Desperate for weight loss, patients risk unregulated drugs amid shortages and high costs

Demand for weight-loss drugs like Wegovy and Zepbound remains high, but steep prices and shortages are pushing some patients toward riskier alternatives. Surveys suggest that up to 30% of overweight adults have considered or used unregulated versions from gray markets or compounding pharmacies. Yet exact numbers of those attempting this route stay unclear, as many avoid reporting it to doctors.

Phil, one such patient, turned to the gray market after his insurance stopped covering Ozempic. He now buys tirzepatide—the active ingredient in Zepbound—online, receiving it in unmarked packaging labelled 'Multi-effect, young skin set'. He mixes the powder with sterile water himself and injects a 10-month supply at once.

Doctors warn that self-sourcing these drugs carries serious dangers. Infections, severe reactions, and ineffective doses are common risks. Emergency physicians have treated complications from unregulated medications, though patients often hide where they obtained them. Dr. Tony Cirillo, president of the American College of Emergency Physicians, stresses that these drugs require proper medical oversight. Dr. Scott Isaacs, president of the American Association of Clinical Endocrinology, acknowledges the desperation behind such choices but urges caution. Both agree: if side effects escalate, patients should seek emergency care immediately. Despite the risks, the appeal of cheaper, accessible alternatives persists. With no clear data on how many are taking this route, the scale of the problem remains uncertain.

The lack of affordable, approved options continues to drive patients toward unregulated weight-loss drugs. While some, like Phil, see no other way to access treatment, doctors highlight the potential for harm. Without better tracking or solutions, the trend—and its consequences—may grow.