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This article contains references to disordered eating and eating disorders.
Welcome to the latest instalment of Body Talk, our monthly column written by journalist, author, and GLAMOUR's Website Director, Ali Pantony. Ali has written extensively about her own journey with body acceptance and eating disorders for GLAMOUR, but still feels there’s so much to be said on this topic. Despite the millions of #bodypositive TikToks, the societal pressures we face as women have never really gone away. In her monthly column, Ali explores the journey to accepting our bodies in a society that has always taught us otherwise.
The pharmacist glances at me briefly before looking back at her screen.
“What’s your date of birth?”
I tell her.
“And your address?”
She types my details into her computer, her gaze still fixed on the screen. “One moment please.”
She walks to the back room where a second pharmacist is also rifling through prescriptions, presumably for the elderly lady who sits patiently on a white, plastic chair between me and the pharmacy counter. She smiles at me and I smile back.
‘I wonder what she’d think if she knew I was here to collect weight loss injections,’ I think.
I can hear the two pharmacists talking, but I can’t make out what they’re saying. I start to panic.
‘What if they’re saying this is clearly a mistake; that I don’t look overweight enough to be taking this medication and that I’ve obviously lied to get a prescription?’
The pharmacist starts walking back towards me and my palms are so sweaty I worry they might start dripping onto the floor. Am I about to be arrested? What if the pharmacist is partial to citizens' arrests? At least if I have to make a run for it, the elderly lady in the way should give me a bit of a head start.
“Here you go,” the pharmacist smiles, handing me a month's supply of Wegovy – an injection that helps you lose weight by reducing your appetite – wrapped in a plastic bag. “Have a nice day.”
I grab the medicine and thank her hurriedly before rushing out of the pharmacy with all the stealth of a giraffe robbing a bank. I make a mental note to never start a career in organised crime.
A few days earlier, I’d filled out a form on Boots’ Online Doctor service and lied about my weight, and my history of disordered eating and eating disorders. Within two days, my order of Wegovy had been remotely approved by a clinician, and I was in my local Boots in north London collecting the injections the following day. The whole process was shockingly easy.
The online “consultation” – which asked about my medical history and symptoms to assess my suitability for the drug – took less than 10 minutes to complete. When entering my height and weight, I added 17kg (2.5st) to my actual weight to push my BMI to 30.4. Semaglutide, which is sold under brand names including Wegovy, Rybelsus and Ozempic (used to treat type 2 diabetes), should only be prescribed to those who are clinically obese with a BMI of 30 or more. I had to take two head-to-toe photos on my laptop’s camera, one from the front and one from the side, and was warned not to wear baggy clothing to conceal my body. Nevertheless, it was very easy to make myself look bigger in the photos than I actually am.
Welcome to the second instalment of Body Talk.
I was also asked a series of box-ticking questions, including if I’d ever had diabetes or any gut, bowel or thyroid conditions, as well as my mental health history. I was asked if I currently have, or have ever had, conditions including depression and/ or anxiety, bipolar disorder, or an eating disorder (“e.g anorexia, bulimia, or binge-eating disorder,” the form specified). I ticked the ‘NONE of the above’ box.
‘I wonder if the ‘none’ is aggressively capitalised in an attempt to deter people like me from lying,’ I thought. ‘I wonder if it’s ever worked.’
I’ve spent most of my adult life dipping in and out of disordered eating habits and behaviours that, had I ever disclosed them to a medical professional, would undoubtedly be diagnosed as bulimia and purging disorder. The latter is categorised as an ‘other specified feeding or eating disorder’ (OSFED), for those who don’t meet the diagnostic criteria for any other eating disorders. It accounts for the highest percentage of eating disorders in the UK. At its worst, I was making myself sick after every meal.
It’s very common for those with eating disorders to never seek help for it. Bulimia, for one, is extremely easy to conceal from those around you because sufferers rarely lose a noticeable amount of weight. This also makes us feel undeserving of help. I can’t tell you the amount of times I’ve thought, ‘I can’t possibly be ill because I’m not thin enough’. The shame and secrecy this breeds makes you utterly unrecognisable to yourself; you become the best liar you’ve ever known. But like any addiction, the dopamine hit keeps you going – and this is another reason I never went to my GP. Getting help means that you want to stop.
That's what makes the online sale of these drugs so alluring (and dangerous) – deception comes naturally to those of us living with eating disorders. I know the fact I lied about my weight on the form may sound shocking, but it's a true representation of the lengths women like me will go to lose weight.
Boots requires you to submit photo ID and details of your GP in order to obtain a prescription for weight loss drugs. But when I asked my GP surgery if they’d been contacted by Boots, they said no. Even if my eating disorder had been on my medical records, the clinician who reviewed my application would’ve had no idea. It was as simple as ticking a box and lying on an online form. At no point, even when collecting the drugs in person, was I ever weighed by a medical professional, asked about my relationship with food or my body, or why I even want to take weight loss medication in the first place.
I also submitted a request for Wegovy to Superdrug Online Doctor with the same incorrect BMI. The application was similar to Boots’, except that Superdrug asked me to upload the photographs from my device – a full-body shot from the side, and a picture of my feet on the scales, both showing the date written on a piece of paper – rather than needing to take them on my laptop them there and then. This made it even easier to submit a photo where my body looked much bigger than it actually is.
One woman vomited blood after using an unlicensed weight loss injection.
Despite this, Superdrug rejected my Wegovy prescription. “We have decided it would not be appropriate for us to treat you remotely,” read a message from the registered doctor who reviewed my assessment. “This is because your current weight and height make you unsuitable for starting this treatment with us.”
She continued: “As this is a remote service, and we can not see you face to face, we must follow strict prescribing guidelines. We do this to make sure that any treatment prescribed is entirely safe and suitable for you.”
Whilst it’s reassuring that Superdrug didn’t prescribe me Wegovy, I was told in the same message that if my BMI is 28 or more, I may be eligible for Alli (the brand name for the active ingredient Orlistat), a weight loss pill that’s taken three times a day after meals to reduce fat absorption. I filled in the same online form and the pills arrived in the post a week later.
It’s clear that getting an online prescription for weight loss medication, even if you don’t meet the medical criteria or could even be at huge risk from taking it, is alarmingly straightforward. It’s no wonder A&E doctors report seeing a rise in vulnerable young women who have lied in order to obtain powerful drugs like Wegovy from online pharmacies, and are suffering serious complications as a result.
Dr Vicky Price, president-elect of the Society for Acute Medicine, says she’s treated young women admitted to hospital with complications from the drugs “almost every shift” recently. None of them have been obese.
“We are very concerned about the increasing numbers of patients we’re seeing with complications from new weight loss drugs they have purchased online,” she says. “Sadly, we are seeing serious, life-threatening complications including inflammation of the pancreas gland and alterations in blood salt levels in these patients who were not aware of the risk they were taking.”
Sir Stephen Powis, NHS National Medical Director, adds that “the NHS is concerned about reports of young women ending up in A&E after using false information about their weight to buy the medication online.”
For those of us familiar with the desperation and determination to shrink ourselves, this sadly doesn’t come as a surprise.
“Anybody with experience in the eating disorder community, either personally or professionally, would’ve very easily predicted that the online sale of weight loss injections and tablets would come with huge potential risk,” says London-based GP Dr Ellie Cannon, who has seen a similar pattern of patients who have lied on virtual forms. “If you’re able to purchase weight loss drugs online, it is a golden ticket for eating disorders. It doesn’t take very much ingenuity at all to play the system.”
I only filled out forms on Boots and Superdrug. Type ‘Wegovy prescription’ into Google, and you’re met with streams of private pharmacies promising to “assist you on your weight loss journey”. They’re doling out weight loss jabs like packs of Piriton at the height of summer. But at least with online pharmacies, you know you’re getting the real product. I have no doubt I could have just as easily obtained these drugs from sellers on the dark web for half the price. Which, when you consider the sky-high cost, begs the question: How many young women are buying them from unregulated, illicit sellers?
I paid £199 for a month’s supply of Wegovy – one pen with four 0.25mg disposable needles for weekly injections – while the same prescription costs £195 from Superdrug. The Alli pills I was prescribed cost £43.49 for 84 capsules, about a month’s supply. Other popular weight loss injections Mounjaro and Saxenda cost £219 and £54 for one pen respectively. These medicines are intended for long-term use, as the forms I filled in repeatedly reminded me. Hardly surprising, then, that sales for weight-loss drugs are predicted to reach £118 billion by 2033. In 2023, this figure was a comparatively measly £4.7 billion.
It’s clear that much stricter regulation is needed – as Dr Cannon says, “consultations must be done face-to-face by a doctor who not only checks you physically, but psychologically too”. But there’s something much more systemic that needs to change. In a society in which ‘skinny injections’ are normalised, we’re simply perpetuating the thinness myth – the idea that we’ll be happier and healthier, if only we were thinner. Even in 2024, our health is so often reduced to the number we see when we step on the scales. But body weight is not body composition – it doesn’t tell us about our percentage of fat, bone, water or muscle. The idea that body fat is bad is so ingrained in our society (and so financially important to the people and companies who profit from it), that it was only a matter of time before a near-instant fix emerged to shrink our bodies with almost zero effort. Until we wake up to the dangers of prescribing and normalising these drugs, women like me will continue to get their hands on them.
Welcome to GLAMOUR's new column, Body Talk.
A spokesperson for Boots said: “We have a number of safeguards in place to support appropriate and safe prescribing of weight loss medicines. The online consultation requires patients to provide photo ID alongside full body photographs of themselves in fitted clothing.
“We ask patients to confirm that all information provided is honest, complete and accurate. We urge people not to falsify their health information to obtain any prescription medicine as it can result in harm.
“We are committed to preventing inappropriate use of the service and will review this case to understand what learnings we can take from it. We continually review the service to ensure we deliver high-quality and safe care.”
A spokesperson for Superdrug said: “Our safeguarding protocols are designed to be more comprehensive than those typically found in online medical services. We also rely on the integrity and honesty of our patients when they provide personal health information. This is no different to information provided to a GP practice.
We ask patients to confirm their BMI by submitting their height and weight in our consultations. We then request further validation of this BMI by asking patients to submit two photos of themselves for our doctors to review. We inform patients at this stage that it is essential that all information they provide is accurate and honest as medications used for weight loss have the potential to cause serious illness and severe side effects if used inappropriately, and our doctors will not be able to assess their health risks if false or inaccurate information is provided. One of these photos requires the patient to stand with their feet on weighing scales and take a clear image of their weight and the other photograph must show their body frame. Our doctors review this evidence which aims to corroborate the information patients provide in their consultation forms.
In addition to BMI verification, we conduct a background identification check for all weight loss treatment requests. It is also mandatory for patients to provide their GP details, which we use to notify their GP with any medication prescribed, enabling their GP to inform us of any discrepancies or concerns they may have with the prescription.
As a reputable provider, we seek to continually review and improve our services to enhance patient safety whilst still providing a robust, fair and accessible service for patients in need.”
For more from GLAMOUR’s Website Director and Body Talk columnist, Ali Pantony, follow her on Instagram @alipantony.
For advice or information on the topics mentioned in this article, contact Beat, the UK’s leading eating disorder charity, on 0808 801 0677.