Are Weight Loss Injections Safe?

Everything you need to know about the jabs that promise "the weight loss results you want".

It sounds impossibly simple to anyone who’s struggled with weight loss: take an injection and watch as the pounds melt away. Yet the promise of weight loss jabs is everywhere on the internet – and the appeal is understandable.

Often referred to generically as SkinnyJab – which is actually only the most visible of several different weight loss programmes on the market that include injections – these jabs are largely marketed and sold online.

They’re targeted, unsurprisingly, at women via glossy social media feeds full of #BeforeAndAfter shots of weight loss, with a heavy focus on tape measure belts, wholesome white underwear, and newly baggy jeans.

“The Original SkinnyJab”, as it markets itself on Instagram, tells potential customers it offers “the best way to get the weight loss results you want”. Among advocates of the UK-based company is reality star Gemma Collins, who “lost 2.5 stone following The Unique SkinnyJab Programme”, according to the brand’s website.

But Claire Pettitt, a qualified dietitian and spokesperson for the British Dietetics Association, says “celebrity promotion shouldn’t be a reason to buy these products”. So, HuffPost UK asked experts the questions you need answered before you consider using them.

What are weight loss injections?

Weight loss injections contain the injectable drug liraglutide, which can help suppress the appetite and control blood sugar levels and is only available on prescription. The drug is sometimes prescribed to patients by medical professionals including doctors and nurses alongside dietary changes and a regime of increased physical activity.

Two of the most commonly known brand names containing liraglutide that are prescribed are Victoza and Saxenda (liraglutide 3mg), which are both made by the pharmaceutical company Novo Nordisk.

Victoza is only prescribed to adults with type 2 diabetes. Meanwhile the National Institute for Health and Care Excellence (NICE) says UK patients may be prescribed Saxenda if their BMI is classed as obese, or they have a weight-related illness – such as type 2 diabetes or obstructive sleep apnoea.

Saxenda received a European marketing authorisation in March 2015 and was launched in the UK in January 2017. Meanwhile Victoza has been licensed in the UK for the treatment of type 2 diabetes in adults since 2009.

But some commercially driven companies are selling prescribed liraglutide injections to people who do not necessarily fit the BMI and health criteria outlined by NICE, but still wish to lose weight quickly.

SkinnyJab, for example, says its £250 three-to-four week plan (which combines jabs and dietary plans) is “suitable for men and women aged between 18 and 76” – excluding pregnant or breastfeeding women and anyone who has had pancreatitis, thyroid tumours, type 1 diabetics or patients taking insulin medications.

How do weight loss injections work?

Liraglutide is a drug similar to the body’s own GLP-1 hormone, explains Dr Sally Norton, an NHS consultant gastrointestinal surgeon and weight loss expert.

“GLP-1 is produced when we eat and slows down stomach emptying which makes us feel full for longer. It helps control blood sugar levels in other ways too, by stimulating insulin release from the pancreas and reducing appetite,” she tells HuffPost UK.

“Whilst GLP-1 lasts a couple of minutes or so in the blood stream, a few tweaks to the chemical make-up have led to the development of the drug, liraglutide, which lasts for around 13 hours, allowing it to be given in daily injections and still have a prolonged effect.”

The drug can be self-administered via injections into the stomach area, thigh or upper arm, depending on recommendations from a medical professional.

Should we be cautious?

Claire Pettitt warns consumers that ordering weight loss injections online could be dangerous – because it’s not always easy to know what you are ordering. Some online pharmacies selling liraglutide appear to conflate Saxenda with the Skinnyjab programme in the wording of their product descriptions, for example.

In order to fulfil regulations, all prescribers – including in-house doctors and nurses at online pharmacies or commercial companies – must follow remote prescribing protocol, by gaining “adequate knowledge of the patient’s health” before prescribing the drug.

You should be cautious of any sellers who do not appear to do this. “[The injections] need to be used in conjunction with a qualified medical team to monitor progress and side effects,” Pettitt advises, “so buying cheaper versions on the internet is dangerous and in any case, drugs will never be the long term solution to weight-related health concerns.”

While studies do indicate that liraglutide can aid weight loss –with 63.2% of patients prescribed liraglutide in one study losing at least 5% of their body weight – Dr Norton says that the results of previous studies can’t necessarily be applied to the general population.

“Any studies of drugs like liraglutide are performed under carefully controlled
conditions. As a result, patients often end up doing better in these trials than they would in real life,” she says. “And the patients may not be the same in terms of their weight, health conditions or other factors as you or me, meaning we can’t necessarily expect the same results.”

She points out that most studies of liraglutide encouraged participants to do 150 minutes of exercise per week and cut calories by 500kcals a day – as well as taking the drug. “If you don’t follow that study protocol, you may well find you don’t have the same benefit,” she says.

How long will results last?

Unless you keep taking liraglutide, the appetite suppression and other effects will soon wear off, Dr Norton claims, adding that the long-term effects are unclear.

“Few people will be able to afford the cost of long-term injections and around a quarter of people pulled out of the studies anyway, meaning we don’t have the full picture of long-term efficacy,” she says. “And if you haven’t changed your lifestyle during your treatment, your weight will go back on and your money will be wasted.”

Claire Pettitt cautions that in her view: “It is not a sustainable way to improve your health and people should think twice before spending their hard-earned cash on it.”

Are there side effects?

Common side effects of liraglutide, as listed on the NICE website, include diarrhoea, dizziness, headaches, increased risk of infection, insomnia, skin reactions, taste alterations, toothache and vomiting. Other uncommon but potential side effects include dehydration, pancreatitis (inflamed pancreas), renal impairment (problems with kidney function), and an increased heart rate.

“Whilst we doctors are aware that any drug has possible side effects, we are careful at balancing the risks against the potential benefits – something that ideally should be discussed in detail with a doctor that knows you and your medical history well, rather than with a commercial company,” Dr Norton says.

A key function of liraglutide is that it can reduce appetite, but appetite alone doesn’t drive our weight gain, she adds: “Many of us don’t eat because we are hungry – we eat because we are stressed, unhappy, bored or have got into fixed habits that we are reluctant to change. And that won’t be changed by a simple injection.”

It is for this reason that Claire Pettitt says that liraglutide “certainly shouldn’t be an option for those with eating disorders [or other] mental health issues”.

What do the sellers say?

SkinnyJab’s owner Caroline Balazs, told HuffPost UK all the company’s patients are fully supported by a team of qualified clinicians and clinical advisors.

“We give a proper dietary programme, nutritional advice as well as health promotion and education,” she said. “This drug is licensed and available on prescription for weight loss. In the right hands and prescribed appropriately it is safe with minimal risks and optimal benefit.”

Qualified Clinicians are CQC Registered Advanced Nurse Practitioners who specialise in diabetes and obesity management, she said. Meanwhile clinical advisors are people who “have been trained in diabetes, weight management and nutrition”. Balazs added: “We are currently recruiting two doctors, but it’s about finding the right person and we haven’t found such a person yet.”

Novo Nordisk, the pharmaceutical company that manufactures Saxenda, echoed the NICE guidelines, saying the drug should be used only in adults clinically considered to be obese, or clinically overweight with a weight-related illness. “Novo Nordisk does not authorise the use of this, or any other of their products, outside of their licensed indications,” a spokesperson told HuffPost.

“Saxenda is governed by a strict regulatory and professional framework that permits suitably qualified independent healthcare professionals to prescribe it for the treatments and circumstances for which the product is approved and also post approval surveillance and adverse event reporting,” the spokesperson added. This reporting is done via the yellow card scheme, which tracks complications or side effects of medicines and is run by the UK Medicines and Healthcare Products Regulatory Agency (or MHRA).

Saxenda is available at a range of online pharmacies, which ask customers to fill out a medical form. SkinnyJab confirmed to HuffPost UK that “Saxenda is one of the drugs that we use to help obesity,” but the Novo Nordisk spokesperson wanted to highlight that Novo Nordisk is “in no way affiliated” with SkinnyJab.

“At Novo Nordisk our first concern is the welfare of our existing and future patients, and it is important to make a clear distinction between the Saxenda product itself and any individual weight loss programmes,” they said.

What can you do instead to lose weight?

Exercise and a healthy, balanced diet are key, says Dr Norton – so speak to your GP or a registered dietician for support.

Improving your sleep can also help reduce cravings for sugary, fatty foods, she says. “This is partly due to the rise in cortisol levels that are associated with poor sleep. As cortisol interferes with blood sugar control, we can reduce the need for liraglutide jabs simply by sleeping better.”

Stress can also affect our cortisol, blood sugar levels and weight, so Dr Norton advises tackling these root causes “for a cheaper way of losing the pounds”.