Weight loss medications are everywhere. At this year’s Oscars, host Jimmy Kimmel mentioned Ozempic in his opening monologue. Wegovy ads have become part of the New York subway landscape. And Zepbound, a new weight-loss drug that will make its U.S. debut soon, is entering a market where it is virtually guaranteed to become an overnight success.
But typical TV ads and catchy jingles aren’t what’s behind the craze for appetite-suppressing drugs from Novo Nordisk and Eli Lilly. The pharmaceutical industry, in fact, barely had to lift a finger.
Instead, a combination of pop culture, social media and profit-seeking third-party sellers have helped turn weight-loss drugs into household names that rival Viagra and Prozac.
U.S. prescriptions for Ozempic, Wegovy and Mounjaro have increased 300% in just two years, putting the drugs on track to become some of the best-selling drugs of all time. Drugmakers are struggling to keep up with demand.
It’s not that Lilly and Novo aren’t promoting their drugs at all. From January to November, Lilly and Novo together spent $218 million on commercials for Ozempic and Mounjaro, diabetes drugs that have become popular for weight loss, according to iSpot.tv.
But together the companies represent just 3.7% of the staggering $5.8 billion that pharmaceutical companies spent on TV ads this year. Novo’s weight-loss drug Wegovy hasn’t even had its national TV debut yet, according to iSpot.tv.
The ads that aired for Ozempic and Mounjaro describe the drugs as medical interventions for people suffering from diabetes, rather than as a miracle weight loss pill that can help anyone get thin.
Pharmaceutical companies must follow strict rules when it comes to targeted consumer advertising. All new weight loss drugs are part of a class of drugs called GLP-1 receptor agonists, which mimic the effects of eating food.
They can be life-changing for patients with obesity and diabetes, but they often have some unwanted side effects, such as nausea and vomiting. And drug manufacturers are prohibited, for example, from marketing products for unapproved uses or exaggerating the benefits of a drug.
These rules, however, haven’t stopped third parties, like telemedicine companies and medical spas, from fueling the weight-loss drug craze.
“None of these new weight-loss drugs are being marketed responsibly,” said Joel Lexchin, associate professor of family and community medicine at the University of Toronto.
Ozempic and Mounjaro, for example, are approved by the FDA (Food and Drug Administration, equivalent to Anvisa in the US) only for diabetes, although doctors are free to prescribe them for what is known as off-label use.
But the telemedicine company Ro spread at least a thousand ads across the New York City subway system last spring, many omitting important details like what medicine they were advertising or what the medicine was for, instead simply stating that they were selling “a weekly weight loss injection.”
The ads also featured people unlikely to meet the medical definition of obesity, the patient population for which the weight-loss drugs are intended. Ro did not immediately respond to a request for comment, but has said in the past that it aims to destigmatize obesity treatment.
Sponsored ads from telemedicine companies on Google promise weight loss without exercise or dieting. Meanwhile, medical spas sometimes treat a prescription weight loss medication as a wellness regimen, offering it alongside Botox and laser hair removal.
“The indirect message companies are conveying in their targeted consumer ads is that anyone who wants to lose weight should ask their doctor for the medicine,” Lexchin said.
Social media has also fueled the enthusiasm, with much-watched videos from influencers and everyday people touting the weight loss and other health benefits they’ve experienced from taking the drugs.
Zepbound hasn’t even hit the market yet and there is already great expectation surrounding the new drug. The medicine is a competitor to Wegovy. Even before it was approved, social media was full of rumors. When Lilly registered the brand Zepbound, for example, TikTok users posted videos opining whether that was the name of the company’s new weight loss drug before it was even approved.
“One problem with social media advertising is that many of the ads don’t display complete information about the drugs, and consumers don’t tend to click ‘learn more’ to be fully informed about the risks,” said Erin Willis, associate professor of advertising at University of Colorado Boulder.
The FDA does not typically regulate drug advertising outside of pharmaceutical companies themselves. This has led to a distorted picture of who can — and should — take weight loss medications. The zeitgeist surrounding medicines has led to ongoing supply shortages.
A black market of sorts for Ozempic has also emerged, as patients clamor for the drugs. Compounding pharmacies and medical spas have begun offering counterfeit versions of weight loss medications to patients who may not qualify for a prescription or whose insurance does not cover them.
“A patient told us recently that she got ‘generic Ozempic’ at her hair salon,” said Louis Aronne, an obesity specialist at Weill Cornell Medicine in New York.
Concerns about misleading messages about weight-loss medications have begun to have an effect, albeit a small one.
Ro temporarily pulled its ads on the New York City subway during the summer when patients were having difficulty getting their prescriptions for the drugs, CEO Zachariah Reitano said in an interview at the time.
TikTok has been trying to crack down on content that promotes the use of weight loss medications. In early July, the platform began temporarily banning some accounts that were posting about Ozempic and Mounjaro.
It’s unclear how many accounts were affected or how long the bans lasted, but many of the creators who said they were banned appear to be posting again. What is clear is that demand for weight loss drugs shows no signs of slowing down.
All this pent-up demand is a huge opportunity for Zepbound. Lilly said Zepbound will hit the market “after Thanksgiving.” If its predecessors are any indication, the company may not need to do much to turn it into a huge success either.