An MHRA drug safety update reminded prescribers and patients of the recognised side effects of GLP-1 receptor agonists and warned specifically about the potential for misuse — including supply obtained outside the legitimate chain and use by people who do not meet the clinical criteria.
What Misuse Looks Like in Practice
Use without meeting the criteria
These medicines are licensed by BMI threshold and, for the higher doses, by BMI plus comorbidity. Use by people who are not clinically overweight is outside the licence, and the risk-benefit calculation that justified approval does not apply to them.
Falsifying an online questionnaire
Overstating weight or understating height to clear a BMI threshold is common enough that the GPhC now requires online pharmacies to independently verify weight, height and/or BMI rather than accepting self-report. The rule exists because the behaviour exists.
Buying outside the legitimate supply chain
The MHRA has seized substantial quantities of falsified weight-loss pens. Some appear to have contained insulin rather than the labelled medicine, and people have been hospitalised — hypoglycaemic shock in someone not expecting insulin is a life-threatening event.
Dose escalation without supervision
Climbing faster than the licensed schedule to accelerate results. The schedule is slow because gastrointestinal side effects scale with dose and speed of increase.
The Eating Disorder Dimension
This deserves stating plainly. A medicine that suppresses appetite is, for someone with a restrictive eating disorder or a history of one, a serious hazard. Online questionnaires ask about eating disorder history, and the question is not a formality.
If you have a history here, it should be discussed with a clinician who knows you, not disclosed to a form and then worked around. If someone you know is obtaining these medicines while showing signs of disordered eating, that is a reason to seek help rather than to keep confidence.
Why "Cheapest" Correlates With "Least Careful"
Assessment costs money. A prescriber who verifies your BMI independently, reviews your history, checks contraception where relevant and offers two-way communication is doing work that has to be paid for.
A service that asks nothing has lower costs, and can price accordingly. So a price meaningfully below the market is worth interrogating rather than celebrating — you may be buying a smaller amount of care, not a better deal on the same thing.
That is a distinction a price comparison can only partly capture, which is why the registration check matters as much as the number.
What Good Looks Like
- Independent verification of weight and height, not just a form
- Questions about eating disorder history, pregnancy and contraception, other medicines and conditions
- A named prescriber you can actually reach
- A dose schedule that follows the licence
- Willingness to say no
The last one is the strongest signal. A service that has never declined anyone is not assessing anyone.