Dear FDA: Influencers are a form of DTC ads

Patients hear misinformation on new weight loss drugs from social media influencers, but they often aren’t getting ALL the information they should know. Regulatory systems are most interested in pharma’s claims, not necessarily those of doctors or their enthused patients. Should the FDA do something?

The FDA approved a few of these drugs for weight-loss drugs, including Novo Nordisk’s Wegovy. But after shortages made that treatment harder, patients turned to other products like Novo Nordisk’s Ozempic and Lilly’s Mounjarapproved only for Type 2 diabetes. Those are often used off-label though you won’t hear that from many of their online boosters.

Patients are not coming to doctors’ offices now because of the science. They cite things they saw on TikTok, like Chelsea Handler and other celebrities discussing their injections.

According to KFF, “the excitement — which doctors worry may cause some patients to misuse medications — comes from business interests. Some are doctors promoting their venture-capital-backed startups. Others are spas hawking everything from wrinkle-smoothing and lip-plumping to, yes, weight loss benefits of semaglutide, the active ingredient in Wegovy and Ozempic; their prices, often in the hundreds of dollars, are well below what consumers would pay if picking up the prescription at a pharmacy.”

Doctors are also sounding alarms about the publicity. They believe patients will be driven to use these medications off-label, obtain unreliable forms of these drugs, or exacerbate other health conditions, like eating disorders. The drugs act in part as an appetite suppressant, which can dramatically reduce calorie intake to a concerning degree when not paired with nutritional guidance.


Social media users and influencers — whether with white coats or ordinary patients — are hopping on every platform to spread the news of positive weight loss outcomes. There are those, for instance, who had gastric bypass surgery that didn’t work and is now turning to TikTok for guidance, support, and hope as they begin taking a GLP-1. There’s even a poop-centric Facebook group where people discuss the sometimes fraught topic of the drugs’ effect on their bowel movements.

So what can/should the FDA do?

The FDA needs a better understanding of how patients decide to ask their doctors about these drugs. They must work with pharma companies to develop messages communicating their risks beyond fair balance. These essential warnings must be on every drug NOT approved for weight loss.

I would also like to see the FDA issue a series of press releases about the drug’s side effects. I’ve talked to a group of physicians, and their feedback that more than half of patients stopped using the drugs because of the GI side effects. As one told me, “GI side effects are among the worst because they interfere with a patient’s daily schedule.”

Finally, the FDA needs to acknowledge the power of influencers and treat their videos and comments like DTC advertising because, in today’s environment, IT IS a form of DTC marketing.