Viewpoint: What’s the skinny on this jab?
Therapy Today, July-August 2025

The skinny jab!’ ‘Its reputation precedes it!’ This relative newcomer is being celebrated as a veritable game changer in the fight against the flab. Ozempic, Mounjaro and Wegovy – medications primarily used to manage blood sugar levels in adults with type 2 diabetes – now form part of the NHS arsenal in tackling the obesity crisis. With the average patient losing 15% of their body weight within a year,¹ weight-loss drugs are being slowly rolled out for those patients whose body mass index (BMI) is a minimum of 35 and who have additional health problems. An estimated 3.4 million adults are eligible for treatment at £11 billion a year, equating to £3,000 per year per patient.^1,2Ìý

Research indicates that these medications are ineffective as a standalone treatment.² As prescribed by the NHS, weight-loss drugs form part of a more holistic package of care. Patients are closely monitored and are supported in making complementary changes through nutrition and exercise guidance alongside the use of medication. 

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Concurrently we are witnessing the rise in popularity of these drugs as a lifestyle product – even an ‘I ♥ Ozempic’ T-shirt by Namilia made its way onto the catwalk of Berlin Fashion Week last year.³ Lauded by celebrities, celebrated on social media, so-called ‘skinny jabs’ are influencing beauty trends and being used by those seeking to lose a few pounds in their pursuit of body perfection. A whole alternative market has developed as a direct result. Individuals can now access these drugs via private pharmacies, online sellers and their local salons. Half-a-million people are reported to be using skinny jabs in Britain alone.⁴ Drugs that NICE guidelines² stipulate should be used only under strict medical supervision and within stringent parameters because of their risks can be accessed as easily as any other beauty treatment despite the statistics surrounding mortality and serious injury. 

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Between 20 and 30 people are thought to have lost their lives after taking skinny jabs, while patients using this medication for lifestyle reasons comprise the majority of associated admissions to A&E.⁴ Between January and May 2024 the Government received 208 reports to its Yellow Card scheme, including 31 serious reactions and one suspected death.⁵ As a clinician I am beginning to see clients with eating disorders (ED) explore the use of skinny jabs. This has led me to consider the implications on their physical health and psychological wellbeing. In order to help my clients manage risk alongside offering the best support, I am striving to pre-empt potential thought processes and likely actions while also remaining mindful of how accessing skinny jabs may affect each client specifically. These concerns are increasingly moving from conjecture to stark reality – a fact not lost on healthcare providers. 

Because of the social acceptability of these drugs, and the lack of emphasis on risk and side effects, the psychological line appears to be very similar to that of using laxatives and purgatives. Easy access – in particular through salons – makes weightloss pharmaceuticals feel relatively safe to use. But they come attached to grave risk when used inappropriately. The physical impact and psychological effects make this medication very unsafe indeed for ED clients. 

Eating disorders

Clients with ED purchasing skinny jabs from beauty outlets and online pharmacies may become anxious of the ever-tightening regulations and become fearful of the cessation of their supply. Online pharmacies are now subject to prescribing criteria in order to prevent people who are already a healthy BMI from purchasing these products. Pharmacies must perform a face-to-face consultation, either in person or on a video call. Prescribers are also required to notify the patient’s GP about any medication administered.⁶ This in itself could heighten both anxiety and intrusive thoughts, which in turn could lead to use of greater dosage to achieve weight loss more quickly and perhaps also a greater reliance on any other purgative methods the client is already engaging in. We also need to bear in mind that not all clients will obtain weight-loss medication via alternative vendors; many will qualify under NHS regulations. It is a common misconception that all ED sufferers are underweight; many have a high BMI and health issues relating to their weight. For this group, gaining a prescription would be as simple as denying their ED – something that most sufferers habitually do. These clients are in the precarious position of qualifying for NHS assistance – which may bring them benefits in regards to their obesity – while at the same time being at risk from the symptoms of their ED. 

As clinicians we need to offer the best support to the client in making the right choice for themselves, while being aware of any possible complications. The expected side effects of this medication have the potential to accelerate the client’s existing eating-disordered thoughts and behaviours. Gastric disturbances mirror the effects of laxatives and purgatives, and may be welcome aspects of the drugs, potentially perpetuating dependence as weight loss is accelerated. Similarly, the side effect of nausea could trigger more purging episodes. When a client feels nauseous there may be a temptation to induce vomiting and thus kick-start a binge-purge cycle that may not have otherwise occurred as part of the client’s habitual pattern. It is equally more difficult for an eating-disordered client to challenge the urge to purge when they already feel sick – it feels more natural and less steeped in their ED framework and therefore easier to give in to. 

Food noise 

One of the perceived benefits of weightloss drugs is the reported reduction in ‘food noise’ – characterised by intrusive thoughts surrounding the urge to eat and the craving for specific foods. Many overweight patients find relief from this symptom, but for ED clients food noise is less clear-cut. It is bound up in separate, comorbid internal pressures that form part of the starvebinge- purge cycle. It cannot be medicated because the drivers are psychological and need to be addressed as such with appropriate support and intervention. For many with ED, the hope that medication will lessen food noise, and therefore help them to further restrict food intake, may be a significant influence in their decision to try these drugs. 

Let us not forget that weight-loss pharmaceuticals come with medical side effects, from pancreas inflammation to kidney disease and septic shock.⁷ Our ED clients are already placing their bodies under extreme stress, whether that be from food restriction, binging or purging. Their bodies are perhaps less able to sustain the onslaught of these chemicals on their systems, and may be more prone to the rarer risks as well as perhaps suffering heightened symptomology regarding the accepted side effects. This is a lot of strain to place on a body that is already struggling under pressure. 

These considerations – while no means exhaustive – highlight the need for us to examine our perceptions while remaining open to exploring what may be new territory in our ED work. We need to be open to challenging ourselves and to changing our existing strategies in working with this client group. 

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It is easy to shift responsibility for abuse of prescription drugs onto the patient, but this is short-sighted. Clients with ED face a daily fight in which their decision making is compromised; they need to be both protected and supported. As clinicians we need to be aware which of our clients may be accessing this medication. There are currently no significant barriers and, furthermore, using skinny jabs is seen as a socially acceptable lifestyle choice. We must keep this in mind and be conscious of the potential risks. It is equally imperative that we agree on protocol with our clients and ensure that they themselves know what to do in case of an emergency. An appropriate care plan could include documenting the name of the precise skinny jab the client is using, and whether it is NHS prescribed or sourced elsewhere – this will be essential to first aid responders. A next of kin contact is desirable, as are the name and telephone number of the client’s GP. We should also ensure that we have the client’s address should we need to call paramedics. Often the simplest measures are the most overlooked. The client needs to be aware that if they fall ill they must call 999 immediately. This information should be agreed with the client and amended or added to as appropriate. Above all we need to educate ourselves about these drugs – how they work, what the side effects are and, mostly, what the psychological implications are. We need to open an honest debate about the influence of, and impact of, weight-loss drugs on our ED clients. Perhaps the above considerations are a good place to start.