Social media has been pushing toxic diet culture, disordered eating, and the pursuit of thinness at any cost on children and teens for years. Before and after images of dramatic transformations pressure teens to pursue unhealthy means to change their bodies to fit these images – even though they are often heavily edited or AI-generated.    

The newest manifestation of this trend is the prevalence of both ads and content heavily promoting semaglutide weight loss drugs – commonly sold under brand names like Ozempic and WeGovy – in the absence of a doctor’s care. Thousands of ads for semaglutide weight loss drugs run on social media platforms. While TikTok and Instagram say they don’t allow weight loss companies to target minors, any minor signed in as an adult can be served these ads. When ParentsTogether researchers logged in as teens on TikTok, Instagram and Snapchat, we were able to watch dozens of unsponsored videos celebrating semaglutide medications for weight loss, including before and after images.

Parents should know that medications like Ozempic and WeGovy, whose active ingredient is semaglutide, are serious, life-long treatments that are approved for use when prescribed by a doctor. There have not been long-term clinical studies of the effects of these drugs, especially for kids and teens. Common side effects include nausea and vomiting, diarrhea, constipation, blurred vision, and fatigue. Rare but serious side effects include kidney damage, pancreatitis, increased risk of cancer, and malnutrition.

“The near-constant barrage of weight loss content, especially content with before and after images, triggered and fueled my teen daughter’s eating disorder,” said Neveen Radwan, whose daughter was diagnosed with anorexia when she was 15 years old. “It didn’t matter that she didn’t need or qualify for weight loss drugs; she heard the message that thinner was better over and over again on social media. Content and ads that push children to pursue drugs, diets, or exercise programs to lose weight without their doctors’ knowledge or recommendation is dangerous.”

As reports of kids and teens – regardless of whether they meet clinical requirements for a semaglutide prescription – increasingly requesting these drugs, parents should be aware of the following:

• Social media has been a major driver of demand for semaglutide drugs, leading to a worldwide shortage and increase in off-label prescriptions for both adults and teens.
• Companies that make semaglutide weight loss drugs are explicitly targeting social media influencers to promote them, especially plus size and body positive fashion influencers who have large followings of young people.
• Social media has also been pushing unregulated and risky products like laxatives and diet pills as “budget Ozempic” or “nature’s Ozempic.” One in 10 teens report they have used these sorts of products to try to lose weight.
• The FDA has warned against buying semaglutide or other weight medications online without the care of a doctor, since they may contain harmful ingredients. 
• Many pediatricians are reluctant to prescribe semaglutide medications to teens for several reasons. There have been no long-term clinical trials to show how these medications impact growing and developing children; they create conditions that are similar to dieting, which is a strong predictor of eating disorders; patients report regaining significant weight after stopping these medications, indicating life-long use may be required for efficacy.

ParentsTogether created a script for parents looking for more support in talking to their kids about diet culture, Ozempic and other weight loss products being promoted or sold online.

Social media companies continue to promote extreme dieting, weight loss, and eating disorder content to kids and teens, despite parents and survivors’ increasingly loud calls for change. The U.S. Surgeon General recently made recommendations that policymakers take steps towards protecting reducing social media’s harmful impact on kids’ mental and physical health, including: 

1. Develop age-appropriate health and safety standards for technology platforms – including preventing children from accessing harmful content that encourages eating disorders
2. Pursue policies that further limit access—in ways that minimize the risk of harm—to social media for all children, including strengthening and enforcing age minimums.
3. Ensure technology companies share data relevant to the health impact of their platforms with independent researchers and the public in a manner that is timely, sufficiently detailed, and protects privacy.

ParentsTogether supports the Kids Online Safety Act (KOSA) at the federal level, which would require tech platforms to design their products with kids’ wellbeing in mind, and age-appropriate design codes at the state level, like those in Minnesota, Maryland, and Vermont, which would require platforms to design their platforms in a way that promotes, rather than threatens, children’s health and well-being.