Roy Suryo
The fervent anticipation surrounding the development of a novel drug, particularly one exhibiting early promise in clinical trials, is typically met with jubilation by its creators. However, the emerging weight-loss drug retatrutide has presented a significant challenge, not only to its developer, pharmaceutical giant Eli Lilly, but also to regulatory bodies in the United Kingdom and across the globe. This potent injectable, which has yet to receive approval for human use from any official regulatory agency, is now being illicitly produced and widely disseminated on the black market in counterfeit forms.
Experts have expressed astonishment at the unprecedented scale at which copycat versions of an experimental drug, still undergoing rigorous testing, have become readily available. Colloquially known as "reta," these vials are being peddled in a surprising array of locations throughout the UK, including gyms, nail and beauty salons, hairdressers, social media platforms, and even by street vendors selling flowers. Sehar Shahid, a pharmacist and director of 24 HR Pharmacy, decries the situation, stating, "The world has gone mad. People are effectively injecting an illegal drug and thinking it’s safe. It’s become so normalized people openly talk about their dealers, where’s best to get it from and post all over social media." A cursory glance at social media feeds reveals the alarming ease with which one can procure a batch of a substance purporting to be retatrutide, with no guarantees regarding its composition, effects, or origin.
Enthusiastic users are actively sharing before-and-after "reta" photographs on platforms like TikTok, detailing its alleged ability to quell food cravings, facilitate significant weight loss, and reshape their physiques, with some users claiming it has profoundly transformed their lives. The critical issue, however, lies in the fact that despite promising results from its most recent clinical trials, the genuine retatrutide is still under investigation for its safety and efficacy. The Food and Drug Administration (FDA) in the United States approves only about 50% of drugs that reach Phase III of clinical testing. This indicates no assurance that retatrutide will ever gain market approval, as drugs often fail to replicate their efficacy in larger, more diverse human populations compared to smaller initial studies, or they may reveal unforeseen safety concerns. Moreover, the counterfeit versions currently circulating may bear little resemblance to the meticulously formulated compound being developed within controlled laboratory environments.
Eli Lilly has issued a stern warning on its website, emphasizing that "no one should take anything claiming to be retatrutide outside of a Lilly-sponsored clinical trial." The company cautions that "illicit retatrutide products may contain unknown ingredients, harmful contaminants and impurities. These products may also have too much or too little active ingredient, or the wrong ingredient entirely." Despite these dire warnings, a substantial number of individuals appear willing to embrace this perilous gamble.
Professor Donal O’Shea, an endocrinologist, reports that "Young fit patients are coming into hospital with nausea, vomiting, diarrhoea, in some cases kidney failure." He further reveals that some personal trainers are not only supplying their clients with the drug but are also administering the injections themselves. "The patients have no idea how much they have been taking, or even what they’ve been injected with," he states, highlighting the extreme lack of transparency and medical oversight.
The harrowing experience of 20-year-old Tom Davies from Brighton serves as a stark illustration of the dangers involved. He nearly required hospitalization after inadvertently overdosing on a counterfeit version of retatrutide, which he ordered from a Chinese supplier following recommendations from gym acquaintances. "It was horrendous," Davies recounted. "My body felt so under pressure, I was so bloated, it was like someone had dropped a 20kg weight on my stomach. For 72 hours I had really bad diarrhoea and nausea. I thought, if this continues I’m going to end up in A&E." Tom later discovered he had self-administered eight times the recommended dose. The preparation of these copycat drugs can be complex, often requiring precise calculations for mixing with sterile, bacteriostatic water, a process fraught with potential for error when undertaken without professional guidance.
Dr. Nas Khattak, a research doctor based in Chester who screens patients for Eli Lilly’s Phase III clinical trials, likens individuals sourcing fake versions to "lab rats without any medical oversight." He sternly warns, "If users who buy it online become their own doctor, they’re taking a huge risk." Dr. Khattak emphasizes the stringent selection criteria for trial participants, which include thorough medical record reviews, emotional well-being assessments, and evaluations for suicidal ideation, self-harm, and mental health conditions, all conducted by qualified physicians. Furthermore, extensive blood tests and comprehensive health evaluations are performed to determine suitability.
Despite his distressing initial experience, Tom Davies, after conducting further research into dosage, decided to try the fake retatrutide again. Over a nine-month period, taking it in cycles, he reports a significant reduction in his cravings for sugar and junk food. However, pharmacist Shahid cautions that the efficacy of a counterfeit drug for one individual does not guarantee its safety or effectiveness for another.
The current generation of approved obesity drugs, such as semaglutide (marketed as Ozempic and Wegovy) and tirzepatide (marketed as Mounjaro), target one or two hormone receptors. Retatrutide, if approved, is poised to become the first weight-loss medication globally to act on three hormone receptors, earning it the moniker "triple G." These three hormones it mimics are: glucagon-like peptide-1 (GLP-1), glucagon-like peptide-2 (GLP-2), and glucose-dependent insulinotropic polypeptide (GIP).
Lisa King has been using a counterfeit version of retatrutide since July. During a period of combined diligent gym attendance and healthy eating, she experienced a weight loss of 3kg (6lb) per week. She also believes it is helping her manage some symptoms associated with polyendocrine metabolic ovarian syndrome (PMOS). GLP-1 agonists are known to regulate blood sugar, and some research suggests these weight-loss drugs may alleviate certain issues linked to PMOS, a condition that can manifest as extreme fatigue, kidney problems, and high blood pressure. "I’m not sure if it’s due to reta," Lisa admits, "but my sugar cravings have gone down, my periods have regulated and I’ve got a lot more energy." When asked if the fact that retatrutide is still in trials concerns her, she replied, "No, not at all. There are many things that have not been approved. If I start to experience any negative side effects I’ll just come straight off it."
Other users of counterfeit retatrutide have reported a spectrum of adverse effects, including brain fog, persistent nausea, debilitating diarrhoea, a diminished libido, and a general loss of happiness and joy. Healthcare professionals are increasingly alarmed by the side effects observed in individuals using these illicit weight-loss drugs. Dr. Sahira Dar, a GP and chair of the British Islamic Medical Association, advocates for healthcare providers to inquire about black market products "without judgement," thereby fostering an environment where patients feel comfortable disclosing their usage.
Eli Lilly has been dedicated to the development of retatrutide for nearly a decade and is now actively engaged in efforts to safeguard its product and curtail the widespread illegal sales occurring internationally. The company is pursuing legal action against peptide manufacturers, social media influencers, compounding pharmacies responsible for producing the fake medication, and wellness clinics. Eli Lilly has reported over 14,000 websites, advertisements, and social media posts that it alleges are illegally marketing the drug.
A spokesperson for Eli Lilly stated, "Any retatrutide available online is unapproved, unverified and simply not worth the risk," adding that the company "continues to work with law enforcement and regulatory authorities to combat black market drugs." In the UK, the Medicines and Healthcare Products Regulatory Agency (MHRA) has conducted raids and seized numerous "products claiming to contain retatrutide" over the past year. The MHRA acknowledges that these products enter the UK through various channels and is actively working to "disrupt illegal importation and distribution." Despite these efforts, the illicit sales persist.
Professor O’Shea emphasizes the importance of "shining a light on the dangers of such black market drugs" while cautioning against a wholesale dismissal of this class of medications. He asserts, "GLP-1s are a major advance in managing obesity, a major advance in our insight into how the brain regulates cravings and appetite. That is huge."
Currently, retatrutide remains a considerable distance from regulatory approval in any jurisdiction. Eli Lilly intends to submit its application for US FDA approval early next year. The review process can extend up to a year, meaning retatrutide would not be legally accessible in the United States until late 2027 at the earliest. In the UK, contingent upon MHRA approval, it could potentially reach the market by 2028.
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