Ozempic, Celebrities, and TikTok: A Regulatory Nightmare Waiting to Happen?

In the neon-lit world of TikTok, Ozempic — along with other GLP-1 medications — has become the worst-kept “secret” in Hollywood and on social media. Celebrities gush about it, TikTokers brag about dramatic weight loss, and suddenly a diabetes drug is a pop culture phenomenon.

But beneath the glamor lies a regulatory nightmare: Current FDA and FTC frameworks, historically designed for traditional media, are ill-equipped to address informal, non-sponsored celebrity mentions online, creating dangerous regulatory loopholes.

When a Diabetes Drug Becomes a Diet Craze

Ozempic dominates social media feeds. The hashtag #Ozempic has garnered millions of views on TikTok and climbing, as users chronicle their shrinkage in real time. While Ozempic (semaglutide) is, first and foremost, an injectable prescription medicine for Type 2 diabetes, the public frenzy over this drug’s off-label slimming powers has overshadowed its actual FDA-approved purpose. Approximately a third of Ozempic prescriptions in 2023 were for off-label weight loss rather than diabetes (with younger adults particularly prone to consuming it purely for weight loss purposes). This has not only driven off-label use but also triggered global shortages, affecting diabetic patients who rely on the medication for its approved purpose.

Celebrity Buzz or Pharmaceutical Promotion?

Celebrity endorsements significantly amplify the Ozempic hype … Stars like Chelsea Handler, Oprah, and Amy Schumer have all weighed in — sometimes lauding Ozempic without the full spectrum of warnings: possible side effects include nausea, pancreatitis, thyroid tumors and blindness. Such endorsements have proven to drive market trends, highlighting the problematic intersection of influencer culture and pharmaceutical regulation.

Legal Boundaries: FTC, FDA, and Social Media

In the U.S., prescription drug promotion is tightly regulated — at least in theory. FDA regulations require that any promotion of a prescription drug be truthful, balanced, and include appropriate risk information​. Those rules might work (more or less) for magazine ads or TV commercials with fine print and fast-talking voice-overs. But a 15-second TikTok clip or a 280-character post? There is no easy way to cram all the necessary warnings into a viral soundbite without losing the audience.

In fact, while the FDA issued new rules on prescription drug advertisement in TV and radio format in 2023, the agency’s draft guidance on social media marketing of drugs was last updated in 2014—long before TikTok existed and when Instagram was in its infancy. Furthermore, influencers can face regulatory actions for failing to disclose promotional relationships clearly or for presenting misleading claims about drug products (as in cases where Kim Kardashian promoted a morning-sickness drug or Khloé Kardashian mentioned a weight-loss injection on TV or social media without listing risks). However, while the FDA sent warning letters in these cases, the response is often after the fact and the enforcement is scattershot and slow-moving.

The FTC’s influencer rules (under its Endorsement Guides) are supposed to keep online marketing honest, requiring that paid endorsements be clearly disclosed (typically through tags like #ad or explicit disclaimers) and not misleading​. On paper, these FTC influencer guidelines should apply to any celebrity endorsement Ozempic receives. However, many of the Ozempic shout-outs fueling this trend are not formal advertisements at all: Elon Musk was not a Novo Nordisk rep; Chelsea Handler was not part of a marketing campaign. They were just talking. And the FTC’s rules, which focus on transparency in paid advertising, are not well-equipped to police an environment where viral word-of-mouth is driving demand.

The FTC has begun to crack down. In one case, the agency sent warning letters to a dozen health influencers (including dieticians) for failing to disclose they were paid to promote certain sweeteners​. Their message is clear: Social media posts must make material connections obvious. Still, monitoring millions of TikToks and Instagram stories is a herculean task. By the time regulators catch one undisclosed promo, 10 more may have gone live. The nuances of social media — ephemeral content, slang and innuendo, influencers “casually” mentioning products during vlogs — make it challenging to apply rules that were written with traditional ads in mind.

The Rise of Counterfeits and the Liability Gap

Beyond misinformation, social media’s Ozempic frenzy fuels a dangerous market for counterfeit medications. The FDA recently warned against fake or compounded versions of Ozempic sold illegally online, often promoted by influencers or rogue telehealth providers capitalizing on desperate consumers seeking rapid weight loss. These counterfeit products pose significant safety risks, potentially leading to severe medical complications or ineffective treatment outcomes.

If a consumer is harmed by counterfeit or improperly marketed drugs promoted via social media, untangling liability could be a nightmare. The influencer who hyped Ozempic, the off-label telehealth prescriber, the rogue compounder, or the platform hosting the ad — all could be in the crosshairs. It’s a perfect storm of diffuse responsibility, which the current legal framework is not well-equipped to sort out. During the official shortage, even legitimate telehealth companies like Hims & Hers jumped in by selling compounded semaglutide under an FDA loophole — an entirely legal move due to the shortage, but one that highlights how far demand outstripped the normal supply chain.

However, the legal landscape may be shifting. Recent FTC crackdowns, including warning letters to dieticians and health influencers who fail to disclose sponsorships, signal increased regulatory scrutiny ahead. Lawmakers are openly considering new penalties to hold bad actors accountable. One Senate proposal would even let the FDA fine influencers or companies up to $500,000 for spreading false or misleading info about drugs like Ozempic and Wegovy.

Charting a Course for Regulatory Reform

The solution to this digital quagmire lies in proactive reform. It is worth noting there are models for effective oversight. The FTC and FDA previously collaborated effectively on similar issues, notably in addressing influencer-driven e-cigarette marketing, issuing joint warnings to companies whose influencers failed to properly disclose risks. A similar coordinated effort for prescription drugs like Ozempic could mitigate public health risks by clearly defining legal boundaries in social media promotion.

The FDA and FTC must then collaborate to issue updated joint guidelines that address the realities of social media drug promotion. Such guidance could mandate any influencer or celebrity endorsement of prescription drugs to include concise, on-screen disclosures about off-label risks and full transparency regarding compensation. The Memorandum of Understanding between the two agencies provides a useful blueprint — if modernized for the TikTok and Instagram era.

Closing the Loop: From Viral Buzz to Legal Clarity

Ozempic’s meteoric rise exemplifies a broader truth: Our drug marketing laws are rooted in an analog age. As TikTok and Instagram reshape how Americans consume medical information, regulators must recalibrate to protect public health. Without proactive reform, the next viral drug trend could escalate into a public health crisis — fueled by half-truths, hype, and legal ambiguity.

The FDA and FTC can no longer afford to treat influencer content as fringe or informal. It is now central to the pharmaceutical marketing ecosystem — and must be governed accordingly.