A scientist tested the knock-off Ozempic sold online. He found dangerous ingredients and doses – and was cheated out of money.

Online versions of weight loss drugs are often a scam or pose a serious risk of contamination or overdose, new research suggests.

nensuria/Getty Images

• Weight loss drugs are expensive, so many people buy cheaper versions online.
• A UCSD researcher bought weight loss drugs online and tested them.
• Its results highlight why people are at greater risk of dangerous side effects from gray market drugs.

Ever since the FDA approved the prescription of GLP-1 weight loss drugs, it’s been hard to find the real thing.

Demand is so high for semaglutide, a GLP-1 sold under the brand names Ozempic and Wegovy, that it ran into shortages almost immediately after it was approved by the FDA for weight control in 2021.

Plus, at over $1,000 for a month’s supply, it’s a hard drug to afford, even if you can access it.

Of course, that wave after wave of cheaper copycat drugs.

Researchers watched nervously as the resulting gray market for trendy injections like so-called generic semaglutide grew. Pharmacies are they are technically allowed to make their own versions of brand-name drugs under specific circumstances and with a prescription. But some websites offer the drugs over the counter, no questions asked.

The question arises: what is in the online versions of semaglutide and how can the consumer know what they are getting or if it is safe.

Cue Timothy Mackey, a professor at the University of California, San Diego, who has been studying the online counterfeit drug market for decades. He decided to buy some of these cheaper and more accessible weight loss drugs himself and study them in a lab with a team of researchers.

Their results, published Aug. 2 in JAMA Network Open, provide some of the clearest information yet about what is — and isn’t — in the copycat versions of Ozempic.

Some sites were scamming people out of money

Not all off-brand semaglutide brands are illegal or necessarily dangerous. Popular telehealth companies typically offer compounded semaglutide, cheaper than brand-name versions, and make it easy for customers to get a prescription online.

There are risks involved in the process, Mackey said. There’s less oversight than seeing a doctor in person, plus combination drugs aren’t FDA-approved and can have unpredictable additives. However, the pharmacies that fill these prescriptions are regulated and have some level of quality control.

Mackey’s team was particularly interested in what he called the highest-risk form of semaglutide — the weight-loss drug sold online without a prescription. They collected samples of these products to test them.

All of the websites the researchers used to buy and test the products appeared in the top results of mainstream search engines and have millions of visitors, according to an analysis of the site’s traffic, Mackey told Business Insider. .

They found that half of the sites advertised the Ozempic brand, costing between $190 and $360 for two pens, plus shipping. This is huge because Ozempic was in short supply when he conducted this study and even doctors were struggling to get the real drug through official means. Predictably, the branded products never arrived. When researchers followed up, they were asked to pay extra money — between $650 and $1,200 — to “clear customs,” but it was a fraud, researchers discovered after contacting customs agencies.

Hazardous ingredients and concentrations

The other sites advertised generic semaglutide. They delivered the product, albeit in a dubious form, with inconsistent dosages.

First, all samples arrived in powder form, requiring users to reconstitute using special sterilized water before injection. (This practice is common for online sales of peptides, a common category of fitness and antiaging supplements.) Only one of the products provided instructions on how to do this, and doing it wrong is a serious risk of contamination , according to Mackey.

All samples were advertised as 99% pure semaglutide. Tests showed they were between 7% and 14% pure. They also provided higher doses of semaglutide than the label suggests—up to 39 percent more per batch—increasing the risk of overdose. Too much semaglutide can cause serious gastrointestinal side effects, such as vomiting, as well as dehydration and acute pancreatitis, according to the FDA.

Mackey’s team also found that the products were likely research-grade semaglutide, never intended for human use. Websites used creative marketing language and imagery to suggest that their products were aimed at people without telling them directly.

One of the products also contained high levels of a substance called endotoxin, a harmful substance found in bacterial cells (although no live bacteria were seen).

Poison control centers saw a massive increase in semaglutide overdoses last year, CNN reported. Based on his team’s results, Mackey isn’t surprised. “This is a clear sign of a product that is not intended for human use,” Mackey said. “The bottom line is that there are discrepancies in their manufacturing process.”

Counterfeit Ozempic doesn’t go away, so buyer beware

Mackey said a wave of telehealth services and online providers have made it easier than ever to get prescriptions and medications online. But it’s also harder to spot a scam now than when it all came from the brick-and-mortar pharmacy after a face-to-face with a doctor.

“The average user is more confused about how to get this legitimately,” he said.

Illicit websites can be convincing, but if they emphasize that their weight loss drugs don’t require a prescription, that’s a major red flag, according to Mackey.

Another warning sign is the cost. Brand semaglutide can cost you more than $1,000 per month. If a product is listed online for a significantly cheaper price, that’s because you’re likely to get what you paid for – an inferior or counterfeit product.

“If providers are advertising $200, that’s because they’re not real, but they’re still advertising a lower price, and that’s going to be attractive to consumers,” Mackey said.

Despite the risks and the FDA’s efforts to crack down on scammers and dubious products, the market for weight loss drugs is too big, too new and too messy to expect counterfeiters to stop anytime soon.

“It’s going to be something endemic in our supply chain because of how popular the market is,” Mackey said. “It’s kind of an arms race here.”