An analysis of records covering 92 million US adults found more than 1.1 million people received GLP-1 drugs without a documented approved indication, raising concerns that demand is outpacing evidence.
A large analysis of US medical records suggests that GLP-1 drugs such as Ozempic are being prescribed far beyond the patients they were designed to help, with more than 1.1 million adults receiving the medicines without any documented diagnosis that would normally justify treatment, according to The Seattle Times. The finding adds to growing evidence that these blockbuster injections have moved from specialist obesity and diabetes care into a broader, more uncertain market driven by public demand.
The study, led by Babak Orandi of NYU Langone Health and published in the journal Obesity, examined records for more than 92 million US adults. It found that prescriptions given without a recorded approved indication rose sharply between 2021 and 2025, increasing 15-fold over that period. Researchers said the figure is likely an underestimate because it may miss people obtaining the drugs through telehealth services or compounded products.
The drugs are formally approved for a limited set of uses, including obesity and type 2 diabetes. Some GLP-1 medicines have also been approved for certain cardiovascular risks, sleep apnoea in people with obesity and kidney disease in patients with type 2 diabetes. Even so, the wider cultural popularity of the injections has fuelled demand, with doctors saying many people appear to be seeking them for weight loss or for hoped-for benefits that are still being studied.
The study also found that more than one-third of off-label users had a normal body mass index, while people receiving the drugs without an approved reason were more likely to have a documented eating disorder. The number of such cases was small, but specialists said the pattern was worrying. Andrew Kraftson of the University of Michigan Medical School told The Seattle Times that hurried prescribing may mean some patients are not being fully assessed for risks and benefits before treatment begins.
There are also questions about how the medicines are being used outside approved populations. A Swedish cohort study published in 2024 found that off-label GLP-1 use among people without diabetes was more common among men with higher household income and varied widely by region, suggesting uneven prescribing practices. More recent safety research, including a 2026 analysis of post-marketing data, has flagged adverse events such as incorrect dosing, nausea, diarrhoea, vomiting and extra dosing, underlining the need for closer monitoring as use expands.
Researchers say the concern goes beyond side effects. Because people without obesity or diabetes were largely excluded from the pivotal trials, there is little solid evidence on how the drugs affect lower-risk users over time. Nils Krüger of Harvard Medical School told The Seattle Times that the possible harms could include malnutrition and loss of muscle mass, especially in people starting from a lower body weight. For now, scientists say the boom in off-label use has outpaced the evidence base, leaving patients and doctors navigating an experiment that is still unfolding.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
