As the obesity epidemic grows, interventions to mitigate related health complications become increasingly important. In recent years, using medicines off-label for weight loss has become an appealing option for many people. Yet just how wide-spread people's interests are, and what the nature of interest in such options is, is relatively unknown.  

Changing lifestyle and diet is recognised for achieving better outcomes for a range of non-communicable diseases, including diabetes. The global burden of diabetes is significant [1], giving rise to the development of pharmaceutical interventions to tackle this epidemic [2]. Semaglutide is an insulin production-targeting drug intended to treat people with diabetes by inducing weight loss [3]. However, the use of this prescribed medication is increasingly being considered in non-medical contexts and especially promoted on social media. Indeed, social media influencers who are endorsing the use of this medicine are suggested to have contributed towards recent worldwide shortages in semaglutide [4]. 

 What inspired this study?

There are a host of medical and non-medical-related factors driving the supply and demand of medicines for weight loss. The interest in off-label use of semaglutide will likely vary between countries and given the far-reaching access to the internet, people’s perspectives on semaglutide can be captured from nations across the globe. The internet is therefore a useful resource in understanding the international viewpoint on semaglutide and Dr Raubenheimer (the lead author for this research) and his co-authors aimed to explore online behaviours to help explain the drivers (often non-clinical) behind the increasing interest in this product. 

Why is it important? 

A healthy lifestyle can contribute towards prolonging life, preventing disease and reducing economic burdens on healthcare systems. However, maintaining a healthy lifestyle can be challenging—quick fixes become more alluring. This study helps to understand why the use off-label medicine for weight loss (like semaglutide) is of interest across a range of populations, where people’s motives may be influenced by a host of environmental, social and situational factors. Understanding patterns of interest in semaglutide usage may help explain recent shortages in supplies of the drug and conceptualise interventions to prevent this happening again.   

Did this study show anything unexpected?

Dr Raubenheimer and colleagues conducted an infodemiology study (a type of epidemiological study using data from internet searches [5]) of Google Trends related to semaglutide between Janurary 2021 and August 2023. The findings highlight some countries where there was increased interest in semaglutide, although media coverage only partly explained the interest. There were specific media and social media events of note that the authors indicated to spike online interest in semaglutide across numerous countries, including an episode of the Dr Oz Show and tweets from Elon Musk. Dr Raubenheimer’s team thematically analysed the Google Trends data, highlighting that weight loss (but not diabetes) was a major theme across most countries related to searches for semaglutide. Interest in many countries was also dominated by searches on how to obtain semaglutide.

 What is the wider significance of the study findings?

The study illuminates the potential power of the internet in exploring what drives people's interests to search for information about medicinal weight loss interventions. The trends identified in different countries may elucidate specific drivers underlying the increased interest in semaglutide, which may be attributed to off-label use for non-clinical purposes. The subsequent shortage in semaglutide, potentially as a consequence of the rapidly growing interest online, may prevent these medicines reaching those who need it most. Furthermore, supply and demand challenges may increase the production of counterfeit and unregulated medicines flooding the markets, further exacerbating the problem. 

References

1. World Health Organization (WHO). The top 10 causes of death. Fact Sheets. 2020. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death. Accessed 19 May 2023.
2. Khan N. How to ‘drug’ our way out of the obesity crisis (or not): the roll-out of semaglutide. Br J Gen Pract. 2024;74:218–218.
3. Walmsley R, Sumithran P. Current and emerging medications for the management of obesity in adults. Med J Aust. 2023;218:276–83.
4. Therapeutic Goods Administration (TGA). About the Ozempic (semaglutide) shortage 2022 and 2023. Therapeutic Goods Administration (TGA). 2022. https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023. Accessed 12 Feb 2024.
5. Eysenbach G. Infodemiology and Infoveillance: Tracking online health information and cyberbehavior for public health. Am J Prev Med. 2011;40:S154–8.