Americans Are Turning To DIY Weight Loss Injections to Dodge $1,000+ Monthly Drug Costs

Demand for glucagon-like peptide-1 weight-loss drugs — such as Ozempic, Zepbound and Wegovy — coupled with limited insurance coverage has fueled a risky but growing “gray” market for purchasing active ingredients from China, Reuters reported recently.

Reuters cited a 44% monthly increase in January in shipments of tirzepatide and semaglutide from Chinese suppliers not registered with the U.S. Food and Drug Administration, according to data from the Partnership for Safe Medicines. The gray market — named because the drugs are technically legal to buy for “research purposes” — provides users with GLP-1 compounds, including semaglutide, tirzepatide and even retatrutide, which is still in clinical trials, in powder form for as little as $50 a vial. Buyers then mix the powder with bacteriostatic water at home to create an injectable solution.

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Without insurance, the monthly cost of these drugs starts at around $500 and can exceed $1,000. A survey by the International Foundation of Employee Benefit Plans found that 36% of employer health plans will cover GLP-1 drugs for obesity in 2025. In April, the Trump administration also announced that Medicare and Medicaid would not cover anti-obesity medications, which includes the GLP-1 class.

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Buyer Communities Try to Mitigrate Gray Market Risks

However, the DIY gray market carries significant risks. Some buyers attempt to reduce these risks by sending powders to labs for purity testing before use. Janoshik Analytical CEO Peter Magic told Reuters that the Czech Republic-based lab tested 3,050 samples of obesity drugs in 2024, up from just over 650 the previous year.

Yet the at-home mixing process still introduces human error. Amy Spencer, a Missouri woman interviewed by Reuters, said she reduced her monthly cost from more than $500 for brand-name GLP-1s to $50 on the gray market. But she accidentally overdosed after a reconstitution miscalculation, suffering severe flu-like symptoms for four days.

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FDA Ruling a Driving Factor to Going Gray

If that level of risk sounds overwhelming to navigate, rest assured, passengers navigating the world of gray market peptides are hardly alone. Subreddits like "SemaglutideFreeSpeech" can provide some hand-holding, and also direct users to outside resources on more secretive channels, like Telegram. Many users on the subreddit are being directed to "go gray" after FDA rulings essentially halted the ability of compounding pharmacies to sell cheaper versions of the medicines. The FDA had temporarily allowed compounding of the GLP-1 drugs semaglutide and tirzepatide during shortages because federal law permits copycat versions when FDA-approved drugs are listed as scarce. When the shortages were resolved, however, the exemption ended — as did a cheaper alternative to brand-name GLP-1 drugs. Some compounders are trying to continue business as usual with workarounds like adding vitamin b12, to differentiate the medications from the FDA-approved versions.

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Drug Companies, State Attorneys Respond

The gray market hasn't gone unnoticed by regulators and drug companies alike. Eli Lilly LLY, maker of GLP-1s Monjouro and Zepbound, and Novo Nordisk NVO said they're combating unsafe products through lawsuits and consumer education, Reuters reports. Meanwhile on the customs front, the FDA does intercept some illegal imports, although personal-use buyers are rarely prosecuted.

Attorneys general from 38 U.S. states and territories also warned the FDA in February about illegally sold weight-loss drugs, including unregulated ingredients from China, Reuters reports. “It can be very dangerous. You’re playing the role of your own doctor, pharmacist, and FDA inspector,” Shabbir Safdar, executive director of the Partnership for Safe Medicines, said in a statement to Reuters.

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