GLP-1 medicines help people feel fuller by mimicking a hormone naturally released after eating, effectively supressing appetite and slowing gastric emptying. Although these medicines were formerly confined to use in the treatment of diabetes, those sold under the brand names Wegovy and Mounjaro are now licensed in the UK for weight loss and management in people with obesity, and in some cases those who are overweight with related comorbidities. These medicines are frequently referred to as ‘weight loss injections’ or ‘skinny jabs’ in the media, having become popularised for accelerating weight loss, particularly by some celebrities who openly discuss their use of the medication. However, as more individuals seek to gain access to these relatively new medicines for weight loss purposes, medical professionals need to remain vigilant regarding the prescription and informed consenting process.
Although the Medicines and Healthcare products Regulatory Agency (MHRA) has approved medicines like Wegovy and Mounjaro as safe and effective for weight loss in people with obesity or who are overweight with related health problems, the safety of these medicines is not guaranteed when used outside approved indications or without appropriate clinical assessment. These medicines are being introduced within NHS services in a phased and criteria-based way, with strict controls on prescription. However, online pharmacies and even unregulated or counterfeit alternatives sold on social media platforms like TikTok Shop offer direct access for individuals who may not meet the traditional criteria.
A Guardian investigation revealed that some online pharmacies in the UK were approving prescriptions of slimming medications for people of a healthy weight. Many only required individuals to provide their height and weight in an online consultation, leaving the system open to abuse where verification processes were limited. Eating disorder charity Beat states that the ease of access to these medications is of particular concern for those with existing eating disorders, and that the resulting rapid weight loss could contribute to such disorders developing for the first time in vulnerable people.
In response to these concerns, the General Pharmaceutical Council has enforced stricter checks to ensure that inappropriate dispensing to individuals who should not have access to weight loss medicines is reduced. Pharmacists are now expected to hold in-person or video consultations with patients to verify their BMI, and where necessary, seek additional clinical information or confirmation to ensure the medication being prescribed is appropriate.
Beyond issues relating to misuse, there are significant safety concerns relating to the side effects that may emerge from inappropriate prescribing. As data on the effects of long-term use of these medicines for weight loss is still developing, there is limited knowledge of the full long-term risk profile that should be discussed during consent and before commencing use. For example, there are reports of medicines that contain semaglutide and tirzepatide, like Wegovy and Mounjaro, increasing the risk of gastroparesis, a condition involving delayed stomach emptying, as well as other gastrointestinal complications.
As discussion of weight loss medications in the media shows no sign of slowing, it is likely that the demand for these treatments will continue to rise. To ensure that due diligence is adequately conducted, UK practitioners can consider the following steps:
As with all medical treatment, thorough note-keeping is key. Medical professionals should ensure that any discussions which take place prior to prescribing weight loss medicines are recorded. By carefully evaluating patients prior to prescribing, prioritising an extensive consent process and maintaining clear documentation, medical professionals should be able to ensure that only patients who genuinely require weight loss medications to improve their health are able to access them.
Weight loss injections are regulated. They are prescription-only medicines that can only be legally prescribed by qualified healthcare professionals such as doctors, nurses or pharmacists, and must be obtained from GPhC registered pharmacies following verification of the patient’s suitability. Unlike aesthetic treatments provided on the side by non-medical practitioners, such as dentists administering Botox, weight loss injections are subject to strict controls due to their rapid effects, creating inherently higher clinical risk if prescribed or monitored inappropriately.
Given the complexities associated with weight loss injections and their relatively recent introduction into the UK medical environment, there is a real possibility that existing clinical negligence policies may inadvertently be triggered by claims stemming from incorrect prescribing, inadequate patient assessment, failure to affectively monitor for adverse reactions, or misuse enabled by off-label prescribing. This risk is compounded by the growth of online prescribing channels, creating a dangerous environment where insurers may need to clarify coverage terms around online consultations and ensure that policies explicitly address negligent prescribing or monitoring practices in this rapidly evolving treatment area.
Complex Paralegal – Healthcare & Sport
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