At 4.30pm last Tuesday afternoon, a dark grey smoke cloud loomed over North Mount Holyoke Avenue in Pacific Palisades, obscuring the setting sun.

The blazes which would become the most destructive wildfire in California’s history were racing up a nearby canyon.

The streets were almost deserted, the air choking, and most people had already evacuated. My team and I spotted an elderly woman at the end of a driveway.

“I don’t drive, I don’t have any relatives,” she said. “What do I do?”

It was 84-year-old Liz Lerner. She grasped my arm as the wind almost blew her off her feet. A neighbour showed up shortly afterwards, loading his Tesla with bags, and agreed to give Liz a ride to safety.

LA wildfires latest updates

A week on, she’s in hospital in Los Angeles and wants to tell the dramatic story of her escape and what came next.

“I thought I would die right there on the sidewalk,” she says. “I thought that was the end of my little life. I really thought that there’s nobody coming by here and I’ll just be a skeleton they find.”

As Liz was being driven by her neighbour, down the hill from Pacific Palisades to the coast, all around the neighbourhood, trees and buildings were catching fire.

“As we drove through the windy streets to get out, it was greyer and blacker and darker,” she says. “I felt a great heaviness pushing on my chest at that time. I’m gasping and gasping just trying to get some air. I was having a heart attack, I found out at the hospital.”

Liz is also being treated at Kaiser Permanente hospital in LA for smoke inhalation.

On the TV in her hospital ward she has been watching some of the news reports about the fire which has ravaged her community. She knows her home has been destroyed and wants to see pictures of it. “Wow,” she says, open-mouthed as she looks at a photograph. “There’s nothing left, nothing at all.”

It is a house her dad built in 1949, which she inherited and has made her own. Then she notices her wrought iron gate is still partially standing. “My gate,” she exclaims. “I designed that. I would like to get it back.”

Liz’s daughter, Skye, died 10 years ago and precious reminders of her life have also been lost with the fire.

“I saved all the paintings that she did in first grade. I lost all of those, all the stories she wrote, the birthday cards with the scribbles on them. It’s those normal things, that’s the worst of it.”

Because of the wildfire risk in her area, Liz says her home insurance was cancelled several years ago.

“I have no insurance, absolutely none, and no documents and no cheques and no credit cards. I don’t even have a pair of shoes.”

Liz hopes to be discharged from hospital soon, to a retirement home where she will share a room with another elderly woman. Her life is forever altered and she will never return to the place she once called her “forever home”.

The rebuilding of the decimated Pacific Palisades will happen, but for Liz it will take too long.

“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.