| Ozempic no longer needs an explanation. The drug is a household name, in part thanks to its popularity on social media. TikTok in particular has been flooded with hundreds — if not thousands — of videos touting the medication and other GLP-1 drugs, which are increasingly prescribed off-label to patients looking to slim down. Ozempic, for example, accounted for nearly 40% of GLP-1 prescriptions in people who did not have diabetes in 2022, according to the data analytics firm Komodo Health. That suggests a large number of patients are using it for weight-loss, when the medication is specifically intended to help to lower blood sugar levels in patients with type 2 diabetes. But now the social media platform seems to be cracking down on content that treats weight-loss drugs as the latest diet fad. In early July, TikTok temporarily banned some accounts that had been posting about GLP-1 drugs. It's unclear how many accounts were affected, or how long the bans lasted, but many of the creators who said they were banned appear to be posting again. One TikTok creator, Jennifer Witherspoon, tells me a video she made about compounded tirzepatide — an alternative to Eli Lilly's weight-loss drug Mounjaro known as a compound drug — was taken down after TikTok flagged it for violating its guidelines related to alcohol, tobacco and drugs. Compounding pharmacies create custom-made medications. Drug shortages and spotty insurance coverage have led to a boom in compounded versions of GLP-1 drugs. While certain pharmacies are allowed to make and distribute drugs that are in shortage, the FDA doesn't approve compounded products or have the kind of oversight it does with a traditional prescription drug. Witherspoon, whose account boasts 65,000 followers, mostly posts videos about her own experience losing more than 103 pounds on Mounjaro. In a video posted over the weekend, she said that TikTok's crackdown on accounts like hers is "censorship at its finest." On Monday, Witherspoon said TikTok removed her account biography, which for the past six months had included the amount of weight she'd lost on Lilly's Mounjaro. The reason was repeated violations of the platform's community guidelines, according to screenshots shared with Bloomberg. But some hailed TikTok's move as a positive change for the platform, which has repeatedly come under fire for not regulating its content, especially when it comes to young kids. A spokesperson for TikTok told Bloomberg that it encourages open discussions on GLP-1s, weight-loss journeys, obesity and more, but accounts that directly violate its disordered eating policies or trade policies will have content removed or be outright banned. It also prohibits ads promoting weight-loss management products or supplements, the spokesperson said. It's not clear which parts of the policies banned accounts have violated. Some users have said TikTok's algorithm continues to push weight loss-related content anyway. "These platforms cracking down on harmful content is one small step in the right direction, but more is needed to make systemic change," says Kristina Saffran, the co-founder and CEO of Equip, a virtual eating disorder therapy provider. For people with eating disorders, like anorexia nervosa or bulimia, Saffran says that GLP-1 drugs can potentially exacerbate an already distorted relationship with food. Regardless, the move is unlikely to quell Americans' insatiable demand for GLP-1 drugs. Already, prescription claims in 2023 are on track to outpace all of 2022, according to Komodo. Morgan Stanley now expects the global obesity market to reach $77 billion by 2030, according to a research note from last week. That's over $20 billion more than the firm's initial projections. — Madison Muller | 
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