People in Ireland being prescribed weight loss injections without seeing doctor

People in Ireland are being legally prescribed weight loss injections without seeing a doctor in person or even speaking to a medical professional on the phone.

Multiple online pharmacies are offering prescriptions for weight loss injections such as Saxenda and Wegovy, which are similar to Ozempic but are allowed to be prescribed in Ireland for obese people who don’t have diabetes. One online pharmacy asks customers to fill out a questionnaire and then send a photo of them standing on a scale – to prove their weight – along with photos showing their body.

While this is done to ensure that the person isn’t lying about their BMI – which must be over 30 to be prescribed the medication – at no point do they speak to a doctor on the phone before being prescribed the injections. Customers can then have the medicine delivered to them, or pick it up at a pharmacy.

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The medication is not covered under the drugs payment scheme for weight loss purposes, and it is costly at around €300 a month. Many websites have also popped up claiming to sell and deliver the weight-loss jabs without the need for a prescription.

Last year, 286 units of products claiming to contain semaglutide (the active ingredient in Ozempic) were detained by the Health Products Regulatory Authority (HPRA), which is urging people not to buy these medications from unknown sources online, as they are likely falsified medicines. Content creator Robyn McManus, who speaks about her journey of using Saxenda online, said multiple TikTok and Instagram accounts claiming to sell the drug were commenting on her videos.

She said: “When I was posting about it I had loads of pages messaging me and commenting under my posts for people to buy it. I was trying to delete them because people are so desperate to buy it and because of shortages and stuff they are buying it. There is a form of it being sold that has ‘not for human consumption on it’ and you mix it at home, it’s a raw semaglutide. It’s crazy.”

While there are fears that the injections are being abused, they have been dubbed a “game changer” by medical professionals. Not only for treating diabetes and obesity but for other illnesses that cause insulin resistance, such as polycystic ovarian syndrome (PCOS).

Ms McManus has PCOS, and since she began taking Saxenda a year ago she has lost a significant amount of weight and regained a normal menstrual cycle. The 28-year-old Dubliner explained: “I don’t know what my starting weight was but I was a size 16-18 and now I’m an 8-10. It has really helped with my PCOS, it has given me back my cycle, I have a regular period.

“It doesn’t agree with everybody but I’m a positive case of it, I can’t imagine my life without Saxenda now.” Immunologist Luke O’Neill said the medication is “life-saving” for those with obesity, which is a massive issue in Ireland, with 23 per cent of people aged 15 and over being classed as medically obese.

However, the professor has stressed that there is a difference between being overweight and obese, and it’s important that these medications aren’t being abused or overprescribed. He told the Irish Mirror: “Obesity is a different thing to just being overweight, it’s a serious clinical condition. And controversies have come in for cosmetic use, in cases where it’s not life-threatening in the same way that obesity is. So I would be distinguishing obesity from just being overweight. That’s a medically important distinction.”

Professor O’Neill said he would also be cautioning against people getting a prescription online without first speaking to a GP in person. He said: “You’ve got to be careful. Always go to your GP, don’t be ordering stuff online. It’s a serious medication, it has side effects and it needs to be watched carefully by a GP in terms of the patients that are on it.”

Dr Illona Duffy, who works as a GP in Monaghan, said she would like to see more patients being able to access the medicine. While she understands there is concern that people would use the medication “to lose a stone before a wedding” or for “yo-yo dieting” purposes, she stressed its importance for treating obesity.

She said: “I had a girl this morning with a BMI of 47, so that’s severely obese, and she’s not going to get approved for it. She can’t afford to pay for it because that’s €250 to €300 a month, and the reality is that this is a long-term medication.” Saxenda is only covered under the drugs payment scheme in Ireland if a person has a BMI over 35 and is pre-diabetic. Ozempic is currently only allowed to be prescribed in this country for those with diabetes, and it’s covered for those patients.

Ms Duffy said she would like to be prescribing the medication to more patients, and while some are happy to pay out of pocket, she is stressing that this is a life-long medication and therefore will be very costly. She added: “Many are thinking it’s like a course of antibiotics, meaning they’ll take them until they get to the weight they want to be and then stop. But the data shows that people regain the weight, and we have experienced that a bit here.

“I have probably three patients who lost lots of weight, were delighted with it, and then decided they didn’t want to continue paying for it. One girl had lost over three stone, and within a month, her three stone was back on.” A spokesperson for Novo Nordisk, the manufacturer of Wegovy, Ozempic and Saxenda said they are “prescription only medicines that should be used exclusively under the guidance of a healthcare professional”.

They added: “Novo Nordisk strongly advises against efforts to procure these medicines from unauthorised sources without a prescription – and is actively working with the regulatory authorities to address this issue. We take our responsibility as a manufacturer very seriously and advocate for the highest levels of patient safety. We encourage all patients to consult with a healthcare professional regarding their treatment and the prescription of any relevant medicine(s).”

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