"I couldn't stop being sick. My side and my back were hurting and I just felt like my body was totally shutting down." That's how one woman described the side effects of weight loss injections she'd bought off-label in a BBC investigation. Her experience is far from uncommon. Medics in the UK are even reporting that young girls are ending up in A&E as a result of taking these products illicitly.
Author
Charlotte Boyce
Associate Professor in Victorian Literature and Culture, University of Portsmouth
Concerns about the off-label misuse of drugs containing semaglutide (such as Ozempic and Wegovy) recently prompted NHS England's medical director to warn that they shouldn't be seen as a "quick fix" to get beach body ready. Speaking to the NHS Confederation, an organisation whose members provide services to the NHS, Stephen Powis (national medical director of NHS England) cautioned that these "powerful medications" can be dangerous, and are unsuitable for people "who are otherwise healthy who just want to lose a few pounds".
Originally developed as a treatment for type 2 diabetes, so-called "skinny jabs" containing the appetite-suppressant semaglutide are a relatively recent innovation. But online speculation about celebrity usage and social media stories of dramatic weight loss have fuelled their surge in popularity - and led people to seek these products out, even if they have no medical need for them.
While drugs containing semaglutide may be new, the feelings of body dissatisfaction that drive people to seek out such products is not. If we look back at magazines for young women and girls from the last 150 years, it's clear that while fashions and norms may have changed, the pressure to achieve an idealised body type has remained constant. The willingness to try potentially harmful prescription drugs to attain this ideal has remained a constant, too.
As far back as the 19th century, the editors of a magazine called Girl's Own Paper were regularly warning their teenage readers off "obesity pills and powders". They characterised these products as "quack medicines", and recommended that any form of dieting should "only be attempted under the direction of a doctor".
Still, readers of the magazine continued to seek advice about potentially dangerous slimming treatments. One correspondent was strongly discouraged from taking "bromide of ammonium" - described by the editors as "an exceedingly powerful drug" that "will only do you harm". A popular sedative in the 19th century, bromide can have toxic effects if taken over an extended period.
Another reader was told to be wary of the "latest thing" in weight-loss medication - a hormone treatment called thyroglandin.
"Like all animal extracts, thyroid is a very powerful drug, and sometimes gives rise to very alarming symptoms," the Girl's Own Paper warned, adding that it should "only be used for very marked cases of obesity". Writing for Cosmopolitan in 1910, Woods Hutchinson, a medical doctor, agreed, suggesting that prolonged use of the drug was "liable to set up a serious and obstinate disturbance of the nervous system."
Despite this, adverts for diet pills containing dried thyroid gland were a regular feature of young women's magazines by the 1930s - though they weren't always transparent about their ingredients. Ads for Marmola anti-fat tablets in Miss Modern, for example, claimed to contain "exactly the right quantity" of "a world-famous corrective" that would help users to "slim without starving". But the ads never specified what this miracle substance was.
Marmola advertised its product as safe and effective, with medically proven benefits. It claimed to be "prescribed by physicians everywhere" and assured women "it is a folly to stay fat in these scientific days". References to science were designed to reassure consumers but, in fact, slimming drugs in the late-19th and early-20th centuries were largely unregulated.
When the British Medical Association undertook a chemical analysis of various easily obtained "obesity cures" in 1909, it found that alongside largely harmless substances such as powdered seaweed, pills like Marmola contained ingredients unsuitable for self-medication. These included dried thyroid gland and phenolphthalein (a potent laxative that was later banned by the US Food and Drug Administration because of its cancer risk).
Alongside scientific language, 20th century weight loss adverts often used endorsements to convince consumers of their effectiveness.
In the 1940s and 50s, the slimming brand Ayds used Hollywood stars Hedy Lamarr and Zsa Zsa Gabor to promote its "reducing" products to women who aspired to a film star physique.
But perhaps these glamorous celebrities' body shapes felt unobtainable to ordinary women, as by the 1970s Ayds changed tack. They began using endorsements from "real-life" users instead - complete with dramatic "before and after" pictures.
Ayds contained benzocaine, a local anaesthetic usually used to relieve pain and itching. The product supposedly reduced appetite by numbing tastebuds.
But other 20th-century weight loss products contained far more dangerous ingredients - including amphetamines. A 1971 article in She magazine sang the praises of "fenny" (fenfluramine), an amphetamine-based appetite suppressant that helped the author lose a stone in less than a month. The drug was later withdrawn from use as an obesity treatment due to cardiovascular risk.
Today, UK advertising codes lay down strict rules for promoting and selling slimming products. The Medicines and Healthcare products Regulatory Agency further ensures that adverts for drugs comply with UK legal requirements. But with recent reports of social media ads promoting weight-loss drugs in ways that breach regulations and "skinny jabs" being sold online without proper checks, we might wonder whether today's young women are any safe than their 19th- and 20th-century counterparts.
Charlotte Boyce receives funding from the British Academy.
