Is the skinny jab too good to be true?

‘I was crying when it arrived. I’m scared of needles and didn’t know how to use it’
‘I was crying when it arrived. I’m scared of needles and didn’t know how to use it’
Controversial, costly and worryingly easy to get hold of, weight-loss injections are the latest fat-shedding trend to hit the headlines. But do they work – and are they worth the risk? Libby Galvin investigates
 There’s little 40-year-old Ciara Lawless hasn’t tried in her quest to lose weight. ‘I’ve joined gyms, done Slimming World and Weight Watchers. I had fat-removal surgery, which left me hypersensitive afterwards,’ says the call centre agent from Dublin. ‘I’ve tried treatments where they freeze away your fat, which doesn’t work.’ And despite all the time, money and effort she’s put in, at 5ft 2in and formerly weighing more than 12½ stone, Ciara is convinced that the only thing that’s helped her shed more than two stone is a weight-loss injection. But the process hasn’t been without its pitfalls.
To get to this point, Ciara has injected herself in the stomach without any guidance. She’s bought the drug from someone she doesn’t know on Facebook. She’s cried with worry that she’s spent hundreds of pounds on something she doesn’t know how to use. She’s asked for support and received nothing. And she’s starved herself by eating just 800 calories a day, as recommended by a company selling these injections.
As weight-loss injections, commonly known as ‘skinny jabs’, increase in popularity, how people access the drug – and whether they should be able to – is increasingly being questioned.
‘Skinny jabs’ take the form of a series of daily or weekly injections containing a drug called liraglutide, which is injected into the stomach with a pen-like device. The drug – which has only been available in the UK for weight loss in private clinics since 2017 – works by mimicking a hormone which suppresses your appetite, meaning you’re likely to consume fewer calories and therefore lose weight.
Like all prescription drugs, there are potential side effects: most commonly nausea, vomiting, constipation or diarrhoea. But there are concerns liraglutide could be associated with thyroid cancer and inflammation of the pancreas, as seen in animal studies and some clinical trials.
‘Under correct medical guidance, it can be an effective drug for people who are clinically obese,’ says Professor John Wass, a consultant physician and professor of endocrinology at the University of Oxford. Currently, liraglutide is available under the names Saxenda, which is licensed to treat obesity in patients with a body mass index of over 30 (or over 27 with a weight-related condition), and Victoza, used as a treatment for type 2 diabetes. ‘There can be a genetic component to obesity; it is not just “greed”,’ explains Professor Wass. ‘Your appetite is controlled by genes and so is your satiety, your feeling of fullness. This is where liraglutide can help.’
And it’s the feeling of fullness that private companies are seeking to capitalise on. While the drug isn’t widely available on the NHS, partly because of its cost, that hasn’t stopped an increasing number of retailers offering it to customers.
High street brand LloydsPharmacy recently announced that it would begin selling a £260-a-month programme, including consultations and access to weight-loss support as well as the jabs, which customers are taught to administer themselves. In keeping with NICE (National Institute for Health and Care Excellence) guidance, the jabs are only offered to those with a BMI over 30, or over 27 with a weight-related condition.
But elsewhere, people who aren’t obese and don’t have health problems related to being overweight are also able to access the drug. Crucially, some of these people are just a few pounds into the overweight category (a BMI of 25-29), even though ‘the guidelines are that it should only be given to people in the obese category’, says Professor Wass. ‘Obesity is classified as a disease – and we should not be giving treatment to people who do not have that disease in the first place.’
It’s all too easy to purchase weight-loss injections, as Ciara found. Her first experience of buying liraglutide – from a company that charged between £249 and £350 for a month’s supply – did not go well.
Her goal was to get back to her wedding weight from eight years earlier
‘I lost 18lb but put about half of it back on after I stopped,’ says Ciara lawless
Left: Her goal was to get back to her wedding weight from eight years earlier. Right: ‘I lost 18lb but put about half of it back on after I stopped,’ says Ciara lawless
‘They’re all about selling,’ she says. ‘They’re not interested in trying to help you. You get your jab in the post, and they tell you that there’s a call centre if you want advice, but I wasn’t shown how to use the jab. I didn’t understand it. I was crying when I got it, thinking I’ve wasted so much money because I don’t know how to use it. And it didn’t help that I was nervous anyway as I’m scared of needles and hadn’t done anything like this before. Trying to get through to them on the phone was very frustrating.
‘They told me to eat only before 1pm each day, to have 800 to 1,000 calories and then nothing else. I would get to the evening and be starving watching my other half eat.
‘I lost 18lb but put about half of it back on after I stopped. It wasn’t manageable or sustainable. I was expecting to get a bit more help, but when I rang and I didn’t want to buy something they weren’t interested in talking to me.’
One company selling weight-loss injections, SkinnyJab, has recently come under fire for using reality stars in its advertising who have claimed that the drug has helped them to lose weight. In the UK, you’re simply not meant to promote prescription medication to the public at all – least of all attribute a result to a drug. ‘The promotion of prescription-only medicines to the public is prohibited by law,’ says a spokesperson for the Medicines and Healthcare Products Regulatory Agency (MHRA). Of the SkinnyJab claims, they state, ‘the Advertising Standards Authority is investigating this issue’.
SkinnyJab also touched a particularly raw nerve by targeting NHS nurses in its advertising during lockdown. ‘100 free jabs to the first 100 nurses to apply’, offered one post, since deleted.
Olivia Tompkins, an intensive care nurse whose Instagram page is dedicated to health and fitness, was incensed when she saw the ad. ‘I was horrified. It said, “We need our nurses to be strong and healthy, many of you are not.” It’s unacceptable that they would try to use us to promote themselves – taking advantage of us being in the spotlight because of Covid-19. What’s more, I would hate to see a colleague in the break room stabbing themselves in the stomach with a jab instead of eating a nutritious meal.
‘The celebrities who advertise it have vulnerable followers who will believe them when they say whatever they are being paid to say. But how much credibility do they actually have? How long until another weight-loss product comes out and one of them becomes the face of it just to make more money?’ When Olivia raised her concerns with SkinnyJab directly, it blocked her from its Instagram page.
SkinnyJab founder Caroline Balazs said, ‘Liraglutide is a very useful tool to help people struggling with weight loss. The drug is usually very safe for adults with no major health problems.’
It’s not just private companies that can be problematic when it comes to weight-loss injections. Before Ciara eventually bought liraglutide from a company that she says has helped her shed more than two stone by providing sustainable diet advice alongside the pens, she went to someone she’d heard was selling the jab on Facebook – who appeared to be a beautician rather than a nurse. Unlike the first company she approached, where she did at least have a detailed health consultation over the phone, this Facebook beautician – who is currently selling the drug for just £85 – didn’t undertake any checks. ‘I have another friend who had bought it from her,’ says Ciara. ‘She was fine with me because I said I’d had it before – maybe she asks for more information from other people. I think she just trusted me.’
The possibility of people getting black market pens through unregulated sources is frightening – and yet it is clearly happening. ‘I have clients who tell me that their friends and family are buying this stuff from their nail technicians,’ says personal trainer Hannah Lewin.
In many cases these beauticians claim to have done some sort of weight-loss injection certification – but this is not possible. ‘Injectable medicines must be supplied in accordance with a valid prescription and can only be administered by or in accordance with the directions of an independent prescriber for a named patient,’ confirms the MHRA.
While Ciara was lucky to experience no ill effects from the jab she bought through Facebook, she didn’t lose any more weight, either.
There are also concerns that the long-term effects of the drug are still not yet fully understood, given how little time has passed since the medication has been made available.
‘I understand that for some people, if these drugs are prescribed by a GP who has the best interests of your health at heart, it makes sense,’ says Olivia. ‘But it shouldn’t be a short-term fix for what is a long-term health issue.
‘If you are overweight, you need to be taught about nutrition – you need to understand your diet and how to maintain it because you can’t rely on jabs for the rest of your life. Otherwise all they’re offering is just a very expensive, potentially dangerous, yo-yo diet,’ she says.
Weighing up the facts from the fads   
Drinking diet teas
Before the jab, ‘skinny’ teas and coffees were at the centre of a controversy over Instagram influencers pushing them to followers. These drinks are really just laxatives, which have no genuine weight-loss properties but can be misused by those with eating disorders.
Slimming with speed
Since the 1930s a host of amphetamine-based pills have been touted as the answer to losing weight – but many have side effects including heart palpitations, damage to heart valves, anxiety attacks and addiction, which has led to most being removed from the market or their use severely restricted.
Fat-blocking pills
Orlistat is the only other prescription medication currently available in the UK for obesity. It works by blocking the enzyme that breaks down fats in your diet. This undigested fat passes out of the body in your bowel movement. Side effects include unpleasant gas and diarrhoea. An over-the-counter pill called XLS Medical has a similar effect using a different process – rather than blocking enzymes it uses a fat-binding fibre which is passed out of the body.
Apple cider vinegar
While it has been used medicinally for centuries, drinking apple cider vinegar – either diluted with water or as a shot – for weight loss has become increasingly popular over the past couple of years. With no definitive evidence to back up diet claims, experts do agree on the fact that it can damage tooth enamel.
Appetite- suppressing lollipops
Another controversial product that has been heavily advertised on social media by influencers including Kim Kardashian are these lollipops. Promising to keep ‘your hunger under control and cravings in check’, they often have cane sugar and brown rice syrup listed as their first ingredients. The appetite-suppressing effect is said to come from saffron extract, but is more likely to do with the fact you’ve filled your mouth with a sugary lolly.

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