Online pharmacies in the United Kingdom are offering weight-loss injections, including medications like Mounjaro and Wegovy, to individuals with a body mass index (BMI) as low as 25, despite these treatments being licensed for patients with higher BMI thresholds. These drugs, classified as GLP-1 medications, are approved by the Medicines and Healthcare products Regulatory Agency (MHRA) for use primarily in obesity treatment, typically for patients with a BMI over 30 or those with a BMI between 27 and 30 who also have an additional weight-related health condition such as high blood pressure.
The pharmacies MedExpress and Bolt Pharmacy promote these treatments through social media advertisements suggesting eligibility for weight-loss injections at BMI levels lower than those stipulated by current licensing. Advertising phrases seen by potential customers include statements like “you might qualify at a lower BMI than you expect” and “weight management now starts at BMI 25+.” After completing questionnaires on the pharmacies' websites, individuals with a BMI of 25 are informed they can access these injections, a threshold that corresponds to the boundary between a healthy weight and being overweight.
Prescribing medications outside the terms of their licence, known as off-label prescribing, is legally permissible in the UK if a healthcare professional deems it appropriate for a patient’s individual circumstances. However, government guidelines stress that prescribers should carefully consider potential risks before doing so. Experts have expressed concern about the routine use of GLP-1 drugs for patients at the lower end of the overweight category without other weight-related health issues. Dr Marie Spreckley, a postdoctoral researcher at the University of Cambridge, stated that there needs to be clear health benefits to justify exposing such patients to the treatment’s risks.
The adverts do not explicitly name GLP-1 drugs and are designed to appeal to individuals slightly above the healthy weight range. While direct advertising of prescription-only medicines to the public is illegal under UK law, no allegations have been made suggesting that these pharmacies have violated advertising regulations.
A spokesperson for MedExpress emphasized the company’s commitment to maintaining high clinical standards and supporting informed choices tailored to individual needs. Bolt Pharmacy did not provide a response to requests for comment on their advertising practices.
This emerging practice raises questions about the balance between expanding access to weight management options and ensuring treatments are prescribed responsibly according to established guidelines and health risks.