The failure of health watchdogs to clamp down on companies selling weight loss injections may have put thousands of unwitting Britons at risk of potentially life-threatening health problems, experts have warned.
The medical jabs have been heavily promoted by reality TV stars, including The Only Way Is Essex’s Gemma Collins, to millions of social media followers – despite it being against UK law to advertise prescription medicines to the public.
But the drug they contain, which ‘tricks’ the brain into thinking the stomach is full, can cause a host of side effects, including vomiting, nausea, severe headaches, damage to the kidneys, thyroid gland and pancreas, and are even linked to the development of cancer.
Intended to treat patients suffering type 2 diabetes, the medicines are being sold online as a ‘quick fix’ diet aid, costing £250 for a one-month supply with the promise that they make shedding weight ‘easy’.
The failure of health watchdogs to clamp down on companies selling weight loss injections may have put thousands of Britons at risk of health problems, experts have warned (file photo)
While medical guidelines advise only those with an overweight or obese body mass index, or BMI, of more than 27 be given the treatment, under supervision of doctors and other healthcare professionals, an investigation by this newspaper found they were being offered to those who were just slightly overweight. Doctors warned if the drug was incorrectly prescribed it could be potentially ‘dangerous’.
The founder of one company selling injections, SkinnyJab, told us the drug helped her lose three stone after she was prescribed it by a doctor in 2017, and that she suffered few, short-lived side effects.
Registered nurse Caroline Balazs said: ‘I wanted to lose weight so badly, when I heard about it, I thought, I don’t care if it’s legal or not, just give it to me.’
Concerns were raised last June after SkinnyJab’s campaign with Collins, in which she claimed to have used the drug and lost three stone.
The Government’s safety watchdog, the Medicines and Healthcare Products Regulatory Agency (MHRA), along with the advertising watchdog, the Advertising Standards Authority, subsequently launched an investigation into the business and other companies offering similar treatments.
But a year after medics voiced concerns, the companies continue to trade – and advertise directly to the public.
SkinnyJab claims to have more than 20,000 customers on its books. Just last week, Collins – who is described on the firm’s website as its ‘ambassador’ – posted pictures on Instagram, where she has 1.8 million followers, alongside the caption: ‘A lot of people have been saying to me, “Gemma, you look amazing, how are you doing it?” SkinnyJab has helped me the whole way through.’
The caption also featured the disclaimer ‘#AD’, which celebrities must use when a post is paid for. Paradoxically, Collins is also paid to advertise takeaway service Deliveroo, and recently posted a video in which she ate KFC chicken.
The Only Way is Essex’s Gemma Collins pictured with SkinnyJab business owner Caroline Balazs. The medical jabs have been heavily promoted by reality TV stars
Promoting prescription medication to the general public is illegal in the UK. Matthew Wilson from the Advertising Standards Authority, says: ‘Advertising prescription medication may encourage consumers to demand unsuitable treatments. It may also encourage the purchase of prescription medication from unregulated sources.’
Doctors have called for immediate action, warning that slimming jab companies are playing ‘Russian roulette’ with people’s health.
‘There’s serious concerns if the drug is not used correctly, under medical supervision,’ says Dr Annice Mukherjee, consultant endocrinologist at Spire Healthcare. ‘Risks include inflammation of the pancreas – pancreatitis – and thyroid cancer. And then there’s the side effects, which can be severe in some people, including vomiting, headaches and terrible nausea.’
Six months ago, an online petition was launched calling for ‘skinny jabs to be removed from the market’. Leeds University student Isabel Stock, who started the petition, wrote: ‘The company “Skinny Jab”, have marketed a fast acting, dangerous weight-loss product which is readily available and potentially life threatening.’
In a post on the change.org petition page, Rachel O’Connor from County Down, Northern Ireland, writes: ‘I don’t know if this caused the sudden death of my best friend and brain haemorrhage.
Ms Balazs, above, says: ‘The health and safety of each patient is at the core of our ethos’
‘She brought this jab cheap on the internet after lying about being obese. She starting taking it two months ago and had vomiting, diarrhoea, headaches, insomnia. But she decided to increase the dosage. She was only 54. This has to be stopped.’
The Mail on Sunday was unable to contact Ms O’Connor, but the post remains on the site.
SkinnyJab isn’t the only slimming injection brand using celebrities to attract customers. The founder and face of another popular jab, Skinny Revolution UK, is Ampika Pickston – star of the ITV reality show, The Real Housewives Of Cheshire. And former pop star Kerry Katona, who has 600,000 Instagram followers, has promoted both brands. When approached, Collins, Pickston and Katona declined to comment.
All the companies offer the same medication – a drug called liraglutide. It works by releasing a naturally occurring hormone called glucagon-like peptide-1, which acts as an appetite suppressant.
‘The hormone sends a signal to the brain telling us that we’re no longer hungry,’ says Dr Abd Tahrani, consultant endocrinologist at University Hospitals Birmingham NHS Foundation Trust and a senior lecturer in obesity medicine.
‘It also increases insulin production, which helps to control blood sugar, reducing the risk of complications in people with type 2 diabetes. Weight loss is a side effect.’
Liraglutide is self-administered by patients via a pre-loaded ‘pen’ – similar to those used by diabetics to deliver insulin medication. It is approved for use under the brand name Saxenda for two types of patients: people with a BMI above 27 and a weight-related health issue such as type 2 diabetes or high blood pressure, and obese patients with a BMI above 30 and no underlying conditions.
But both SkinnyJab and Skinny Revolution prescribe the drug to those with a BMI above 25 – on the edge of the overweight category. SkinnyJab founder Ms Balazs admitted doing so occasionally ‘under certain circumstances, for instance, if we had a new mum who really wanted to lose weight’.
But neither company require that customers have a secondary, weight-related health complaint to qualify for treatment, as set out in the NHS guidelines.
High-profile: Reality TV star Ampika Pickston, who is founder and face of Skinny Revolution UK, with ex-pop star Kerry Katona at a Skinny Revolution publicity event
Another company, Cheshire-based Slim Jab, which promotes its product on YouTube and Facebook, claims to be ‘doctor supervised’. Its GP, Dr Anthony Kaufman, was temporarily suspended in 2014 for writing a fake whiplash report for a family member.
Professor John New, consultant diabetologist at Salford Royal NHS Foundation Trust, expressed ‘deep concern’ at liraglutide being prescribed ‘for aesthetic reasons’, and that doing so would be ‘unethical’. He adds: ‘The drug can be safe and effective, but only if it’s used for improving health and under the supervision of a medical team.’
Liraglutide is not routinely prescribed on the NHS for weight loss. According to trials, users lose roughly eight per cent of their body weight after a year of treatment. But beyond two years, there is a lack of evidence showing patients keep the weight off.
Prof New adds: ‘It isn’t deemed cost effective, because studies show just a modest reduction in weight, which is often regained as soon as you come off it without psychological and dietetic support.’
One study found roughly 40 percent of patients taking liraglutide suffered vomiting and nausea.
The Mail on Sunday has also learnt of users suffering ‘horrendous’ side effects.
Porsche Jay, a 36-year-old marketing manager based in the US, took a lower dose of liraglutide for two months to treat insulin resistance. She says: ‘I had continued nausea, stomach aches… and depression. By week four I just had no interest in food, because I felt sick all the time.
SkinnyJab’s Ms Balazs, next to the message ‘the easy way to a slimmer, happier you’, which she uses to sell her injections. The firm claims to have more than 20,000 customers on its books
‘I had to eat on a schedule or I’d miss too many meals. I got to 8pm one day and realised I hadn’t eaten all day.’
Other patients injecting Saxenda – the same drug prescribed by SkinnyJab – similarly report ‘bad fevers’, ‘dizziness’ and ‘feeling like you’re going to vomit all day’. According to Skinny Jab, the side effects ‘settle’ eventually. But doctors have also raised concerns about far more serious risks when taking the drug without supervision from a healthcare professional.
Taking the highest dose of the drug doubled the risk of acute pancreatitis resulting in hospitalisation, a study published in the journal Diabetes Care found.
‘Early animal studies also suggest increased risks of thyroid cancer when giving this type of drug,’ says Dr Tahrani. ‘There’s also a risk of damage to the kidneys in people whose kidneys aren’t functioning well.’
So far, few cases of thyroid cancer have occurred in patients, but those with thyroid disease and a family history of thyroid cancer are excluded from taking liraglutide, due to the risk. Skinny Jab’s Caroline Balazs says: ‘The health and safety of each patient is at the core of our ethos.’
But there are concerns that giving the drug to people with a BMI below 27 could be unsafe. ‘There’s a higher risk of side effects because there is limited safety data for healthy patients of a lower BMI,’ adds Dr Tahrani.
Before being prescribed medication, SkinnyJab customers speak to a ‘non-nurse clinical advisor’ over the phone. Next, they fill out a health form – including any history of thyroid cancer or eating disorders – and must provide a picture of their current weight as it appears on bathroom scales as well as photo ID.
Then there’s a call with a senior nurse who has a licence to prescribe medicine, who ‘checks you’re fine with everything’. At the end of the consultation, if they decide to go ahead, a £249 payment for a four-week course is taken.
The pen, which is loaded with the starting dose of 0.6mg, arrives in the post in the following days.
‘You have breakfast and lunch, then at 1pm every day, you inject the drug,’ explains Ms Balazs.
She claims that her senior nurses ‘check in’ with customers each week to ensure they are injecting correctly, monitor side effects and assess their need for a higher dose.
‘We invest thousands in a comprehensive aftercare and support service – and provide nutritional and dietary advice every step of the way,’ says Ms Balazs.
Yet several customer accounts, posted online, detail little to no aftercare. ‘I got a text once and that was it,’ wrote a young woman named Heidi. Others claim the firm failed to respond to queries sent via email and social media.
Customers of rival company Skinny Revolution are similarly aggrieved. One patient suffering ‘terrible headaches’ claimed that she had ‘no follow-ups’. Dr Tahrani says: ‘Regular blood tests are often needed when patients are on this drug to monitor complications – especially if patients have cardiovascular disease or diabetes.’
Ms Pickston, the founder of Skinny Revolution, claims to be ‘living proof’ the weight-loss jabs work. The 38-year-old reality TV star credits them with helping her drop from a size 20 to a ten.
But in July 2018, a routine inspection of the Skinny Revolution’s Cheshire headquarters by the clinical regulator, the Care Quality Commission, found ‘unsafe practices’ which were ‘a risk to patients’.
Inspectors found medicines which were stored at incorrect temperatures, a lack of patient records and no proof of staff members’ medical qualifications.
The inspectors returned in September to find their demands had been met – and staff prescribing the jab to patients against the drug manufacturers’ guidance. They were also ignoring guidance relating to patients with high blood pressure and blood sugar. The care watchdog issued Skinny Revolution with a legal warning. But the latest report, published last autumn, notes that it has now made improvements and is ‘meeting the legal requirements’.
The majority of slimming jab companies also offer a diet plan alongside the medication.
A document, issued to all SkinnyJab customers, advises they stick to between 800 and 1,000 calories a day (‘preferably 800’) and stop eating after lunch. It also suggests avoiding sugar, carbohydrates, fruits and sweeteners after injecting, and exercising for at least 30 minutes daily.
Professor Partha Karr, a diabetes consultant in Hampshire, says: ‘These rules are completely made up and based on no evidence. When we prescribe these drugs to patients, we’d never say “don’t eat”. Extreme diets combined with these drugs could risk blood sugars dropping too low in some patients.’
But Ms Balazs says using the drug to suppress her hunger ‘improved’ her relationship with food. ‘I had a war with food for 30 years,’ she says. ‘It was a noose around my neck – a constant battle. I drove myself mad.’
Now she says she ‘loves food’ but is no longer ‘hungry all day’.
When presented with findings of our investigation, an MHRA spokesman said that SkinnyJab is currently being investigated by the Advertising Standards Authority. They added: ‘It is untrue to suggest the MHRA has not taken appropriate action. We take very seriously, the advertising of prescription only medicines to members of the public, which is prohibited by law..’
In a statement, SkinnyJab said: ‘SkinnyJab is regulated by the MHRA, all clinical practitioners are fully qualified and registered with the corresponding medical or nursing authority while our lead clinician is registered and approved by the CQC for weight-loss treatments.’