“Have you ever thought about going on ‘the pen’?” My friend texts me.

I’m in bed, doomscrolling and my social media feed is full of hot takes about Ozempic. Insanely beautiful and glossy people are telling me why I should or shouldn’t take weight loss drugs.

Warning: This article contains details of body image and weight loss that some people might find distressing

Normally in January, everyone is talking about who’s going sober or trying (and failing) the latest viral health challenge.

But this year the hot topic is “who’s going on the pen?” – the weekly injection that is now widely used for weight loss.

There’s no denying that 2024 was a breakthrough year for weight loss drugs. Boris Johnson and Elon Musk are just a few of the celebrities who have announced they have taken it.

Robbie Williams even made headlines joking he’d lost his “arse” due to Ozempic. “Now it just looks like the place where you put a credit card,” he quipped.

It’s not just celebrities and TikTok creators jumping on the weight loss drug hype. According to Simple Online Pharmacy, more than 500,000 people in the UK are now taking one of the few weight loss drugs, with experts predicting a nationwide fall in obesity rates as a result.

Even friends who didn’t seem like they would meet the medical criteria for the drugs were tempted. And I can’t lie, so was I. What happened to body positivity, I wondered, as I typed ‘How to buy weight loss drugs’ into my phone.

‘Ozempic changed my life’

Marketed as Ozempic, Wegovy or Saxenda, these drugs are administered via a weekly injection that mimics GLP-1 – a hormone that helps regulate hunger and slow digestion. It is only available with a prescription and online pharmacies have certain checks to ensure you meet the criteria.

Depending on your weight, some weight loss drugs can be approved for use alongside exercise and diet to manage weight loss – if your Body Mass Index is 30, or you have a BMI of 27 and above but have pre-existing medical conditions.

For people who medically qualify for this drug, it can be life-changing. Helping with weight loss and reducing the risk of heart attacks, strokes, and heart failure. The UK government is even proposing to use weight loss drugs to help tackle obesity and get people back to work.

Meranda, a law firm administrator, lives in New York. After seeing celebrities using Ozempic, she went to her doctor and asked for the drug. Now, she has lost over eight stone and counting.

She was always an “active fat person”, she explained, but “never considered weight loss before”. “Ozempic totally changed my life,” she said, her smile radiating through the video chat.

But what happens when a drug that can be transformative for the people who need it, ends up in the hands of someone that doesn’t?

‘I started going in and out of fainting’

A simple internet search revealed a raft of online pharmacies advertising the drugs, including Superdrug and Simple Online Pharmacy.

I filled in some personal details and my health history. Then it asked for some pictures to verify my weight. I didn’t meet the BMI criteria, so I increased my weight on the form. Then I uploaded my pictures and pressed submit.

A couple of days later, I was approved by both online pharmacies.

I was genuinely surprised. It seemed pretty quick, considering I only submitted my application a couple of days ago.

If I could get my hands on it that easily, I wondered how many other people were taking it under the radar without the right supervision.

If you take the drug without being prescribed it, the side effects can be brutal.

Consultant Vicky Price has seen it first-hand.

A consultant in Liverpool A&E, she has dealt with patients who’ve got the drug from online pharmacies after “not being truthful about their weight because they’re so desperate”.

At first, Dr Price said these cases were rare but then as the year progressed, numbers started rising, until it felt like she was seeing someone in that position almost every shift.

The symptoms they exhibited ranged from vomiting and diarrhoea to feeling lethargic and being dehydrated. Some even appear to have gone into a “starvation process”.

Many were put on IV fluids for days.

What did all of them have in common? Dr Price said none of them were obese.

Laura* knows what it’s like to have an adverse reaction to weight loss drugs.

After hearing about celebrities and friends using them with success, she decided to try it. At first, she experienced no side effects but then one night at work on a night shift, she started to feel “dizzy, clammy and shaky”.

After trying to eat something she started “vomiting and going in and out of fainting”. She ended up in A&E, on a drip and felt “terrified”.

Changing the rules

I spoke to Superdrug and Simple Online Pharmacy and asked them why I was able to lie about my weight and be approved for Wegovy.

Superdrug said: “The safety and well-being of patients remain our top priority… all medical consultations between a patient and healthcare professionals relies on the integrity and honesty of patients.”

Prescribing protocols are “regularly reviewed and new measures are implemented where required to continue to strengthen the integrity of these services”, the firm added.

Since my prescription was approved Superdrug has introduced “enhanced assessments” and will require new patients to submit three date-verified photographs.

Simple Online Pharmacy said: “We take clinical care very seriously and have numerous checks and protocols in place for prescribing.”

The pharmacy is carrying out a full review into my case and says it “constantly” seeks to enhance its ability to “identify falsified patient information”.

After taking these findings to the pharmacy regulator, the General Pharmaceutical Council (GPhC), it confirmed it is following up with the pharmacies involved.

The GPhC publishes guidance “specifically for the safe and effective provision of pharmacy services at a distance which we expect online pharmacies to follow”.

“We are issuing an updated version of our guidance shortly, which will set out additional safeguards around medicines used for weight management,” it added.

Novo Nordisk, the company behind Ozempic, Wegovy and Saxenda, made it clear it does not “promote, suggest or encourage the use of any of our medications outside of their approved labels”.

It can be so overwhelming, for anyone, but particularly young women, growing up in the age of Ozempic and TikTok. But there is so much more to life than what you weigh.

“The number on the scale is not going to change how you feel on the inside,” Meranda said as we wrapped up our chat.

Dr Price echoed her view and added that, if abused, weight-loss drugs can create more problems than they solve.

“There is a lot of social pressure to look a certain way but your health is worth so much more,” she said.

If you’re struggling, someone you love is struggling or just needs some support, the NHS recommends Beat, a charity focused on eating disorders. which has many resources that can help.

Women and their partners should be given paid time off work if they experience a miscarriage, MPs have said.

As of April 2020, employees can be eligible for statutory parental bereavement leave, including pay, if they have a stillbirth after 24 weeks of pregnancy, but there is no specific leave for a pre-24 week miscarriage.

The Women and Equalities Committee (WEC) is recommending the two-week leave period should now be made available to women who experience a miscarriage, and their partners who support them.

An estimated one in five pregnancies end before 24 weeks, with as many as 20% ending in the first 12 weeks, known as early miscarriage.

The cross-party group of MPs acknowledged that while a “growing number of employers have specific pregnancy loss leave and pay policies” there remains a “very substantial” gap in support.

And while the introduction of baby loss certificates was welcome it “does not go far enough and it should be backed up by statutory support”.

Many women are forced to take sick leave, which the committee says is an “inappropriate and inadequate” form of employer support as it does not afford women adequate confidentiality or dignity and puts them at high risk of employment discrimination.

Charlotte Butterworth-Pool, 34, has suffered two pregnancy losses before 24 weeks.

She didn’t tell her employer about the first – as she “just so happened to have the week off” – but her devastation after the second meant she spoke to her workplace.

“I took a week off sick and had to spend the full week in bed,” she tells Sky News. “But then I had to go back to work, and everyone knew I was expecting a baby, which was upsetting. That was quite difficult to manage.”

Ms Butterworth-Pool says she “probably would have taken longer [off]” if a statutory policy had been in place.

The committee intends to put forward amendments to the government’s Employment Rights Bill, in the name of WEC’s Chair, Labour MP Sarah Owen.

This recommendations would cover anyone who experiences miscarriages, ectopic pregnancy, molar pregnancy, in vitro fertilisation embryo transfer loss, or who has a termination for medical reasons.

“I was not prepared for the shock of miscarrying at work during my first pregnancy,” Ms Owen said.

“Like many women, I legally had to take sick leave. But I was grief stricken, not sick, harbouring a deep sense of loss.”
She added that the case for a minimum standard in law is “overwhelming”.

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“A period of paid leave should be available to all women and partners who experience a pre-24-week pregnancy loss. It’s time to include bereavement leave for workers who miscarry in new employment rights laws.”

‘We need more compassion for mums and their loss’

A number of women have backed the committee’s proposal, including Leila Green, 41, who says “people just didn’t understand why I couldn’t just get on with it” after she suffered a pregnancy loss.

Ms Green, who went on to have triplets, even found it hard to explain her feelings to her husband.

“He didn’t know that baby, that baby was a stranger to him,” she says. “But the baby shared my blood, I knew that baby. I had all these wonderful ideas of what I would do with this wonderful child that got snatched away so suddenly.”

She now supports women with her organisation F**k Mum Guilt and adds: “We need more compassion for mums and their loss. You cannot expect us to act like robots.

“If we go on like nothing has happened, it’s like a ticking time bomb waiting to go off.”

Tess Woodward, 35, has experienced six pregnancy losses and felt like “the rug had been pulled out from under us” after the first in 2020.

“Physically I had to take some time off work for the surgery, and then to recover from it,” she says. “Emotionally, it was very difficult to deal with.”

Ms Woodward’s employer offered her all the support she needed but prior to this, she admits she had been worried.

The fact she was supported “removed some of the extra worry that could have been there,” she adds.

A spokesperson from the Department for Business and Trade said: “Losing a child at any stage is incredibly difficult and we know many employers will show compassion and understanding in these circumstances.

“Our Employment Rights Bill will establish a new right to bereavement leave, make paternity and parental leave a day one right, and strengthen protections for pregnant women and new mothers returning to work.”

Thousands of children are being failed because of the “inequitable” special educational needs system, MPs have said.

In a damning report the Public Accounts Committee (PAC) says too many families are struggling to access support their children with special educational needs and disabilities (SEND) “desperately need”.

Over the past nine years, the number of young people receiving SEND support in state schools has increased by 140,000 from 1m to 1.14m. Budgets have not kept pace, leading to a “crisis” in the system.

Children with even more complex support needs are legally entitled to education, health and care (EHC) plans, and the number of these obligations has more than doubled, increasing by 140% to 576,000.

Local authority spending on SEND has consistently outstripped government funding, leading to substantial deficits in council budgets.

Representatives of the chief financial officers of 40 councils in England, the SCT, estimate that rising demand and costs have resulted in SEND deficits of £4bn among English councils, projected to grow to £5.9bn this year. 

This increase is not unusual, with similar rises seen in other high-income countries, but the committee notes that the Department for Education could do more to better understand the reasons behind the rise.

In response to today’s report, Cllr Roger Gough, children’s social care spokesperson for the County Councils Network, said: “While government has committed to reform, it is vital that it is done quickly and correctly. Both councils and families can ill-afford to wait.

“We need the government to set out a comprehensive reforms package and begin to implement them within the next 12 months, including immediate clarity on how government intends to address councils’ deficits.”

Eats into wider schools funding

A recent report by the Institute for Fiscal Studies (IFS) on education spending in England found that despite an expected fall in pupil numbers in coming years, forecasted increases in spending on SEND are projected to undo any resulting savings.

The PAC report found that increased spends were already eating into school budgets, with more than half of the increase in school funding between 2019 and 2024 explained by growth in high needs SEND funding.

As a result, an 11% real terms increase in funding over the period only equated to a 5% increase in mainstream school funding per pupil.

Luke Sibieta, research fellow at the Institute for Fiscal Studies, told Sky News: “We’ve seen rapid rise in the number of pupils with the most severe special needs over the last 6-7 years.

“Numbers have gone up by around 70% and funding has gone up by 60%, so it hasn’t met the rapid increase in numbers.

“That puts mainstream school budgets under real pressure. With half the budget going towards educational needs, the amount left over for extra resources elsewhere in the system will be quite small.

“It’s a picture of rapidly rising demand that just soaks up any funding increase really quickly.”

Postcode lottery in services

Beyond the funding crisis, the Public Accounts Committee’s report highlights serious issues with the current standard of SEND services available in different parts of the country.

They describe a postcode lottery of services, with the quality of support varying significantly between council areas.

In 2023, only half of education, health and care plans for high support needs children and young people were issued within the legal 20-week limit.

Families in neighbouring local authorities could experience very different EHC plan waiting times, with 71.5% of EHC plans written on time in Lambeth compared to 19.2% in neighbouring Southwark.

Parents are also increasingly appealing EHC plan decisions, with the number of appeals more than doubling from 6,000 in 2018 to 15,600 in 2023.

Nearly all (98%) of these were found either partially or wholly in favour of the parents, which the Department for Education recognises as poor value for money and contributing to families’ low confidence in the system.

“Lost generation” of children

The inquiry report concludes that a “lost generation” of children could leave school without having received the help they need without urgent reform of the system, and lays out seven key recommendations.

These include working with local authorities as a matter of urgency to develop a fair budget solution to the immediate financial challenges facing many as a result of SEND related overspends.

They also call on the government to set out the provision which children with SEND should expect, and how schools will be held to account, as well as earlier identification of SEND and improved teacher training, within the next six months.

Commenting on the report, Daniel Kebede, general secretary of the National Education Union, said: “Teachers have described navigating the current system as ‘spinning plates on a roller coaster’. Recommending that a plan of action is in place to resolve the lack of provision, support and resources is clearly good to see.

“The High Needs funding system is fundamentally broken. With EHC plan numbers continuing to rise the current shortfall in SEND funding will only continue to grow.”

The Data and Forensics team is a multi-skilled unit dedicated to providing transparent journalism from Sky News. We gather, analyse and visualise data to tell data-driven stories. We combine traditional reporting skills with advanced analysis of satellite images, social media and other open source information. Through multimedia storytelling we aim to better explain the world while also showing how our journalism is done.