The Women DIY-ing Their Weight-Loss Drugs

Last fall, Miriam set a goal: She wanted to lose two pounds. “It sounds so dumb,” she told me. But at only five-foot-two, any little weight gain was visible on her petite frame, she added. If she wanted to slim down the old-fashioned way, she could have. She had done it before. She knew how to white-knuckle her way through the hunger of a 1,200-calorie day. But, she thought, why bother?

Instead, Miriam paid $195 for a vial of retatrutide — or reta, as she and others call the drug — that she ordered from a peptide distributor she found through Instagram. It’s a newer version of a GLP-1, sometimes called a GLP-3 or “Triple G” because it targets three hormone receptors instead of one. (It’s still considered experimental and is currently in Phase 3 clinical trials.) She loves talking about how she figured out how much to take. “So I knew that the clinical trials started at two milligrams, but this was for people who are obese,” she said. “I’m like, Okay, well, I’m not obese. I’m going to go lower.”

On YouTube, she found videos made by people who, like her, wanted to lose just a little bit of weight and had experimented on themselves until they found a dose that helped them reach their goal while avoiding most side effects (namely, gastrointestinal issues like nausea and vomiting). Many of them microdosed the drug, which they defined as taking a lower dose than what’s been studied. That’s what Miriam did: 0.5 milligrams for three weeks and then up to 0.75 milligrams for nine weeks. Instead of two pounds, she lost ten. She was shocked, but she was also a little thrilled at the results of her personal clinical trial. True, she experienced some side effects. “Things are … looser than I want,” she said. “A lot of people get constipated. I have the opposite issue.” But overall, her experiment in self-prescribing had worked even better than she’d hoped.

As shortages of GLP-1’s have resolved and off-label usage has become increasingly common, a class of casual users like Miriam has emerged — not obese, not diabetic, not even overweight, and, often, not on the radar of doctors. Some of the people I spoke to said they worked with a health-care professional to determine how much they should take and for how long, but many did not and instead DIY’d and improvised their dosage with advice cobbled together from online commenters and their real-life friends. They know this is not the approved way to use a GLP-1 and that what they’re doing is risky. But they also know enough people who are doing the same thing to not be that worried about it.

“I’m not under the care of a physician while taking an injectable medication. Like, is that a red flag? Yes,” said Debbie, who is 54 and works in software sales in Portland, Oregon. Since last summer, she has tinkered with the frequency and the dosage of the compounded tirzepatide she ordered online with a goal of losing 15 pounds. Experts don’t love the fact that some are self-prescribing unregulated weight-loss drugs and at dosages and frequencies that haven’t been well tested. “I mean, as a physician, I wouldn’t recommend doing that,” said Dr. Jennifer Manne-Goehler, who studies metabolic disease at Brigham and Women’s Hospital. That said, she knows people in medicine who do something similar: They don’t buy unregulated versions of the drug online, but they’re experimenting with the dosing and frequency of their own GLP-1’s, just like Debbie and Miriam.

Casual GLP-1 users are an understudied, and possibly undercounted, group. What we do know: About 15 percent of GLP-1 users have never been diagnosed with one of the predominant conditions the drug is intended to treat (specifically, obesity or being overweight, diabetes, and heart disease), and about one in six Americans who have used a GLP-1 ordered it online, and one in ten got it from a med spa, according to a recent national poll from KFF.

In December, at eight months postpartum, 27-year-old Madison Olson walked into a med spa near her home in Vancouver, Washington, and walked out with a prescription for tirzepatide. Within two months, she lost almost all of the 15 pounds that had been driving her crazy. When I asked if it had been difficult to get the tirzepatide, she laughed a little at my naïveté. “Honestly, if you want a GLP-1 nowadays, you can get one basically no matter your size,” said Olson, who added that she spends about $530 a month on the injections.

Olson, and many others I spoke to, know that plenty of people take issue with the way they’ve used the drug. “People say, ‘Oh, when you only have 15 pounds to lose, that’s an abuse of a GLP-1,’” Olson said in January on TikTok. When we spoke recently, she wondered aloud, How is a GLP-1 different from cosmetic injectables like lip filler or Botox? It’s a comparison I heard over and over again from casual GLP-1 users. “Most of the successful, interesting women in New York that I know use GLP-1’s like Botox,” said Grace McCarrick, 36, a corporate speaker and content creator in New York.

Many of the people I’ve spoken to appreciated the way the weight-loss medications eased symptoms of some other health issue, like brain fog from perimenopause or inflammation from PCOS. But even those who had underlying conditions tended to say their decision to use a GLP-1 was triggered by a desire to lose a relatively minor amount of weight. They told me they feel safe using the drug in part because it’s been around for decades. The most common side effects are GI issues like nausea and vomiting — not fun but also not life-threatening. “Could you have an allergic reaction, or could you develop one of the rare side effects? Sure, but those are called ‘rare’ for a reason,” said Manne-Goehler, who served as technical expert for the World Health Organization’s GLP-1 guidelines. “I’m a huge believer in these drugs. I honestly think they’re a transformative-medicine category,” she said, adding that they have so many benefits beyond weight loss. That’s part of the reason why some plan to stay on one indefinitely. “I’m sold on this drug for life,” said Miriam, who has seen positive changes in her cholesterol levels and insulin control (she uses a continuous glucose monitor) since starting the medication.

Others I spoke to said they cycle on and off the drug, depending on how they’re feeling about their bodies. “I probably do what almost everyone else does, which is have a little bit in my fridge,” McCarrick said. She initially used a GLP-1 in 2024 to drop around ten pounds; now, she uses it every few months, whenever she feels as if she’s starting to gain some weight back. Currently, scientists are studying the efficacy of maintenance dosing, or reducing the frequency after the patient hits their target weight, Manne-Goehler said. It’s a promising area of research, though so far these trials have dialed back the frequency dosing to only every six weeks (from every two weeks). “Quarterly seems poorly supported in terms of pharmacokinetics,” she told me in a text message. “But I guess we are in a Wild West learning moment?”

Manne-Goehler said the stop-start approach worries her, though. Rapid weight loss and regain has been linked to visceral fat — the kind of fat that accumulates around your organs and that, when too plentiful, can make you more likely to develop heart problems, diabetes, and metabolic disease. “You can effectively mimic a crash diet with these medications,” she said. As for microdosing, she is more concerned about the hit women might be taking to their wallets than to their health. “What are the real benefits of that? We don’t even really know,” she said. Everyone I spoke to, including Manne-Goehler, said they believed that as access improves, it will only become more common to use a GLP-1 for a variety of reasons, including relatively minor weight-loss goals.

Before taking GLP-1’s, many of the weight-loss-drug improvisers I interviewed said they devoted an inordinate amount of mental energy to their weight. Miriam’s sister keeps telling her to see a therapist to talk about her preoccupation with weight, but she doesn’t see the point. “What is a therapist going to tell me? That I shouldn’t let the scale determine my mood for the day? Like, I know that,” she told me.

If she didn’t own a scale, she said she likely wouldn’t even have noticed those two pounds that inspired her to try the reta. A few times as we spoke, she acknowledged that she probably has body dysmorphia. “I don’t think I have it anymore,” she said. “I mean, I look really great.”