Six-pack abs, but still hooked on weight-loss jabs? It sounds like a paradox, but it's a growing trend that's sparking serious concern. People are using these powerful medications, meant for obesity or diabetes, purely for cosmetic reasons. But is the pursuit of a perfect body worth the potential health risks?
Luis Barrucho of the BBC World Service investigated this phenomenon, finding individuals caught in a cycle of injections and weight regain. Take Gabriela, for example. After struggling to shed those last few post-pandemic kilos, she turned to weight-loss injections like Ozempic, swayed by friends who touted their amazing results. Despite being a dedicated fitness enthusiast, she felt pressured to achieve an even leaner physique.
Gabriela, a 40-year-old Brazilian lawyer (whose real name has been withheld), stands at 1.69m (5ft 6in) and weighed 76kg (11st 13lb) when she started. She had diligently tried stricter diets and consistent, high-intensity workouts six times a week, but felt it wasn't enough. "Nothing worked," she confessed. In February 2024, she acquired Ozempic from a Rio de Janeiro pharmacy without a prescription or medical supervision.
She describes the initial effects as "surreal." At a Japanese buffet, a mere six pieces of sushi left her feeling as full as if she'd devoured a whole rack of ribs. The weight melted away, but here's where it gets controversial... The transformation was temporary. Once she stopped the injections, the weight gradually returned, trapping her in a continuous loop. When she's happy with her reflection, she stops. When she's not, the injections resume. This cycle has been ongoing for a year. "When I look in the mirror and like what I see, everything in life feels easier," she admits.
Doctors, however, are sounding the alarm. Using weight-loss jabs intermittently and without medical supervision – especially when there's no medical need – is a dangerous gamble. In the UK, the National Health Service (NHS) typically only prescribes these injections (which mimic a natural hormone that regulates hunger, creating a feeling of fullness) to individuals with a Body Mass Index (BMI) above 35 or 40, depending on the specific drug. This threshold is sometimes lower for certain ethnic groups or those with weight-related health issues.
Gabriela's BMI was 26.6 when she began using the jabs. She had no weight-related health conditions and was a muscular woman who exercised regularly. "There is a growing trend of its use for cosmetic purposes," warns Dr. Bharti Shetye, Vice-President of the Obesity Medicine Association in the US. "I hear of so many cases of people using it just to look good."
Professor Simone van de Sande Lee, an endocrinologist, is even more direct: "These are drugs approved to treat conditions like diabetes or obesity – they are not cosmetic tools." And this is the part most people miss: these drugs are designed for managing chronic conditions, not for achieving fleeting aesthetic goals.
Andrew, a 49-year-old top executive at a food company in London, echoes Gabriela's story. He too was well below the NHS threshold for prescription but felt unhappy with his appearance. "I felt like I was a bit puffy… I didn't feel good about myself," he explains. He weighed approximately 90kg (14st 2lb) and is 1.83m (6ft) tall, resulting in a BMI of 26.9, similar to Gabriela's. Like her, he was also muscular.
He secured the jabs from an online pharmacy by completing a self-assessment. He claims there was no verification of his responses or assessment of whether the treatment was appropriate. He started weekly injections of Wegovy and later Mounjaro in early 2024.
"Almost immediately what I felt with the jab is that the food noise went away from me… I really enjoyed not having to think about food so much," he says. While he still dines out, he consumes significantly less. "I never feel, or very rarely feel, that urgent hunger that I used to."
Like Gabriela, Andrew cycles on and off the injections based on social events. He used them before a boat trip to the Mediterranean, paused for a few months, and then resumed before Christmas. Gabriela even skips doses before parties to indulge more freely. "If I know I'm going to drink a lot one day, I don't take it," she says. "I'm like, 'Come on, I'm already going to be drinking a ton of beer - why would I take it?' So I don't." She admits her usage is "pretty sloppy" and that cycling helps her stretch the medication and save money, having already spent over $2,000 (£1,500).
While both Gabriela and Andrew are pleased with their experiences, health experts emphasize the risks of irregular, unsupervised use. Early GLP-1 drugs were used for type 2 diabetes in the 1990s, but their popularity for weight loss surged only in the past four years, after regulatory approvals. “We simply don't know the effects in people using these drugs purely for cosmetic purposes,” says Simon Cork, Senior Lecturer in Physiology at Anglia Ruskin University in the UK. Prof Lee adds that our understanding comes from consistent, medically supervised use, making intermittent patterns harder to assess long-term.
Dr. Bruno Halpern, Endocrinologist and President-elect of the World Obesity Federation, suggests that while the drugs are "relatively safe" for those with obesity or diabetes, "if millions of healthy people start using them – some without medical need – we may begin to see rare side effects more regularly." Common side effects include nausea, vomiting, diarrhea, and constipation. Rarer, more serious ones include acute gallstone disease, pancreatitis, and severe allergic reactions.
Gabriela reports only mild stomach pain, attributing it to combining lack of food with alcohol while using the jabs. "I was going through a wild phase," she confesses. Another concern is muscle loss, particularly in slimmer individuals on restrictive diets, says Halpern. "Slim individuals on restrictive diets tend to lose muscle more than fat," he explains. "If they regain weight later, their body composition worsens," creating a “yo-yo cycle” that “raises the long-term risk of weight gain.”
The patient leaflets for Ozempic, Wegovy, and Mounjaro recommend once-weekly injections on a fixed schedule under medical supervision, indicating they are intended for regular, continuous use. They should be injected into the upper arm, thigh, or stomach, with gradual dose increases.
But there are also emotional tolls. Dr. Halpern observes patients who believe weight loss will bring love, happiness, and acceptance, expectations that are rarely met. When the weight returns after stopping the jabs, they often feel like failures. Our bodies naturally resist long-term weight loss, explains Dr. Cork. "When you lose weight, your body doesn't just say, 'Great, job done.' Hunger hormones ramp up, your metabolism slows, and your body tries to restore what it sees as your natural point."
As soon as patients stop the hunger-suppressing jabs, the body fights to regain the lost weight. This is why they are intended for long-term use in patients with chronic conditions like obesity. In the UK, NHS guidelines currently limit their use to a maximum of two years.
Despite the risks, Gabriela and Andrew say they have no plans to stop. "I think I've become addicted to it," admits Gabriela, while Andrew sees the drug as a long-term commitment to his appearance, a "relatively informed risk." "If I happen to cycle on and off this for the rest of my life, that would probably be OK."
In early 2025, Britain’s General Pharmaceutical Council tightened restrictions on how online pharmacies can sell and prescribe the jabs in response to growing concerns about misuse, safety, and supply shortages. Brazil also tightened its rules this year for similar reasons.
So, what do you think? Is the pressure to conform to unrealistic beauty standards driving this trend? Should access to these powerful medications be restricted further, even if it means limiting options for those who genuinely need them for medical reasons? Let us know your thoughts in the comments below.
*Details of mental health support in the UK are available at BBC Action Line.
