A large new study has found an increase in the use of GLP-1s among people without apparent approved indications.
Using the medical records of over 300 million people, it found that of 92,415,648 US adults without an apparent FDA-approved indication, 1,133,953 were prescribed GLP-1s. Notably, 35.1% had a normal BMI.
And it’s on the rise. Between 2021 and 2025, prescriptions without an apparent indication increased from 0.11% to 1.5%, a 13.6-fold increase.
A class pattern was also seen - use without an apparent indication was associated with lower social vulnerability and private insurance. This kind of prescribing “has increased rapidly and disproportionately, and involves socioeconomically advantaged populations, including those without obesity”, concluded the study authors.
“This may be happening in Europe too,” says Dr Nadia Ahmad, medical director of The Weight Care Clinic. “A French study found potential use without a recorded diabetes or obesity indication. Social pressure, online discussion and the appeal of rapid weight loss may all contribute to demand.”
She points out that it cannot confirm that every person had no medical reason for taking a GLP-1 nor that everyone identified in either study sought treatment for cosmetic reasons.
But for whatever reason people are seeking the medications without meeting the criteria, it’s unclear what the health implications are. “The risk-benefit profile in these populations remains uncertain,” said the study authors.
“GLP-1 medicines can offer substantial benefits to people who meet the clinical criteria,” says Dr Ahmad. “If someone takes one solely to lose a small amount of weight for appearance, the expected benefit is less clear, while side effects such as nausea, vomiting and dehydration are still possible. More serious problems, including pancreatitis, are uncommon but need to be taken seriously. A proper assessment also gives us the chance to identify issues such as disordered eating and decide whether treatment is appropriate.”
For Wegovy and Mounjaro, the criteria is a BMI of 30 or more (obesity), or a BMI of 27 to less than 30 (overweight) as well as weight-related health problems.
“GLP-1s play an important role in supporting people living with obesity and other health conditions when prescribed appropriately,” says Laura Wilson, director for Scotland at the Royal College of Pharmacy, “but they are not suitable for everyone and should only be supplied following a robust clinical assessment.”
Why does this research matter to F&B?
Staying abreast of research on user demographics is vital for adapting and innovating to meet their needs.
This latest study shows that GLP-1s are penetrating society in unexpected ways, potentially adding users beyond just those with obesity and its related problems. This layers on top of emerging evidence that the drugs may have benefits beyond their original indications, and the cheaper and more accessible pill format becoming available from private pharmacies in Europe.
While checks are in place for private prescriptions from online pharmacies, it’s hard to match in-person consultations. A recent investigation in The Grocer found that an online pharmacy in the UK prescribed Mounjaro to a patient with a healthy BMI.
“Pharmacies can help prevent inappropriate supply by carrying out prescribing and verification checks as appropriate for their setting, helping to ensure these medicines are only provided to people who meet the approved indications,” says Wilson. “As demand for GLP-1 medicines continues to grow, pharmacists are an important safeguard in supporting safe, evidence-based use and protecting patient safety.”
