Once touted as the “miracle drug” that could end type 2 diabetes, Ozempic is now better known for its viral success as a weight loss treatment.

Ozempic has been in high demand and short supply since 2022, but other similar medications like Wegovy and Mounjaro have since emerged in its place.

The advent of these new weight loss medications has ignited new conversations about body image, ethics, health, and accessibility. But how are Australians, particularly young people, engaging with these drugs?

This week, we launched a new three part podcast series: Investigating Ozempic. Today, I wanted to give you a bit more insight into the topic, and share some key findings.

CW: Today’s newsletter contains distressing themes including suicide and eating disorders. For 24/7 support, please contact Lifeline on 13 11 14.

Ozempic was first approved by Australian health authorities as a medication to treat type 2 diabetes in 2018. The drug now generates billions of dollars annually for its Danish manufacturer, Novo Nordisk.

Ozempic is a drug name for a medication otherwise known as semaglutide. As Dr Michael Bonning from the Australian Medical Association explains: “Semaglutide falls into this family of drugs called GLP-1s… and generally, they were developed for diabetes patients”.

“Ozempic is the [GLP-1] that has been talked about so much in the media, but actually, two others get a lot of coverage as well… Wegovy and Mounjaro,” he said.

Taken as an injection, usually once a week, Dr Bonning said these drugs act on hormones in our body. For diabetics, they work by “making sure that the cells work better with insulin,” but they also slow gastric emptying, so you feel fuller faster”.

It’s that feeling of fullness that put Ozempic on the world stage. Its virality and demand subsequently ushering in a new weight loss era.

“You ended up with people losing significant amounts of weight. That side effect… has meant that these drugs have become increasingly popular for an indication that they weren't originally put on the market for,” Dr Bonning said.

In part one of Investigating Ozempic, we explored the booming demand for these medications and their broader impacts. Experts, patients, and advocates paint a complex picture.

Around 25,000 TDA followers responded to a TDA poll earlier this year. 11% told us they had used Ozempic or a similar drug before. We asked the 89% who hadn’t used it if they’ve ever wanted to try Ozempic. 43% of respondents said yes.

The drug has been life-changing for some, like Grace, who responded to our survey in January. The 26-year-old told TDA that Ozempic and Mounjaro dramatically improved her physical and mental wellbeing. “For the first time in my life, I felt in control,” she shared.

Grace, like hundreds of others, had only positive things to say about taking GLP-1s. She said these medications have improved her confidence, health, and mobility.

But Ozempic’s popularity isn’t without controversy.

Many users reported serious side effects in our callout, including gastrointestinal issues and emergency surgery to remove their gallbladder. We also received several reports of severe mental health side effects associated with the use of GLP-1s.

One user, Mackenzie, was hospitalised weeks after starting Ozempic for weight management.

“For no reason whatsoever, and I hadn't felt like this for a very long time, I became suicidal, unable to work… It was really quite unexplained and I was really, really concerned,” she told TDA.

Mackenzie’s GP said he was seeing an increasing number of patients reporting the same side effect. He later concluded that the Ozempic may have interfered with the 26-year-old’s long-term antidepressant medication.

“He explained to me [Ozempic] slows the digestive system, which then can have negative effects on absorption…  I was in such a bad place that [my GP] suggested I go to hospital [and] stop taking Ozempic immediately,” Mackenzie said.

Mackenzie’s experience is not an isolated one, according to data from the Therapeutic Goods Administration (TGA).

GPs and healthcare providers can report adverse side effects relating to GLP-1 medications like Ozempic to the Federal Government Department of Health. These reports are tracked on the TGA’s Database of Adverse Event Notifications.

The tracker includes negative symptoms associated with the use of Ozempic, Wegovy, compounded products (pharmacy-made versions of Ozempic) and semaglutide products where the brand name was not specified.

Gastrointestinal disorders made up around half of adverse events reported between January 2023 and January 2025.

Suicidal ideation was reported in one out of every 20 cases.

In the two years to January 2025, the TGA listed three reports of attempted suicide and, separately, two deaths by suicide associated with the use of these medications. Ozempic was the only product “suspected to be related” to both deaths.

The TGA notes it uses adverse event reports “to identify when a safety issue may be present,” but assessing the safety of a medicine “cannot be made” using its tracker alone.

During our research for Investigating Ozempic, we heard from nurses, surgeons, GPs and other health professionals who said GLP-1 medications are among the most prescribed medications in the country. But it’s how people are accessing these drugs, or rather, where they’re getting them, that has some experts concerned.

While Ozempic is subsidised under the Pharmaceutical Benefits Scheme (PBS) for diabetics, it can be prescribed “off-label” for weight loss at full cost (around $400 a month) — often via virtual/telehealth platforms.

Food and nutrition scientist Dr Emma Beckett says the lack of data on private prescriptions makes it impossible to track usage or outcomes. She suspects that “the vast number” of Australians accessing these medications are going through telehealth, and not their standard GP.

“The question then is, why? Are they going to their standard GP and their [GP] is going, ‘no, no, you don't need that.’ And so they go to the people who are selling them directly and that's their purpose?”

She warns regulatory gaps in the telehealth space could be putting vulnerable patients at risk.

“ If you Google, ‘interested in these drugs,’ the top hits are not results to studies. They're not informational pieces. They're links to the companies who are selling it… I can't think of any other medication that happens like this. Medicine and marketing should not be this connected in this way.”

TDA took a closer look at major Australian telehealth provider Juniper during our investigation. Former patients have accused the platform of careless prescribing practices, inadequate follow-up care and potentially harmful marketing tactics. Juniper strongly denies any allegations of wrongdoing.

It’s worth noting that Juniper is not the only virtual health provider that prescribes weight loss medications in Australia. Other popular platforms include Mosh, InstantScripts and Youly.

However, a clear pattern emerged amongst the large volume of audience feedback we received which put Juniper in a category of its own. TDA does acknowledge some of the issues and prescribing practices we’re going to discuss may be common to other platforms.

Mackenzie told Juniper about being hospitalised with suicidal ideation after the platform prescribed her Ozempic. Mackenzie, who has a history of depression (which she disclosed to the provider), claimed Juniper was dismissive of her situation, and that its processes lack transparency around potential side effects.

Sarah, another former Juniper patient, was prescribed weight loss medication when she was 24.

“I became really fixated on how much weight I was losing. I was weighing myself two or three times a day, and it really turned into a bit more of probably an eating disorder.”

Part two of Investigating Ozempic also features an account from “Kate,” a former Juniper employee. She alleges intense pressure to meet prescribing targets, reports of delayed responses to high-risk patients, and a culture that prioritised business growth over customer safety.

Juniper’s treatment program now centres around Wegovy and Mounjaro, and some claims relating to Ozempic and Juniper pre-date its current processes.

Juniper denies all allegations of negligence or unethical conduct, saying it screens patients rigorously, employs qualified professionals, and regularly audits patient care protocols.

Juniper rejects claims it failed in a duty of care to patients, and maintains there is no major known risk of suicidal ideation as a side effect of the weight-loss medications it prescribes.

It cited specific guidance from the UK health regulator to TDA, which stated in September 2024: “The available data does not support a causal association between [GLP-1s] and suicide, suicidal ideation, self-injury and depression”.

Juniper also flagged similar findings detailed in a January 2024 update from the U.S. Food and Drug Administration (FDA) which, “did not find an association” or clearly demonstrated “relationship” between GLP-1s “and the occurrence of suicidal thoughts or actions.”

However, the FDA data quoted by Juniper comes from the preliminary evaluation of an ongoing study. Due to limitations in the scope of reporting and research in this space, the FDA conceded more clinical trials are needed, and that it “cannot definitively rule out that a small risk,” of suicidal ideation associated with GLP-1s, “may exist.” It said it’s continuing to look into this issue, and will “communicate final conclusions and recommendations,” after it completes its review.

Additionally, recent analysis of adverse reactions within the World Health Organization’s global database identified a “disproportionate link” between suicidal ideation and semaglutides, (a type of GLP-1) - contrasting the findings cited by Juniper.

Concerns have also been raised about Juniper’s marketing strategy, including ads that suggest patients could “save money” on food by using weight loss medication. For example, this Facebook ad:

In a statement to TDA, Juniper defended this ad, which it said “depicts an exchange which was inspired by real conversations between members of the Juniper online community.”

“To protect the privacy of those members, we did not use their actual words or names but instead reflected their expressed sentiments in a paraphrased manner.”

The platform describes saving money on food as a “genuine benefit experienced by Juniper’s patients,” and a “legitimate angle to canvas in Juniper’s messaging.”

The provider's comments did not clarify whether Juniper’s marketing strategy is in alignment with the latest harm-minimisation advice from eating disorder experts.

For example, anyone can enter their details in Juniper’s initial online screening questionnaire. To find out more, I took the quiz myself. After completing the questionnaire, I was shown this graph telling me I could lose 10kg in four months if I signed up to Juniper’s program:

To go any further, I needed to pay a refundable deposit to speak to a Juniper practitioner.

After weeks of follow-up emails, text messages and promotional offers, I eventually paid a deposit and booked in a phone consultation.

From there, a Juniper nurse told me that I was below the provider’s minimum BMI threshold, and was never actually eligible for treatment.

So why did I receive a personalised projected weight loss goal if I was never eligible for a prescription? From the graph to the promotional emails, eating disorder experts warn this type of promotion “can be highly triggering” and exacerbate feelings of body dissatisfaction.

We asked Juniper about this directly, to find out why it continues to heavily market its weight-loss program to patients who are within a ‘healthy’ BMI range.

Juniper said: “We accept TDA’s concerns in relation to this specific graph and are in the process of amending it so that it does not display an initial weight which falls within a healthy BMI range.”

As weight-loss drugs continue to dominate headlines and social media feeds, concerns are growing about how this messaging could be reinforcing harmful beauty/body image standards.

Youth mental health advocate Varsha Yajman has lived experience with an eating disorder and says the surge in Ozempic indicates a worrying trend — “Thinness is definitely back in”.

She told TDA, “it feels like the entire body positivity/body neutrality movement has almost had this regression where it's like, we're actually back to those sizes that we were trying to get away from, and here's a drug that's going to fix everything.”

Sarah, a 26-year-old navigating life with an eating disorder, believes telehealth services should face more scrutiny to protect these vulnerable Australians.

“At the time that I applied for [Ozempic], it was  super easy to be dishonest.”

She thinks the platform should conduct video calls with all its patients, “so they can actually physically see it's you”. Sarah also told TDA she knows people, “who have submitted photos to these platforms and been like, ‘I’ll just put a fat filter on’ and photoshopped them.”

Experts are calling for broad changes, including more access to dietitians, better training for GPs, more education in schools, and meaningful regulation of how weight loss is portrayed online — including government action to hold social media companies to account.

Some people will be on GLP-1s for life. For others, the financial or physical toll will be too great. But for the many Australians like Sarah who sit somewhere in the middle, the future remains uncertain.

“I'd be lying if I said I didn't still tightly moderate what I eat… it's been really hard on the other side of it… not to just go back on it. I would love to have a supply, but I can't afford it. I know how bad it is for my mental health. But it is definitely a battle.”

You can catch up on all three episodes of Investigating Ozempic here:

For 24/7 crisis support please contact Lifeline on 13 11 14. For eating disorder support, help is available through the Butterfly Foundation on 1800 ED HOPE (1800 33 4673).

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