Alison Cave, MHRA's chief safety officer, said: "Evidence shows that almost a third of side effects to medicines could be prevented with the introduction of genetic testing, it is predicted that adverse drug reactions could cost the NHS more than £2.2 billion a year in hospital stays alone. Information from the Yellow Card Biobank will help us to better predict those most at risk of adverse reactions - enabling patients across the UK to receive the safest medicine for them, based on their genetic makeup.'

When a Yellow Card report is received, the MHRA will contact patients to ask if they would be willing to take part in the study. Patients will be asked to submit more information and a saliva sample which will be assessed to explore whether some people are at a higher risk of acute pancreatitis when taking these medicines due to their genes.
GLP-1 agonists can lower blood sugar levels in people living with type 2 diabetes and can also be prescribed to support some people with weight loss. Recent estimates suggest that about 1.5 million people in the UK are taking weight loss jabs, mostly via private prescriptions. Some have reported having to stop taking them due to side effects, particularly nausea.

The new study is part of the UK Biobank project which is the biggest of its kind in the world and holds genetic data on half a million Brits.
Dr Cave added: "To help us help you, we're asking anyone who has been hospitalised with acute pancreatitis while taking a GLP-1 medicine to report this to us via our Yellow Card scheme. Even if you don't meet the criteria for this phase of the Biobank study, information about your reaction to a medication is always extremely valuable in helping to improve patient safety."

It comes after GPs started offering the jab Mounjaro this week with it being prescribed first to those most overweight. Before it was only prescribed to on the NHS to patients already accessing specialist weight management clinics.
A spokesperson for Novo Nordisk, which manufactures Wegovy and Ozempic, said: 'Patient safety is of the utmost importance to Novo Nordisk. Like all medications, side effects can occur and vary from patient to patient. The known risks and benefits of GLP1 medicines are described in the Summary of Product Characteristics.
'We recommend that patients take these medications only for their approved indications and under the strict supervision of a healthcare professional, who can also advise on potential side effects.

'We continuously collect safety data on our marketed GLP-1 medicines and work closely with the authorities to ensure patient safety. The benefit-risk profile of our GLP-1 medicines remains positive, and we welcome any new research that will improve our understanding of treatments for people living with chronic diseases.'
A spokesman for Eli Lilly, which makes Mounjaro, said: 'Patient safety is Lilly's top priority. We take reports regarding patient safety seriously and actively monitor, evaluate, and report safety information for all our medicines. Adverse events should be reported under the MHRA's Yellow Card scheme, but may be caused by other factors, including pre-existing conditions.
'The Mounjaro Patient Information Leaflet warns that inflamed pancreas - acute pancreatitis - is an uncommon side effect which may affect up to one in 100 people. It also advises patients to talk to their doctor or other healthcare professional before using Mounjaro if they have ever had pancreatitis.

'We encourage patients to consult their doctor or other healthcare professional regarding any side effects they may be experiencing and to ensure that they are getting genuine Lilly medicine.'
NHS leaders warn jabs are not 'quick fix'
Prescribing guidelines state that weight loss injections should be part of a comprehensive weight management plan including tailored diet and exercise advice.
Side effects - particularly nausea and stomach cramps - can mean people stop taking the jabs. Some also find they can no longer afford the private prescriptions.
The injections can see users lose around a fifth of their body weight but, crucially, this includes muscle as well as fat.
Without drastic lifestyle changes research shows people pile fat back on a year after they stop taking the injections - but not the muscle. This makes it harder for them to lose weight again in future as they have less muscle to burn calories.
Anyone considering the injections should consult their GP.
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How booming ‘fat jab' black market is STILL rife after celeb stylist sells meds to Sun reporter for £280 via Instagram
How booming ‘fat jab' black market is STILL rife after celeb stylist sells meds to Sun reporter for £280 via Instagram

The Sun

timean hour ago

  • The Sun

How booming ‘fat jab' black market is STILL rife after celeb stylist sells meds to Sun reporter for £280 via Instagram

WEIGHT loss drugs are still being brazenly flogged on the black market by a celebrity hairdresser who gave The Sun a Mounjaro jab with NO consultation, Sun Club can reveal. The news has led Mounjaro manufacturer Lilly to beg those taking weight loss drugs to only buy from a licensed healthcare professional and warn that "dangerous" black-market products are often made in "unsanitary conditions". 9 9 9 As part of a Sun probe, we obtained self-injectable Mounjaro, dubbed the King Kong of fat jabs, for £280 after responding to an Instagram post by celeb stylist Ozzy Tudo, who is known for working with Katie Price and telly personality Jessica Alves. Our reporter was sold potentially deadly prescription weight loss drugs by Tudo, despite having a normal BMI and telling him she wanted to shed at least one stone in just TWO WEEKS before going "on holiday". The investigation exposed the ease of obtaining the fashionable diet drugs on the booming black market and, despite being confronted about the illegal sale on hidden cameras, Tudo has now started openly selling them again. Less than 24 hours ago, he posted an image of a slim model in white underwear with bottles of Mounjaro underneath and wrote the caption: "Available at great price #mounjaro." He also then posted an image of a Mounjaro injection pen to his 72k followers with the words: "#mounjaro. Very effective." When we asked Tudo about him continuing to sell Mounjaro over Instagram, he said: 'Why don't u go after the pharmacies which sells hundreds or thousands of pens without prescription [sic]? "It's no me do does wrong , it's these big companies, pharmacies and suppliers who sells to everyone who pays pharmacies accept fake prescriptions or without prescription [sic]." Asked to provide evidence that he was a qualified prescriber, Tudo refused to respond. Weight loss drugs can only be lawfully supplied when prescribed for someone by an appropriate practitioner – such as a doctor, a nurse or a pharmacist-independent prescriber - after a detailed health assessment. Mounjaro - which has been linked to 33 deaths in the UK - is approved for adults who are classed as "obese", so with a BMI of 30 or more, or those with a BMI of 27 or more who also have weight-related health conditions. I went on fat jabs but the hair loss was unbelievable so I quit - I'd rather be chubby with hair than skinny and bald However, earlier this year our reporter - who has a BMI of 21 - contacted Tudo through a mobile number on his Instagram account, which he uses to advertise Mounjaro and Ozempic. She told him she weighed nine-and-a-half stones, a size small dress size, and wanted to shed at least one stone before going on a holiday. She was not asked her height or her BMI. She was also not asked for her name or address. Tudo, 47, advised that a dose of 5mg 'is enough' and said to travel to his studio near King's Cross Station in London, where he would supply the drug. Once at the address, a woman, who did not speak English, led us up a staircase and handed over a brown paper bag containing the pen - which holds four injections of the drug, to be taken once a week for a month. With no consultation or explanation of how the prescription drug works, our reporter messaged Tudo saying: 'I don't know how to take it.' He replied: "Send u a video. It's so easy." The hairdresser then sent a YouTube tutorial video on how to self-inject. Asked if it would have any side effects, he replied: "It depends on each person, usually no." When we later confronted Tudo about the illegal sale, which was filmed using concealed cameras, he said: 'I don't even have Mounjaro here.' Pressed on how he prescribed the drug, which has been linked to 'deaths' without the necessary qualifications or even asking our undercover reporter for a name, he said: 'Deaths? No. Just a few overdoses.' Harley Street doctor Sophie Shotter, who has been practising for 16 years, said it was "terrifying' and a "risk to public health" that The Sun had obtained the drug without any medical consultation. Everything you need to know about fat jabs Weight loss jabs are a hot media topic at the moment, with hundreds of success stories from people who shed the pounds. In March 2023, the NHS announced it would make Wegovy, a drug made by Danish firm Novo Nordisk, available on prescription to thousands of obese Brits. It contains the drug semaglutide, which is said to have helped reality star Kim Kardashian and Twitter boss Elon Musk lose weight. Wegovy, which helped a third of people reduce their weight by 20 per cent in trials, is now available from pharmacies like Boots. How do they work? The jabs work by suppressing your appetite, making you eat less and therefore lose weight. To do this, semaglutide mimics the role of a natural hormone, called GLP-1. GLP-1 is part of the signalling pathway that tells your body you have eaten, and prepares it to use the energy that comes from your food. London GP and founder of Dr Zoe Watson, said: 'Your body naturally produces an appetite regulating hormone called glucagon-like peptide-1. 'These jabs work by regulating your appetite, which can lead to eating fewer calories and losing weight.' Aren't they diabetes drugs? Semaglutide, the active drug in Wegovy, was originally sold under the name Ozempic specifically for diabetes patients. But people started noticing it helped suppress their appetites, stopping them eating as much and helping them shed the pounds. Novo Nordisk then developed Wegovy, which contains the same chemical but at higher doses specifically to aid weight loss. Wegovy is not prescribed for diabetes patients. Can I get them? Wegovy is offered on prescription to obese adults given specialist weight loss treatment. The NHS currently also offers a similar drug called Saxenda, or liraglutide. Both are only available throught specialist weight management services, which means you have to be referred to clinics led by experts. GPs can't prescribe them on their own, Dr Watson said. The jabs have to be taken as part of an overall programme to help with lifestyle changes and psychological support to get the best effect from the medication prescribed. Are there any risks? Like all medicines, the jabs do not come without side effects. Around half of people taking the drug experience gut issues, including sickness, bloating, acid reflux, constipation and diarrhoea. Dr Sarah Jarvis, GP and clinical consultant at said: 'One of the more uncommon side effects is severe acute pancreatitis, which is extremely painful and happens to one in 500 people.' Other uncommon side effects include altered taste, kidney problems, allergic reactions, gallbladder problems and hypoglycemia. What other options are there? Mounjaro (brand name for tirzepatide) also came onto the market in early 2024. Like Wegovy, tirzepatide stems from a drug originally designed to treat diabetes. The weekly injection helped overweight people drop more than two stone in 18 months. It is available with to order with a prescription online from pharmacies including Superdrug and LloydsPharmacy Online Doctor. It works in a similar way to Wegovy and Saxenda, but is more effective. Dr Mitra Dutt from LloydsPharmacy says: 'Based on clinical trials, 96 per cent of people were able to lose more than five per cent of their body fat using Mounjaro. In similar trials, 84 per cent of people lost more than five per cent of their body weight on Wegovy, and 60 per cent on Saxenda. 'Mounjaro works by activating two hormonal receptors (GIP and GLP-1), which enhance insulin production, improve insulin sensitivity, and work to decrease food intake." After examining the pen at her Harley Street practice, Dr Shotter said: "This is a controlled, prescription-only drug. "This is a UK-approved pen, so this has not been smuggled into the country. "It is a huge concern, because, how has it appeared on the black market in the first place? "If you [our reporter] came into my surgery asking to go on a weight loss drug, immediately the answer would be, 'No.' "If you lost one to two stones, you could drop into a low BMI category. "This is not what the drug is intended for and it is, quite frankly, terrifying that you've been able to buy it. And not just that, it is the fact, you've been placed on a higher dose. "If a patient came to me who did qualify because of their weight, then I would have a thorough consultation with them. 'I would possibly run blood tests to ensure it is as safe as possible and to make sure there are no underlying liver or pancreatic problems. "This man has not even asked you your name, so how is the drug being prescribed? It is impossible that this is legitimate. "It is a genuine risk to public health and especially dangerous to those with eating disorders. 'These drugs carry risks to your health and your mental health, especially to those who suffer from eating disorders.' 9 9 9 9 The rise in the 'dangerous' black market availability of weight loss injections is being increasingly seen by eating disorder charities in the UK. After being informed about The Sun's investigation, Tom Quinn, Beat's Director of External Affairs said: "We're incredibly concerned that it's so easy to access weight loss injections on the black market. "Medications which cause weight loss can be very attractive to people with eating disorders, and can contribute to these dangerous mental illnesses getting worse. "They pose severe health risks, especially if they are easily accessible without prescriptions. "Weight loss injections are very serious medications with severe side effects such as vomiting and nausea, which can contribute to an eating disorder developing, or make it worse. "We also have concerns about what happens after somebody stops taking these drugs. If somebody gains weight after their prescription finishes, this may trigger feelings of guilt and shame, which could increase the chances of an eating disorder developing. "More action needs to be taken to prevent these drugs being so easily accessible. 'And it's vital that there is more education so that people are aware of how dangerous it is to abuse medication in order to lose weight. "For those with binge eating disorder, losing weight won't help a person recover from an eating disorder. 'While it may bring their BMI down in isolation, it will do nothing to address the root cause or symptoms of the eating disorder – and could make things worse. "Doctors and pharmacies must make the general public aware of these dangers, and ensure that prescriptions are only possible after stringent health checks." BLACK MARKET Medicines bought on the black market that have not been through rigorous safety testing bring additional risks. The market leaders Mounjaro, which contains tirzepatide, and Ozempic, which contains semaglutide, are administered via injection of pre-filled pens. They work by mimicking the hormone glucagon-like peptide-1, which is released after eating, and suppresses a patient's appetite. The National Institute of Health and Care Excellence (Nice) recommends semaglutide for adults who have at least one weight-related comorbidity and a body mass index (BMI) score of at least 35, or a BMI of at least 30 and meet criteria for referral to a specialist weight management service. A Lily spokesperson said: "Patients should only use Mounjaro (tirzepatide) when prescribed by a licensed healthcare professional and prescriptions should be fulfilled and supplied only by registered pharmacies and providers. Any tirzepatide offered without a prescription or for purchase on social media or black market is unlawful. These products are either fake or being 'resold' by an individual who obtained them through illicit means. Both practices put patients at risk. "Counterfeit, fake, and other unsafe products that are sold in a manner that falsely represents their authenticity, origin, or effectiveness are dangerous. These black-market products are often made in unsanitary conditions, which is especially dangerous for sterile injectables, like tirzepatide. "They may contain the wrong ingredients, contain too much, too little, or no active ingredient at all, or contain other harmful ingredients. No one should ever risk putting them into their bodies. "Lilly has taken steps to help address the risks posed by the proliferation of counterfeit, fake, and unsafe products across the world, including working with regulators and law enforcement, and identifying and removing fraudulent or unsafe content online and on social media — and we will continue to pursue all available avenues to combat fake and black-market medicines. "But our efforts alone are not enough. We applaud the MHRA's warnings on the risks of unsafe fake weight loss pens and the risks of buying medicines online without a prescription, and we welcome their continued partnership in the fight against counterfeit and illegal medicines. "We call upon regulators and law enforcement across the globe to take action against those who threaten the health and wellbeing of patients by selling fake or unsafe medicines." 9 9

Woman, 37, ‘drowning in her own body' at 18st shed 5st with weight loss jabs and says ‘it isn't cheating, it's survival'
Woman, 37, ‘drowning in her own body' at 18st shed 5st with weight loss jabs and says ‘it isn't cheating, it's survival'

Scottish Sun

time7 hours ago

  • Scottish Sun

Woman, 37, ‘drowning in her own body' at 18st shed 5st with weight loss jabs and says ‘it isn't cheating, it's survival'

Find out more about who's eligible for weight loss jabs on the NHS below WEIGH TO GO Woman, 37, 'drowning in her own body' at 18st shed 5st with weight loss jabs and says 'it isn't cheating, it's survival' Click to share on X/Twitter (Opens in new window) Click to share on Facebook (Opens in new window) FOR years, Emma Morris hid from cameras, avoided mirrors and felt like a prisoner in her own body because of her weight. But now five stone lighter and brimming with self-confidence, Emma is the face of a new kind of weight loss. Sign up for Scottish Sun newsletter Sign up 5 Emma Morris would always hide from cameras and mirrors because of her weight Credit: Cover Images 5 But after a nurse recommended she try Zepbound to lose weight, she now feels like she's living again Credit: Cover Images The 37-year-old mum credits her transformation to powerful new tool Zepbound, known as Mounjaro in the UK - a GLP-1 medication designed to help regulate the biology behing weight gain. And while some critics call it "the easy way out", Emma isn't having any of it. "This isn't cheating, it's survival," the dental hygienist based in the US said. "And for the first time in years, I finally feel like I'm living again." Living in Winder, Georgia, with her husband Stephen and daughters AvaGrace, 11, and Eliza Anne, 7, Emma's life on the outside looked picture perfect. But inside she was crumbling. She weighed 18.5 stone at her heaviest, had no energy, her joints ached, and was "just surviving each day." "I had tried everything, clean eating, working out, you name it. But my body just wouldn't cooperate," said Emma. She was also battling a string of health issues. 'I struggled with PCOS, inflammation, borderline high blood pressure, and extreme fatigue,' Emma said. Weight Loss Jabs - Pros vs Cons 'I went to doctor after doctor, and no one had answers. I was drowning in my own body.' It wasn't until a routine appointment with a nurse practitioner that everything changed. 'She looked at me and said, 'If we can get some of this weight off, you'll feel better'. That moment felt like someone had finally heard me.' 'I've gained my life back' Emma was prescribed Zepbound and within just a few weeks, Emma felt the shift, physically and emotionally. 'The inflammation started to go down. I could walk upstairs without pain,' she said. 'And that constant obsession with food, what I was eating, when I'd eat again, just stopped.' What followed was a steady weight loss and a dramatic change in mindset. 'I've lost five stone, but I've gained my life back,' she said. 'I used to define success by a number on the scale. Now it's about playing with my kids, enjoying dinner with my family, and loving the woman I see in the mirror.' Zepbound didn't 'do it for me'. It gave me a chance to actually fight back Emma Morris Emma is quick to shut down those who claim medication is a shortcut. 'For years I blamed myself, thinking I was weak or lazy,' she said. 'But obesity is a disease, it's hormonal, metabolic, and neurological. Zepbound didn't 'do it for me'. It gave me a chance to actually fight back.' She compares the treatment to managing any chronic condition. She said: 'If I had diabetes, I'd take insulin. If I had high blood pressure, I'd take medication. This is no different.' These days, Emma tracks her progress through more than just numbers. 'I journal my mental health, my energy levels, how my clothes fit,' she said. 'I take monthly progress pictures because sometimes the scale doesn't reflect what's really changing.' She's also built healthy habits that support her transformation, including walking daily, staying hydrated and prioritising protein. 5 Emma had tried everything to lose weight but found nothing worked for her Credit: Cover Images 5 She's quick to claim medication isn't a shortcut for weight loss Credit: Cover Images 5 She now hopes to lose another 30lbs, but says her goal is to feel good and stay healthy Credit: Cover Images And when tough days come, she "gives herself grace". She said: "This is a long-term journey. Not every day is perfect, but every day is progress.' Emma's definition of thriving has shifted. She continued: 'Thriving used to mean being thin. Now it means being strong, joyful, and fully present in my life. I'm a better wife, a better mum, and a better version of myself.' And her transformation has deepened her connection with family and friends. She said: 'I used to avoid photos. Now I'm in the pictures with my kids. That means everything to me.' Though she still hopes to lose another 30lbs (13.6kg), Emma no longer obsesses over the finish line, and said her goal now is to feel good and stay healthy. Her message to others? To start small and be kind to yourself. She advised: "Use the tools that work for you, whether that's medication, therapy, or movement. And don't ever let shame stop you from taking control of your health.'

Focus: To stay on weight-loss drugs, US patients cut doses and maybe vacations
Focus: To stay on weight-loss drugs, US patients cut doses and maybe vacations

Reuters

time7 hours ago

  • Reuters

Focus: To stay on weight-loss drugs, US patients cut doses and maybe vacations

Aug 13 (Reuters) - Doctors advise most patients on GLP-1 obesity drugs such as Wegovy and Zepbound to stay on them to keep the weight off, but as more U.S. insurers restrict coverage people are trimming costs by stretching doses or forgoing expenditures like vacations to pay for the medication out of pocket. A half dozen doctors who spoke with Reuters said insurance coverage has tightened in 2025 as many employers drop it for the expensive GLP-1 drugs. While patients on these medications are counseled on proper diet and exercise, clinical trials show that people who stop taking these drugs are apt to regain weight, opens new tab. Novo Nordisk's ( opens new tab Wegovy and Eli Lilly's (LLY.N), opens new tab Zepbound are weekly injections with U.S. insurer list prices of more than $1,000 a month. For customers willing to pay cash, both drugmakers will ship directly for $499 a month if refills are purchased at fixed intervals. "A significant number of my patients now pay cash," said Dr. Nidhi Kansal, an obesity specialist at Northwestern Medicine in Chicago. "People find a way to scrounge up $6,000 a year, which sucks, because that's a vacation or two." More than a billion people worldwide are obese, according to the U.N. World Health Organization, which has said the GLP-1 drugs could help end the obesity pandemic. A tech industry job change for Yelena Kibasova, a 40-year-old who lives in the Minneapolis area, meant loss of coverage for her Zepbound prescription that helped her achieve and maintain a 150-pound (68-kg) weight loss. "My new company does not cover GLP-1s, so now I am in a kind of purgatory," Kibasova said. "I stopped doing my nails. I stopped doing my hair. Those things are not as important as me staying at a healthy weight." The doctors interviewed by Reuters said patients once leery about long-term obesity treatment are now more comfortable staying on a drug. The doctors said that conversations about temporary use happen only when a patient is trying to lose a certain amount of weight for issues such as fertility treatment or an organ transplant. These obesity specialists said they are hopeful that competition will help bring down prices as new weight-loss options emerge, including new oral drugs that may be available next year. Lilly last week announced trial results for its easier-to-manufacture pill, which was shown to cut patient weight by 12.4%, a few percentage points less than injected drugs. The company hopes to launch it in August 2026. Kenneth Custer, Lilly's head of cardiometabolic health, told Reuters the pill is being tested in several settings, including as a maintenance therapy. Custer declined to comment on how it might be priced. Dr. Anne Peters, an endocrinologist at Keck Medicine USC in Los Angeles, said it is important that patients who reach their weight-loss goal not stop a prescription "cold turkey," so the dose can be tapered down over several months. Peters said about a third of her patients are able to reduce their dose and maintain weight loss, while the rest need to stay on the medication. An analysis of U.S. pharmacy insurance claims found that nearly two-thirds of patients who started on Wegovy or Zepbound in 2024 were still on the medications a year later. Peters said she uses "every technique in the book" to secure insurance coverage for patients, but noted that a growing number of plans no longer pay for the treatments, and patients have to pay out-of-pocket. U.S. pharmacies supply self-injection pens pre-loaded with doses of Wegovy or Zepbound. Lilly's direct-to-consumer service also offers vials. "Some patients can stretch out the vials longer. Get 15 mg, and then give a 10 mg dose for instance," Dr. Peters said, noting that the drug's instructions advise that such an approach should not be taken. Doses of 5 mg, 10 mg and 15 mg are recommended for weight-loss maintenance. Patients also are turning to lower-cost compounded versions of the GLP-1 drugs, or are even mixing them at home with raw ingredients, both of which Peters and other doctors advise against due to safety concerns. Dr. Angela Fitch, former president of the Centennial, Colorado-based Obesity Medicine Association and chief medical officer at online primary care provider Knownwell, said nobody wants to be on a medication, but patients who respond to a GLP-1 drug "really don't want to go off of it when they recognize that it has such a value to them." Both Wegovy and Zepbound were first launched, under the brand names Ozempic and Mounjaro, as diabetes treatments. The class has been linked to a range of benefits, including improved heart health and less sleep apnea. Fitch said the most common reason for her patients to stop taking a GLP-1 drug is loss of insurance coverage. She said her experience is that about 10% of patients are able to reach a target weight and maintain it without further treatment. "We are in a dip where people are dropping coverage," Fitch said, adding that the direct-to-consumer options are an "upper-ish middle-class thing."

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