More Than 1 Million People were Prescribed GLP-1s Without Medical Need Like Diabetes or Obesity, BMI Normal Range; Study

A study by New York University researchers published on 22 September states that among 92 million people without an FDA approved indication, more than 1.1% of people were prescribed GLP-1 medication. 

The prescription of GLP-1 receptor agonists to people without an FDA-approved indication increased from 0.11% in 2021 to 1.5% in 2025.

Around 35.1% of these people receiving GLP-1 prescriptions without an FDA approved indication had normal BMI.

According to the study, among people who received GLP-1 prescriptions, 85.5% were females and 60% of them were white. 

The US Food and Drug Administration approves the use of GLP-1 drugs for the treatment of obesity and type 2 diabetes.

FDA has also set up certain parameters to qualify a person as obese. A person with a BMI of 30 or higher, or a BMI of 27 to under 30 with a weight-related condition qualifies as obese and is eligible for consuming GLP-1 drugs.

Recipients differed from non-recipients. According to the study, eating disorders were more frequent among patients who were prescribed GLP-1 receptor agonists. 

1.8% of GLP-1 recipients had eating disorders, compared with 0.3% of non-recipients, which highlights a significant sixfold difference.

The overall picture was mixed, while recipients comparatively had a higher rate of high blood pressure and abnormal cholesterol, heart failure was less common in recipients than in non-recipients.

GLP-1 drugs mimic glucagon-like peptide-1, which is a naturally occurring hormone in the body that tells the brain when we have eaten and helps regulate blood sugar and appetite.

The GLP-1 drugs signal to the brain to reduce hunger and make other metabolic changes.

Benefits: GLP-1 drugs reduce the risk of heart and kidney disease, they lower blood pressure, improve fatty liver disease, and improve lipid disorders.

Risk: GLP-1 drugs are reported to have side effects, such as loss of appetite, nausea, vomiting, and diarrhea.

The researchers analyzed data from COSMOS, which is a dataset created in collaboration with health care systems that use software from Epic Systems to maintain their electronic medical records.

Researchers included adults who were prescribed liraglutide, semaglutide, and tirzepatide, without clear indication. Liraglutide, semaglutide, and tirzepatide are three classes of GLP-1 drugs. 

MedBound Times connected with Dr. Harini Jayaraman, MD, Internal Medicine, DM Endocrinology, Senior Resident, Department of Endocrinology at A.J. Institute of Medical Sciences and Research Centre, Mangalore who noted that tirzepatide is approved as an add-on to diet and exercise for people with obesity, or for those who are overweight and have at least one weight-related condition such as diabetes, high blood pressure, abnormal cholesterol levels, heart disease, or sleep apnea.

To reduce misclassification, patients without a recorded weight at least six months before their first prescription were excluded from the analysis.

The US FDA describes GLP-1s as ‘chronic weight management medications’. However, some companies suggest that they can be short-term solutions for people with less weight to lose.

People who are already underweight could experience additional health risks if losing weight on GLP-1s. People with eating disorders may be at risk for physical or mental health consequences. 

According to the new study, eating disorders were more frequent among people taking GLP-1s without an FDA-approved indication.

Earlier this year, in March 2026, the Government of India published a press release advising companies manufacturing GLP-1 drugs to stop misleading advertisements and any promotion that could encourage people to use GLP-1 drugs without a prescription.

The Drug Controller General of India strictly restricted unauthorized sale and promotion of GLP-1 drugs. They also stated that the drug can be prescribed only by endocrinologists, internal medicine specialists and cardiologists.

Reference:

1. Orandi, Babak J., Leila Yan, Macey L. Levan, Holly F. Lofton, Karan R. Chhabra, Christine J. Ren-Fielding, S. Ali Husain, Mara A. McAdams-DeMarco, Dorry L. Segev, Michal A. Mankowski, and Allan B. Massie. “Trends in GLP-1 Receptor Agonist Prescribing Without an Apparent FDA-Approved Indication.” Obesity (2026): 1–5. https://doi.org/10.1002/oby.70301

2. https://www.pib.gov.in/PressReleaseDetail.aspx?PRID=2247459&reg=3&lang=1

(Rh/MF)