Ozempic and other GLP-1 drugs used to treat obesity and diabetes [AFP]
Ozempic and other GLP-1 drugs used to treat obesity and diabetes [AFP]

A large-scale study has found that a significant number of Americans are taking GLP-1 drugs — including Ozempic and Wegovy, used to treat diabetes and obesity — without a medically approved indication for doing so.

The New York Times reported Tuesday (local time) on a new study analyzing the medical records of more than 92 million American adults, which found that more than 1.1 million people had taken GLP-1 medications despite having no documented diagnosis of obesity, diabetes or other conditions for which the drugs are approved.

"You see this everywhere," said Babak Orandi, an obesity medicine specialist at NYU Langone Health who led the study. "People are talking openly about their experiences, and that's spreading curiosity — 'Could this work for me, too?'" The study was published Tuesday in the journal Obesity.

GLP-1 drugs are currently approved only for a limited set of indications, including obesity, diabetes, certain cardiovascular conditions, sleep apnea and diabetic kidney disease. But a surge in public interest, combined with aggressive marketing by pharmaceutical companies, has driven rapidly growing demand beyond those approved uses.

"I've never seen the general public know this much about a specific drug," said Nils Krueger, a researcher at Harvard Medical School. Off-label prescriptions — those written outside approved indications — rose 15-fold between 2021 and 2025. The researchers noted that GLP-1 drugs obtained through telehealth platforms or compounding pharmacies were likely not captured in the data, suggesting the true scale of off-label use could be considerably larger.

For people without obesity or diabetes, the primary reason for seeking the drugs is weight loss. More than one in three off-label users already had a body mass index in the normal range, and they were also far more likely than non-users to have a prior diagnosis of an eating disorder. While they represent a small share of the overall user population, clinicians say the pattern is a worrying signal.

Orandi also said many patients were seeking the drugs for unverified secondary effects — including improving fertility, curbing alcohol cravings and relieving "brain fog" — and that off-label users more commonly had conditions such as high blood pressure or high cholesterol.

Andrew Kraftson, a professor at the University of Michigan Medical School, said the study also exposes a problem on the prescribing side. Busy primary care physicians, he said, often write prescriptions too readily, reasoning that the harm is unlikely to be serious. "In situations like this, it's hard to say that comprehensive care is really being provided," he said, expressing concern that many prescriptions are being written without adequately weighing the risks against the potential benefits.

There is little data on how GLP-1 drugs affect people without obesity or diabetes, largely because such individuals were excluded from major clinical trials. Krueger warned that for people who are not overweight, side effects such as malnutrition and muscle loss could pose a greater risk. "Nobody knows how this is going to play out," he said. "In a sense, we're in the middle of a massive Ozempic experiment right now."


mokiya@heraldcorp.com