As a GP who was obese with a BMI of 41, I know how cruel the world is to overweight women. Cut-price weight-loss jabs are so tempting… this is what I tell my patients

The scenario is now a familiar one – my patient comes in with a random health concern, but halfway through the appointment quietly admits what is really worrying them: weight-loss jabs, which they have bought on the black market online and fear may be putting their health at risk.

They may come to see me about stomach pain or something completely unrelated to the jabs – I had one patient recently who in fact had Covid – but they are so anxious about what they may be doing to their body, any symptom they get they worry is related to the jab.

Judging from the numbers I’m seeing, the black market for weight-loss jabs isn’t small-scale. This is a massive operation.

It is so widespread a problem that now when someone comes to see me with any abdominal pain – a common side-effect of weight-loss injections – I always ask: ‘Are you taking weight-loss medication that you have bought online?’

Many are taking cheap version of what they think is the weight-loss jab Wegovy (containing semaglutide, mimicking the effect of the hormone GLP-1 which signals that we are full), or Mounjaro (which has the added benefit of mimicking another hormone, GIP, as well). Most are sourcing them from unauthorised sources online – or from those who shouldn’t be selling them, such as beauty therapists.

The appeal is obvious – they are paying as little as £40 a month, when a private prescription for Mounjaro, for example, would cost £200-£300 for a month’s supply – but the risks are high.

This week, the daughters of Karen McGonigal, 53, from Salford in Greater Manchester, who died in May after using weight-loss jabs she’d bought from a local beautician for £20, warned others not to risk their lives.

We don’t yet have the details of how Karen died, but I find it incredibly sad that people are willing to risk their health in this way.

That’s not to say I don’t understand what compels people to take such risks – I understand only too well, as I have battled with obesity for most of my adult life.

I have a condition called lipoedema. This is a condition which affects almost exclusively women typically from puberty, causing excess fat cells to develop usually on the legs, buttocks and arms. The fat does not respond to diet and exercise as normal, and in severe cases the only way to remove it is liposuction. It means if I do gain weight, it is very hard to get it off.

By 2017, my BMI hit 41 – obese. I began to despair of ever shifting the weight.

The world isn’t a kind place for a person with obesity. You encounter stigma all the time.

I worried about fitting into plane seats and wearing swimsuits on holiday – not to mention looks from those who judge you.

I opted for weight-loss surgery – a gastric sleeve [during which the size of the stomach is surgically reduced to cut how much food can physically be eaten, but the operation also changes the hormones that signal hunger in the same way that the medication does].

When I came round, for the first time in my life I wasn’t thinking about food.

I can’t say how much weight I lost as I have since given up weighing myself – partly as I have had enough of it and partly to be a good role model to my daughters, aged 21 and 14. I prefer to rely on how I feel and how my clothes fit as a guide.

But after developing long Covid in 2020, I became unable to exercise and started putting on weight again.

That’s why this year I tried weight-loss jabs myself (prescribed by a private authorised online pharmacy) and it was like magic.

Just like it was when I came round from the gastric sleeve operation, I instantly stopped thinking about food and I lost weight (although this time I had nowhere near as much to lose).

I tried Wegovy and Mounjaro and paid more than £150 a month.

So yes, I understand why someone battling excess weight feels tempted – but the risks of cut-price weight-loss medications must not be underestimated.

Rather than arriving in pre-measured self-injectors as they do from authorised pharmacies, the cut-price jabs typically come in vials of powder that you must mix with the fluid supplied.

You have no guarantee that the powder really is the drug you think it is – in fact, police raids have found that it is being substituted for insulin in some cases, which is incredibly dangerous – and may even be fatal.

Even if it is the active drug, as a doctor even I get nervous making medications up from a powder.

All sorts of things can go wrong – you could add the incorrect ratio of liquid, or pull out the wrong amount into a syringe. It worries me hugely that people may be trying this on their own at home.

The other risk is that you end up taking a far bigger dose than you should – which will leave you more at risk of complications.

To investigate this problem further, I have joined online forums – and come across people who say they are buying Retatrutide or CagriSema, the newest weight-loss medications, which despite promising results aren’t even licensed for use yet.

That means at best people are taking drugs that haven’t been fully tested in trials – at worst, they may be injecting something else entirely.

It worries and saddens me that the NHS has rationed access to weight-loss jabs so much that people are now taking these risks. (I am doing what I can to get the Government to allow more people to have these drugs on the NHS.)

The situation is virtually unprecedented – all I can liken it to was what happened a few years ago when Viagra became available online, but even that didn’t happen on such a scale.

The rapid expansion of the weight-loss medication market has led to it becoming a Wild West.

The regulators can’t keep up. The General Pharmaceutical Council has said that online pharmacies should have video calls with those seeking weight-loss jabs to ensure they do need the medication and to ask about, for example, if they have other conditions or take other medication. But while there are some very good providers who do this, others don’t. The system is overwhelmed.

Although I haven’t seen anyone who has become seriously unwell from taking fake or unlicensed forms of these medications, that isn’t to say I never will. So I implore people thinking about trying a cheap version not to. If something (in this case, the price of your medication) seems too good to be true, it probably is.

I absolutely understand the difficulty that may lead people to consider doing so – but the risk just isn’t worth it.

Dr Stephanie de Giorgio is a GP with a special interest in obesity who works in east Kent, and is also co-director of the advocacy group All about Obesity.

As told to Lucy Elkins