Investigation: Availability of GLP-1 Drugs on the Dark Web

As the world grapples with the shortages of so-called miracle weight loss medications — GLP-1s — they are offered on the dark web marketplaces. To better understand the scale of illegal sales of these drugs, Healthnews initiated the investigation and analyzed the findings, which are presented in this report. Experts warn against purchasing such medications due to considerable health, legal, and cyber risks.

Miracle weight loss drugs

About 40% of Americans have obesity, a condition that raises the risk of chronic diseases like cancer and type 2 diabetes and early death. Weight loss requires complex interventions, which may include dietary changes, exercise, and prescription drugs.

Drugs called GLP-1 agonists, short for glucagon-like peptide-1 (GLP-1) agonists, have skyrocketed in popularity in recent years. Initially developed for type 2 diabetes, the drugs are increasingly used for weight loss, including off-label. The number of individuals without diabetes using GLP-1 rose by more than 700% between 2019 and 2023.

So-called ‘miracle’ medications work by mimicking a hormone GLP-1 in the body that helps control insulin and glucose levels and promotes the feeling of satiety, resulting in reduced food intake. When combined with lifestyle changes, these medications may help lose 20% or more of the body weight in individuals with overweight or obesity.

Although one in eight Americans reported ever using GLP-1 drugs, they remain inaccessible to many due to their high price. Without insurance, these drugs may cost over $1,000 for a monthly supply.

Additionally, only three GLP-1s — Wegovy (semaglutide), Zepbound (tirzepatide), and Saxenda (liraglutide) — are approved specifically for weight loss, and they are usually prescribed to individuals with a body mass index of at least 27 who have other comorbidities.

The unexpected increase in demand for GLP-1s for weight loss resulted in shortages, further limiting access. At the same time, people started looking for these medications outside the doctor's office. Some choose compounded drug versions, even if it goes against the FDA's advice. Others turned to the dark web, the hidden part of the internet only accessible by special software, notorious for selling illegal products like drugs and weapons.

The investigation discovered that GLP-1 medications are broadly available on the dark web marketplaces. However, experts warn that purchasing such products poses significant health, legal, and cyber risks.

Methodology

In cooperation with the Cybernews research team, Healthnews conducted a dark market analysis of GLP-1 medications, including those with semaglutide, liraglutide, or tirzepatide as active ingredients.

To broaden the search, medications were searched based on their active ingredients, not their brand names. Certain drugs have the same active ingredients but are FDA-approved for different purposes. For example, Ozempic is a semaglutide-containing medication for managing type 2 diabetes, while Wegovy, with the active ingredient semaglutide, is approved for weight loss.

Three dark web markets were chosen for the analysis, primarily for their popularity and prominence within dark web forums where weight loss drugs, particularly GLP-1s, are frequently discussed and sought after. These markets were identified as having the most orders and consumer reviews, increasing the likelihood of buyers discovering these markets and their associated products. Other markets had lower visibility or did not offer the medications of interest.

While collecting the data, security researchers focused on vendors with the highest numbers of reviews and orders for the selected GLP-1s. Key data points gathered included:

• Type and quantity of products
• Pricing excluding shipping
• Countries of dispatch
• Shipping destinations
• Order volumes (where available)
• Reviews (where available)

Overall, data for 23 GLP-1 products on the dark web was analyzed, including 12 products for the semaglutide category, seven for tirzepatide, and four for liraglutide.

These products include selected medications with the highest number of orders and reviews from three dark markets the research team analyzed. One exception is for the liraglutide category, as two products have zero orders declared. The team included these for other data points since liraglutide was not popular in the dark markets surveyed.

The data was collected over around one week, from November 28, 2024, to December 4, 2024.

The Healthnews team analyzed the gathered data and authored the report summarizing the tendencies and comparing products' key data points. The team also spoke to experts in their respective fields to discuss the risks related to medications from dark markets.

Investigation findings: most drugs come from Europe

According to the analysis, most (10 out of 23) dispatch countries are European, likely because the manufacturers of GLP-1s are based or have factories in Europe. However, it is impossible to verify that GLP-1s sold on the dark web are made in these facilities.

Significant shares of these drugs come from the U.S. (7 out of 23) and India (5 out of 23), one of the major providers of counterfeit drugs, according to the Drug Enforcement Agency (DEA).

Of 23 products analyzed, more than half (13) can be shipped worldwide, with four having the U.S. as the only shipping destination. Three products are only available for buyers in Europe.

Below is a visual summary of the logistics aspects of our analysis of the GLP-1s on the dark web. It includes a world map with marked dispatch countries and graphs of GLP-1s’ dispatch and shipping region share on the dark markets analyzed.

Semaglutide is the most popular GLP-1 on the dark web, accounting for around 63% of orders included in the analysis (1,033 out of 1,643 orders). It is followed by tirzepatide (28% or 463 orders) and liraglutide (9% or 147 orders).

Based on our findings, products marketed as GLP-1s on the black web cost between around $7 and $84 per mg. While this may seem like a more affordable option for individuals without insurance, there are no guarantees that they are actual GLP-1 medications approved by official regulatory bodies and have an acceptable safety and efficacy profile.

The graphs below represent discussed order volume shares and list prices per 1 mg of GLP-1 medications analyzed on the dark web.

Semaglutide dominates the dark web marketplaces

According to our analysis, semaglutide is the most common choice of GLP-1s on the dark web. The trend reflects the drug's popularity in the legal market, partly due to endorsement from celebrities like Elon Musk and Oprah and its high effectiveness for weight loss.

On average, the drug leads to a 14.9% body weight reduction in people with overweight or obesity when combined with lifestyle changes in 68 weeks. However, the findings are not applicable to the general population with a healthy weight range. Another driver of the high demand could be the continuous global shortage of semaglutide.

On the dark web, buyers can pay from $9.50 to $79 per mg of what is marketed as semaglutide, with a monthly cost reaching $90⁠–760. The calculation is based on the assumption that it is the same active ingredient as in Wegovy, semaglutide approved for weight loss, whose maximum monthly dose is 9.6 mg.

For comparison, the list price of Wegovy is $1,349.02 for a monthly supply, although many people with health insurance pay less than $25, depending on their plan, according to the manufacturer. Ozempic is a cheaper option in the legal market with a list price of $968.52 per month; however, it is FDA-approved for type 2 diabetes only.

Tirzepatide: $480 for a monthly supply

Tirzepatide, sold under the brand names Zepbound and Mounjaro in the legal market, is the second most popular GLP-1 on the dark web. The drug may lag behind in popularity because the tirzepatide-containing drug was only FDA-approved for weight loss in late 2023. However, there is data suggesting that people with overweight and obesity lost more weight on tirzepatide treatment compared to semaglutide.

The monthly price of Zepbound, tirzepatide approved for weight loss, is $1,059.87 without insurance, but the out-of-pocket cost depends on the prescription drug insurance plan.

On the dark web, buyers pay around $8–84 per mg for what is marketed as tirzepatide, according to our analysis. The price of a monthly supply of tirzepatide bought on the dark web may reach $480–5,040. Assuming that it is the same active ingredient as in Zepbound, the FDA-approved tirzepatide-containing drug for weight loss, the price calculation is based on the officially recommended four maximum (15 mg) Zepbound doses per month.

Three out of seven of the tirzepatide products discovered in the investigation are shipped from the U.S., where the drug is legally available. However, it is unclear if the active ingredient in these drugs is really tirzepatide.

Liraglutide: the least popular choice on the dark web

Analysis indicated that liraglutide is the least popular GLP-1 on the dark web. In people with obesity and type 2 diabetes, liraglutide leads to an average loss of 6% of body weight in 56 weeks.

Based on our findings, liraglutide's price on the dark web can start from around $7 per mg or $84 per monthly supply. The monthly price is calculated based on the maximum dose of Saxenda, a liraglutide-containing drug approved for weight loss. In comparison, American buyers pay $1,349.02 for a monthly supply of Saxenda in the legal market, although insurance is likely to cover most of the cost.

India is the main country of dispatch for the analyzed liraglutide products, and it is impossible to verify if these drugs contain the same ingredients as FDA-approved liraglutide.

Below, you can find a graph that compares the monthly supply pricing of GLP-1 drugs on the dark web with respective FDA-approved GLP-1 options for weight loss.

Review analysis: positive but untrustworthy

Dark web vendors allow buyers to write reviews of their products, but since the dark web is known for anonymity and illegal activities, it is impossible to determine if they are honest and written by real buyers.

Of 387 reviews of semaglutide and tirzepatide, only 10 (2.6%) are negative. Below, you can find a graph indicating these findings. The overwhelming number of positive reviews adds to the suspicion that they might have been manipulated.

For the analysis, we chose reviews related to the products themselves rather than shipping time and good stealth, which refers to discreet shipping practices that prevent illegal products from being confiscated.

The most common semaglutide review themes are reduced appetite and absence of side effects. However, one review suggests that the medication bought on the dark net caused an autoimmune reaction, leading to optic nerve damage and leaving the buyer with 50% of their vision.

Alleged buyers of tirzepatide also report curbed appetite, leading to weight loss varying from 6.6 Ibs (3 kg) to 22 lbs (9.9 kg) during unspecified periods.

Are you interested in the key data points we analyzed? Below, we provide a summary of the complete data.

Health, legal, and cyber risks

While some may be tempted by a lower price and circumventing the need for a prescription, buying any medications on the dark web comes with significant health risks.

Suneye Koohsari, MD, an obesity medicine specialist, says medications purchased on the dark web did not undergo rigorous testing to ensure their safety and effectiveness, contrary to the FDA-approved drugs. There are no guarantees that such medications contain advertised ingredients or that dosages are accurate, posing the risk of overdose. Another concern is contamination.

Contaminated drugs can cause serious issues, including allergic reactions or infections, making them highly unsafe for use.

Suneye Koohsari

The FDA has recently warned against using unapproved compounded semaglutide and tirzepatide, citing multiple reports of adverse events, some requiring hospitalization, that may be related to dosing errors. The agency also investigates reports of counterfeit Ozempic, which could contain too little, too much, no active ingredient, or other harmful substances.

Meanwhile, the DEA reports an increasing number of illegal online pharmacies selling counterfeit pills made with fentanyl, a potent synthetic opioid that is a Schedule II controlled substance, and methamphetamine, an illicit and highly addictive drug.

In recent years, GLP-1s have been making headlines not only for their effectiveness but also for their side effects. The drugs carry black box warnings about the increased risk of medullary thyroid cancer, while the most common side effects include gastrointestinal issues, particularly pancreatitis, but also diarrhea, nausea, and vomiting.

A 2023 study suggests that using GLP-1s elevates the risk of pancreatitis, stomach paralysis, and bowel obstruction. Therefore, using GLP-1 medications without a doctor's supervision may have dire consequences on health.

Koohsari says close monitoring of patients taking GLP-1s is essential to manage potential side effects like dehydration or kidney injury. Additionally, it is important to make sure that dose titration is done thoughtfully to minimize the risk of side effects.

Proper nutrition, exercise, and muscle mass loss prevention are vital while on these medications, Koohsari says, as the primary goal is overall health improvement, not only weight loss.

All prescription drugs should be stored at appropriate temperatures and under appropriate conditions to ensure their potency, which sellers on the dark web cannot guarantee. Most GLP-1s come in injectable pens, which have to be stored in the refrigerator, so the drug would maintain effectiveness and not expire before the expiration date.

Vikas Dhar, a criminal defense attorney at Dhar Law, LLP, says individuals buying medications from an unknown seller on the dark web may not know what exact substances are in the purchase package. If a medication contains a controlled substance, such as opioids or benzodiazepines, purchasing or possessing it without a prescription is illegal under federal and state laws in the U.S.

The legal risks are severe and compounded by the likelihood of law enforcement monitoring dark web activity. Coupled with the potential for counterfeit or dangerous controlled substances, buying GLP-1 meds on the dark web is highly inadvisable

Vikas Dhar

Moreover, buying GLP-1 medications on the dark web is a potential violation of U.S. importation laws that prohibit importing prescription drugs without proper authorization. Customs agents often intercept packages from suspicious sources, such as unorthodox parcels from dark web sellers, which could lead to criminal investigations. Being caught with a controlled substance or unauthorized medication could result in monetary fines, civil penalties, and criminal charges.

Neringa Macijauskaitė, a security researcher who conducted the investigation, says purchasing pharmaceuticals from the darknet exposes users to significant data security risks, including identity theft through data harvesting and payment fraud via traceable cryptocurrency transactions. Even with privacy tools, users remain vulnerable to de-anonymization through traffic analysis or browser fingerprinting.

Downloading files such as fake product information or invoices or communicating with vendors can lead to malware infections, compromising personal data and device security, with no recourse for recovery due to the lack of consumer protections.

Neringa Macijauskaitė

The FDA says that to ensure the safe use of GLP1, individuals should obtain a prescription from their doctor and fill it at a state-licensed pharmacy. You can find resources to safely buy prescription medicines online here.