Weight loss jabs – a litigation time bomb

You are bound to have heard about the new weight loss jabs, such as the branded product Ozempic.

These have seen a meteoric rise in sales in recent years and are being referred to in popular media as the 'secret' behind a number of drastic celebrity weight loss transformations. Ozempic's original purpose was to manage blood sugar levels in diabetic patients. However, it has the effect of suppressing hunger, as its operative ingredient is semaglutide - the hormone which indicates to the brain that the stomach is full. The injections enable users to lose around 10% of their body weight.

Sales for these injections and other semaglutide products have increased 300% in the last three years. Novo Nordisk, the largest manufacturer of weight loss injections, reported a 77% increase in Ozempic global sales in 2022 alone.

The surge in sales is propelled by Medi-spas (hybrids between traditional day spas and medical clinics), and online pharmacies, which sell the injections for off-label weight loss use.  Clinically, the injections are recommended only for patients with a BMI over 30; however, undercover investigations have found clinics offering the products without verifying BMI or even when customers have overtly revealed that their BMI falls below the suitability requirements.

The off-label use of the injections is raising numerous health concerns. Doctors in the US have reported Ozempic-users coming into A&E with severe complications from malnutrition as a result of their suppressed appetites. In early October 2023, the FDA required an update to Ozempic's labelling, in response to user reports that it could cause blocked intestines.

Some of these novel health concerns are sprouting into litigation. Novo Nordisk has been sued in the US, alongside its competitor, Eli Lilly. The plaintiff alleges that the injection caused gastroparesis- a condition which stops the intestine absorbing any nutrients. The lawsuit recognises that weight loss is an off-label use for the injection, but states that this is widely popularised in the media. It claims that manufacturers are aware of the popularity of this use and mimic this trend in their advertising. The claim references Novo Nordisk's 2018 ad-campaign, which stated that "adults lost on average up to 12 pounds", with the 1970s pop-classic "Magic" playing in the background. The lawsuit therefore alleges that, in the circumstances, the manufacturers have failed to adequately warn prescribers and patients of known risks associated with the injections.

Plaintiff law firms in the US are scouting the market for a new class action. Some firms have been offering consultations to consumers of the injections who have experienced adverse side effects. The firm representing the plaintiff against Novo Nordisk and Eli Lilly has reported that 400 people have come forward with potential claims – but they anticipate the numbers will grow into the thousands.

Whilst these movements have been contained in the US, what happens across the pond tends to be mirrored in the UK – also a large consumer of these products. In the UK, semaglutide products are only available on prescription; however, prescribers operate in a variety of settings, including online pharmacies and Medi-spas' which might escape robust oversight.

Manufacturers must have clear guidelines for the intended purposes of their products, and show caution in warning about side effects from known off-label uses. Where insuring prescribers, whether at Medi-spas or pharmacies, insurers should consider the risk exposure, where prescribers may not be following the manufacturer's guidelines – such as failing to undertake proper medical checks into a user's suitability for these 'weight loss' products.

Mass litigation around these trending weight loss injections is bubbling under the surface and insurers should be alive to the emerging risks.