Ireland’s chief obesity clinician has said he was unaware of the extent of private obesity drug use or the availability of unlicensed versions still under development.
Professor Donal O’Shea, consultant endocrinologist and the HSE’s national clinical lead for obesity, said he was “absolutely shocked” by revelations of the drug use in an RTÉ investigation due to air on Monday.
The various products, designed to treat patients with obesity, are based on hormones and vary in strength. Despite some being labelled as “not for human use”, they are making their way on to a black market.
“I was absolutely shocked to see the use of a drug [retatrutide] that I’m hoping to have access to in two years’ time quite widely being distributed through cosmetic outlets in Ireland,” he said.
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Prof O’Shea, who recently filmed a Ted Talk on the subject, said the consumer culture around Ozempic and other related drugs, with celebrity promotion and advertisement, is unprecedented in its ability to stigmatise obesity.
“These are obesity treatments, they are not weight loss drugs. And people who are using them for weight loss – the minute you stop these drugs, the weight goes back on. The cultural narrative around this is very disturbing.”
The RTÉ Investigates programme delves into the big business behind injectable pen versions of the drug and a black market meeting demand and supply restrictions.
The programme examines so-called skinny pens, medications referred to as GLP1s, which mimic a hormone that regulates appetite and reduces hunger. It found pens imported from Turkey; counterfeit semaglutide pens; and unlabelled glass vials with clear liquid alongside hypodermic needles.
In most cases the products are openly advertised on social media as “skinny pens” or “skinny jabs”, the programme producers said.
One woman in Tuam, Co Galway, was alleged to be selling retatrutide – an experimental, unapproved product still in clinical trials in the US.
The GLP1 hormone is used in Ozempic which, when compounded with another hormone, creates tirzepatide, manufactured as Mounjaro. Another hormone combination creates retatrutide. Different versions of the drug are stronger but can lead to more severe side effects.
“What stunned me is that retatrutide is not available as a drug yet ... but some of the cosmetic outlets are sourcing it, allegedly, from a compound pharmacy in the States and giving it to people in Ireland,” said Prof O’Shea, highlighting the danger in using medication “for a disease you don’t have”.
Prof Francis Finucane, consultant endocrinologist at Galway University Hospitals, likened the term “skinny jab” to calling morphine pain relief medication a “chill pill”, and stressed concerns around side effects.
“I would say it’s clinically unacceptable for people to take these risks by using these drugs to satisfy a cultural desire for thinness,” he said.
However, he said there were also “desperate patients” who seek out the drugs due to inadequacies in their provision through conventional medical channels.
The Health Products Regulatory Authority (HPRA) said it repeatedly warns of the risks associated with GLP-1 products obtained outside pharmacies and without prescription.
“Criminals are drawn to the illegal trade in these new medicines because it presents a lucrative opportunity to exploit high demand and limited supply,” it said in response to the programme.
“There is no way of knowing what substances these products actually contain and taking them poses a real and significant risk to their health.”
The regulator also noted that demand is driven by global promotion, typically via social and other online media.
During 2024, over 450 URLs, or website addresses, linked to GLP-1 products were removed or amended, more than twice the amount in 2023. This year, the HPRA has also confiscated almost 1,500 GLP-1 product units, a rate close to three-times that of 2023. Several investigations are under way.
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