A recent study analyzing medical records of over 92 million adults in the United States has found that more than 1.1 million individuals are using glucagon-like peptide-1 (GLP-1) medications without documented medical reasons such as obesity or diabetes. These drugs, which include widely known brands like Ozempic, are approved by the Food and Drug Administration (FDA) primarily to treat obesity, Type 2 diabetes, and related cardiovascular and kidney conditions. However, the new research indicates a significant rise in off-label use, where patients take the medications without meeting established clinical criteria.

Published last week in the journal Obesity, the study highlights a dramatic increase in off-label prescriptions for GLP-1 drugs, noting a 15-fold surge between 2021 and 2025. Researchers caution that this figure might underestimate actual use, as it does not fully capture individuals accessing the drugs through telehealth services or compounded formulations.

Doctors involved in the study and external experts suggest that many users without obesity or diabetes are motivated by desires to lose weight or explore other potential benefits associated with the drugs. "You see it all over the place," said Dr. Babak Orandi, an obesity medicine specialist and transplant surgeon at NYU Langone Health and lead author of the study. He noted that widely shared patient experiences, both positive and negative, may be encouraging others to try the drugs even without clear medical indications.

While the medications have become a cultural phenomenon due to extensive marketing and public discussion, healthcare professionals warn that the implications of widespread off-label use remain uncertain. Dr. Nils Krüger, a Harvard Medical School researcher who has studied GLP-1 therapies, pointed to potential risks, particularly for individuals with normal body mass indices (BMIs). The study found that over one-third of off-label users had a normal BMI, and these patients were also more likely to have documented eating disorders compared to non-users, raising additional concerns.

The study also found that patients using GLP-1 drugs off label were more likely to have conditions such as high blood pressure and elevated cholesterol, suggesting that some individuals may seek the medication for perceived broader health benefits. Preliminary research is exploring possible uses of GLP-1 drugs in areas like fertility enhancement, reduction of alcohol cravings, and cognitive symptom relief, although clinical evidence to support these applications is still lacking.

Clinicians express caution regarding prescribing practices. Dr. Andrew Kraftson, a clinical professor at the University of Michigan Medical School, remarked that some busy primary care physicians may be prescribing these drugs without thorough evaluation, often responding to patient requests. He emphasized that this approach may result in care that is not comprehensive, potentially overlooking the balance of risks and benefits for patients who do not meet official indications.

The full impact of widespread off-label GLP-1 use remains unclear, as clinical trials have largely excluded people without obesity or diabetes. Potential adverse effects include malnutrition and muscle loss, which may pose significant risks for individuals with lower BMIs. Dr. Krüger described the current trend as an "experiment," underscoring the need for more research to understand long-term safety and efficacy in these populations.