In order to get the coveted weight loss injections, some people forge prescriptions.

Weight-loss injections have become veritable lifestyle products. Celebrities are also driving demand. SpaceX and Tesla CEO Elon Musk, for example, has publicly admitted to using them. There have been supply shortages at times. The hype is attracting criminals. This starts with fake prescriptions. An overview:

The Federal Criminal Police Office (BKA) has observed an increase in cases of prescription forgery over the past two years, allowing people to obtain weight-loss medications. However, according to a spokesperson, there are no precise statistics on this.

The 2024 Security Report of the Baden-Württemberg Ministry of the Interior also describes the phenomenon without providing concrete figures. "The identified suspects are often traveling and supra-regional criminal groups of Eastern European origin," it states.

The GKV-Spitzenverband der Gesetzliche Krankenversicherungen (GKV-Spitzenverband of statutory health insurance funds) also reported that the number of professionally forged paper prescriptions in particular has increased dramatically in the past two years.

According to Thomas Preis, President of the Federal Association of German Pharmacists (ABDA), the fake prescriptions are paper-based. These are now so easy to forge that pharmacists have little chance of detecting them. "Sometimes they involve doctor's addresses or information from insured persons that doesn't even exist," Preis told the German Press Agency.

"We haven't seen any counterfeit e-prescriptions so far," says the pharmacist. The statutory health insurance system, at least, says that consistent use of e-prescriptions should make counterfeiting significantly more difficult in the future.

Preis explains the increase in counterfeit products like "Ozempic" and "Wegovy" by saying that "reports in the lay press or advertising by influencers" are driving demand for these drugs. "This then makes them tempting for criminals."

From the BKA’s point of view, it can be assumed that “the increased demand, the limited patient group and the higher price of these medicines also play a significant role.”

While the drugs "Ozempic" and "Mounjaro" are primarily intended for the treatment of diabetes, "Wegovy" is a prescription drug intended to help with weight loss and weight maintenance. The other two drugs also have this effect.

The key active ingredients are semaglutide and tirzepatide. Among other things, they mimic the effects of the gut hormone GLP-1 (glucagon-like peptide-1): The brain is informed that food has been eaten and that it can develop a feeling of satiety. Thus, appetite is curbed.

In Germany, diabetes medications are prescription-only and therefore only available in pharmacies, explains the Stuttgart Ministry of the Interior in its safety report. "Statutory health insurance companies cover the costs." Therefore, if a prescription is issued for the treatment of obesity, users must pay for the medication themselves.

Often, the counterfeit is only discovered during an inspection by health insurance companies, says Preis. These companies frequently refuse to cover the costs, leaving the pharmacies to foot the bill. "This represents a significant financial loss," the ABDA president emphasizes.

The GKV-Spitzenverband also explains that even a relatively small number of cases ultimately resulted in high amounts of damage. This is due to the particularly high price of these drugs.

Pharmacies are in a tense situation: "You have to have serious reasons to refuse to supply medication," says Preis. "With hundreds of prescriptions filled every day, the employees here have to weigh things up and make decisions very quickly."

Preis warns against taking prescription weight-loss medications without the supervision of a doctor or pharmacist—which is usually the case with forged prescriptions. "Self-medication is dangerous," he warns.

The same applies to drugs on the black market, whose dosages are often incorrect. Sometimes they contain no active ingredient at all, harmful dosages, or other questionable substances.

Yes, that happens too. The Baden-Württemberg safety report describes the purchase of 199 packs of "Ozempic" by a Freiburg wholesaler. "What's striking is that the delivered Ozempic pens all have the same serial number." The Federal Institute for Drugs and Medical Devices (BfArM) has informed the supervisory authority in Karlsruhe.

The company confirmed that these were relabeled insulin pens. It also found that the drug semaglutide was not present in these samples. The insulin, in turn, could lead to life-threatening hypoglycemia in users.

According to the report, the counterfeit products also appeared in Great Britain and Austria. Investigations revealed links to North Rhine-Westphalia and Bavaria, as well as to other European and non-European countries.