The scene has become all too common. Patients arrive at my office with various health concerns, yet mid-conversation, a deeper worry emerges. They confess to using weight-loss injections procured from the black market online, fearing these might be jeopardizing their health.

Initially, these patients may consult me for issues like stomach pain or even unrelated conditions—one recent case involved a patient with Covid. However, their anxiety about the potential impact of these injections on their bodies means they often attribute any symptom to the jab.

The scale of this underground market is staggering, far from being a minor issue. The sheer number of cases I encounter suggests it’s a massive industry.

Such is the prevalence of this problem that whenever a patient presents with abdominal discomfort—a known side effect of these injections—my first question is invariably: “Have you been taking weight-loss medication purchased online?”

Many patients are using cheaper alternatives they believe to be akin to Wegovy, which contains semaglutide, a compound that mimics the hormone GLP-1 signaling satiety, or Mounjaro, which also mimics the hormone GIP. These are often sourced from unauthorized online sellers or inappropriate vendors like beauty therapists.

The allure is clear—at a mere £40 a month, these options are a bargain compared to a legitimate private prescription for Mounjaro, which could run between £200 and £300 per month. However, the savings come with significant risks.

This week, the daughters of Karen McGonigal, 53, from Salford in Greater Manchester, who died in May after using weight-loss jabs she’d bought from a local beautician for £20, warned others not to risk their lives.

We don’t yet have the details of how Karen died, but I find it incredibly sad that people are willing to risk their health in this way.

Karen McGonigal died in May aged 53 after taking a weight-loss jab she bought for just £20

That’s not to say I don’t understand what compels people to take such risks – I understand only too well, as I have battled with obesity for most of my adult life.

I have a condition called lipoedema. This is a condition which affects almost exclusively women typically from puberty, causing excess fat cells to develop usually on the legs, buttocks and arms. The fat does not respond to diet and exercise as normal, and in severe cases the only way to remove it is liposuction. It means if I do gain weight, it is very hard to get it off.

By 2017, my BMI hit 41 – obese. I began to despair of ever shifting the weight.

The world isn’t a kind place for a person with obesity. You encounter stigma all the time.

I worried about fitting into plane seats and wearing swimsuits on holiday – not to mention looks from those who judge you.

I opted for weight-loss surgery – a gastric sleeve [during which the size of the stomach is surgically reduced to cut how much food can physically be eaten, but the operation also changes the hormones that signal hunger in the same way that the medication does].

When I came round, for the first time in my life I wasn’t thinking about food.

I can’t say how much weight I lost as I have since given up weighing myself – partly as I have had enough of it and partly to be a good role model to my daughters, aged 21 and 14. I prefer to rely on how I feel and how my clothes fit as a guide.

But after developing long Covid in 2020, I became unable to exercise and started putting on weight again.

That’s why this year I tried weight-loss jabs myself (prescribed by a private authorised online pharmacy) and it was like magic.

Just like it was when I came round from the gastric sleeve operation, I instantly stopped thinking about food and I lost weight (although this time I had nowhere near as much to lose).

I tried Wegovy and Mounjaro and paid more than £150 a month.

So yes, I understand why someone battling excess weight feels tempted – but the risks of cut-price weight-loss medications must not be underestimated.

Rather than arriving in pre-measured self-injectors as they do from authorised pharmacies, the cut-price jabs typically come in vials of powder that you must mix with the fluid supplied.

You have no guarantee that the powder really is the drug you think it is – in fact, police raids have found that it is being substituted for insulin in some cases, which is incredibly dangerous – and may even be fatal.

Even if it is the active drug, as a doctor even I get nervous making medications up from a powder.

All sorts of things can go wrong – you could add the incorrect ratio of liquid, or pull out the wrong amount into a syringe. It worries me hugely that people may be trying this on their own at home.

The other risk is that you end up taking a far bigger dose than you should – which will leave you more at risk of complications.

Dr Stephanie de Giorgio, who used fat jabs to lose weight, warns patients not to buy them on the black market

To investigate this problem further, I have joined online forums – and come across people who say they are buying Retatrutide or CagriSema, the newest weight-loss medications, which despite promising results aren’t even licensed for use yet.

That means at best people are taking drugs that haven’t been fully tested in trials – at worst, they may be injecting something else entirely.

It worries and saddens me that the NHS has rationed access to weight-loss jabs so much that people are now taking these risks. (I am doing what I can to get the Government to allow more people to have these drugs on the NHS.)

The situation is virtually unprecedented – all I can liken it to was what happened a few years ago when Viagra became available online, but even that didn’t happen on such a scale.

The rapid expansion of the weight-loss medication market has led to it becoming a Wild West.

The regulators can’t keep up. The General Pharmaceutical Council has said that online pharmacies should have video calls with those seeking weight-loss jabs to ensure they do need the medication and to ask about, for example, if they have other conditions or take other medication. But while there are some very good providers who do this, others don’t. The system is overwhelmed.

Although I haven’t seen anyone who has become seriously unwell from taking fake or unlicensed forms of these medications, that isn’t to say I never will. So I implore people thinking about trying a cheap version not to. If something (in this case, the price of your medication) seems too good to be true, it probably is.

I absolutely understand the difficulty that may lead people to consider doing so – but the risk just isn’t worth it.

Dr Stephanie de Giorgio is a GP with a special interest in obesity who works in east Kent, and is also co-director of the advocacy group All about Obesity.

As told to Lucy Elkins