Migraine and epilepsy drugs promoted to under-18s as weight-loss aids on TikTok

Exclusive: Social media platform removes posts after investigation by The Pharmaceutical Journal reveals that prescription-only drugs are being recommended to teenagers wanting to lose weight.
Young girl looking at TikTok on her mobile phone

An investigation into one of the UK’s fastest growing social media platforms has found that several prescription drugs are being promoted to teenagers searching for diet pills.

The analysis of the top 100 most popular user posts under the #dietpills hashtag — carried out in August 2022 registered as a female aged 16 years — found that commonly prescribed drugs for epilepsy, alcohol addiction and migraine were being openly promoted.

The Pharmaceutical Journal found that nearly a third (31%) of the 100 most popular posts — viewed during a single 90-minute sitting — were actively promoting the use of diet pills for weight loss and, of those, more than a quarter (26%) were promoting a specific named prescription-only medication.

Healthcare experts shown the information said this was “completely inappropriate” for users of any age and that it could cause real harm, with the drugs promoted by users linked with birth defects and some serious side effects.

In response to the findings, a spokesperson from TikTok said that the platform cared “deeply about the health and wellbeing of our community” and it has since removed a number of posts that The Pharmaceutical Journal had highlighted to them and reviewed the hashtag ‘diet pills’.

Multiple accounts that were selling prescription weight-loss medication were also removed.

At the time of the investigation, the #dietpills hashtag had 10 million views, and the most popular post had over 20,000 ‘likes’ with more than 1,000 shares.

The most commonly mentioned prescription drug mentioned in the posts was phentermine, or phentermine-based products, which is an appetite suppressant not licensed in the UK, but available on some online sites without a prescription.

Other prescription drugs mentioned as possible weight-loss aids included naltrexone (indicated for treating alcohol and opioid addiction), topiramate (an antiepileptic and migraine treatment), metformin (for diabetes) and the obesity drug orlistat, sold over the counter in the UK under the brand name Alli.

In the posts, users claimed that the pills helped to “curb” their appetite, increase their body temperature and lose substantial amounts of weight. One said they had heard the drugs were dangerous for their health, adding “but I already bought them”.

The Online Safety Bill currently going through parliament is expected to extend UK regulation of “online harms” on social media platforms to Ofcom​, although this bill was reportedly paused while the new UK prime minister was chosen.

Responding to the investigation, a spokesperson for the British Dietetic Association said: “Diet claims that are unrealistic and not supported by evidence-based science on social media can be dangerous no matter what your age. But, for under 16s, they can have very real consequences.”

John Wilding, professor of medicine and honorary consultant physician in the Department of Cardiovascular and Metabolic Medicine at Aintree University Hospital in Liverpool, described the promotion of medication for the treatment of obesity via social media platforms as “completely inappropriate”.

He added: “Those containing phentermine can be legally prescribed for short-term use but only under very specific conditions. It remains a controlled drug. Topiramate has never been approved for weight loss in the EU or the UK as it has some significant potential adverse events and may be teratogenic.”

The spokesperson for TikTok said: “Our community guidelines make clear that we do not allow the promotion or trade of controlled substances, including prescription weight-loss medication, and we will remove content that violates these policies.”

The investigation coincides with a survey by The Pharmaceutical Journal, which has found that nearly 60% of pharmacists have been asked about medicines patients have seen on social media. The survey carried out in July 2022 of more than 1,500 UK pharmacists found the most commonly asked about medicines were those related to weight loss and COVID-19 as well as cannabis-based medicines and cannabidiol oil.

Last updated
The Pharmaceutical Journal, PJ, September 2022, Vol 309, No 7965;309(3965)::DOI:10.1211/PJ.2022.1.157337

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