Association of Endocrinologists

Anti-obesity drugs: surge in private purchases – up 85.7 per cent in a year. Concerns over the risks

Ame endocrinologists are sounding the alarm over self-medication: from the illegal market on social media to treatments ‘shared’ amongst family members, including minors. With tablets on the way, the risk could increase

by Francesca Cerati

13 November 2026

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Translated by AI

Versione italiana

Key points

Medicines ‘passed on’ amongst family members
Who can employ them
Effective, but with side effects
The mystery of the tablets
Training and checks

3' min read

Translated by AI

Versione italiana

The use of anti-obesity drugs is on the rise in Italia, and with it, their misuse. According to AIFA’s OsMed 2025 Report, private purchases of GLP-1 receptor agonists and GIP/GLP-1 dual agonists have risen by 85.7 per cent in terms of consumption and by 75.8 per cent in terms of expenditure compared with 2024. Of particular concern are off-label prescriptions and the illegal market on websites and social media, which AIFA has already highlighted in relation to the presence of counterfeit medicines in Europe.

The warning comes from the Association of Endocrinologists (AME), which is meeting in Rome until 15 November for its 25th National Congress. The risk is very real: in November 2025, a 31-year-old woman from Padua fell into a hypoglycaemic coma after buying a counterfeit incretin drug online that contained insulin. She was saved by medical staff.

Medicines ‘passed on’ amongst family members

Experts also point to a less obvious practice: medicines prescribed to one patient and passed on to others – often family members, including minors – without any medical assessment. “I frequently come across patients who are taking medicines prescribed to relatives,” says Silvia Irina Briganti, of the San Raffaele Online University in Rome. “ “This behaviour goes far beyond common sense: a medicine that may have significant side effects is being administered to someone who has not been assessed by a doctor.”

The issue also concerns prescriptions issued simply to satisfy those who want to lose a few kilos. “These are not medicines to be used simply to satisfy a desire for a better appearance,” explains Briganti.

Who can hire them

Marco Chianelli, coordinator of the AME Obesity Commission, highlights the criteria proposed by the European Association for the Study of Obesity (EASO) in 2024, which shift the focus from weight to health risk. In adults, obesity is diagnosed when the BMI is 30 kg/m² or higher, but also when the BMI is 25 or higher if the waist-to-height ratio exceeds 0.5 and there are medical, functional or psychological complications.

“It is important to distinguish between those with a health condition who can benefit from these medicines and those who simply want to lose a few kilos,” emphasises Chianelli. Obesity, he points out, is a chronic condition: those who stop taking the medication after two or three months, once they have reached their target weight, in most cases regain the weight and also lose the benefits the treatment had brought in terms of reducing obesity-related complications. For those for whom the medication is not indicated, lifestyle changes remain the best option.

Effective, but with side effects

Incretin mimetics represent a significant innovation, with benefits which, depending on the specific molecule, also extend to metabolic control and certain cardiovascular and renal complications. “The problem is not the treatment itself, but its use without proper assessment and clinical monitoring,” the experts emphasise.

The risk of self-medication is not knowing the correct way to take the medication. “Some people, in order to lose weight more quickly, start straight away with high doses, rather than increasing them gradually,” warns Chianelli. “This can cause significant gastrointestinal side effects, including vomiting, diarrhoea and severe dehydration.” More rarely, complications affecting the gallbladder or pancreas may occur, adds Briganti, which is why patients need to be monitored over time.

The mystery of the tablets

Oral semaglutide, authorised in Europe in July 2026, is expected to be available in pharmacies in 2027. Orforglipron received a positive opinion from the EMA in October and is awaiting final authorisation. According to Chianelli, the oral route could make treatment more accessible to those who currently opt out due to the difficulty of administering injections, in a context where these therapies are still underused, partly for financial reasons: for 80 per cent of endocrinologists surveyed by AME, cost is one of the main barriers to prescribing them.

However, the convenience of tablets could also make it easier for medicines to be passed between private individuals. ‘With the oral formulation, I fear this phenomenon may increase,’ warns Briganti. ‘A pack will be easier to carry and to pass on to someone else. There is already a black market for these medicines, and we must ensure that this increased convenience does not encourage further misuse.”

Training and checks

For the AME, which has almost 3,000 members, the solution lies in training endocrinologists and GPs – who act as the ‘first line of defence’ in the treatment of obesity – as well as ensuring correct dispensing in pharmacies, checking prescriptions and raising public awareness of the risks associated with unauthorised purchases.

“These medicines are not a quick fix for weight loss, and a prescription must be clinically justified,” concludes Briganti. “When a doctor says no, it doesn’t mean they don’t want to help the patient: it means they are looking after the patient’s health.”