What did @mariannas_pantry actually say?
The creator's core argument is that wealthy influencers and celebrities have been using semaglutide (Ozempic) for cosmetic thinness long before it was formally approved for weight loss, and that public outrage about this is naive. She says, "if you have money, you can get your hands on a Zempik," and frames this as an open secret. She's not celebrating it. She's calling out the hypocrisy of the shock response. That's a meaningful distinction worth making.
The claim breaks into two parts: one, that off-label prescribing of semaglutide for weight loss happened before official approval, and two, that thin celebrities and influencers have been driving this. Both claims deserve scrutiny, but they're not equally verifiable with evidence.
Does the science back this up?
On the regulatory timeline, she's largely right. Semaglutide (Ozempic) was approved by the FDA for type 2 diabetes in December 2017. Wegovy, the higher-dose version approved specifically for chronic weight management, received FDA approval in June 2021. That's a gap of roughly three and a half years during which off-label prescribing of Ozempic for weight loss was legal, common, and documented.
Off-label prescribing is standard medical practice in the U.S. Physicians can legally prescribe any approved drug for unapproved uses. A 2023 analysis published in JAMA Internal Medicine noted a sharp rise in semaglutide prescriptions well before Wegovy's approval, consistent with widespread off-label use. The STEP trial program, which produced the clinical data eventually used to support Wegovy's approval, was also generating results and press coverage from 2020 onward, which likely fueled early demand among people who could afford private-pay prescriptions. So the creator's framing of "before it was legalized" is slightly imprecise, but her underlying point holds up.
What did they get wrong (or right)?
The phrase "before it was legalized" is the one factual stumble here. Semaglutide was never illegal for weight loss purposes. Off-label prescribing is a protected and widespread practice. What changed in 2021 was FDA approval specifically for obesity, which affects insurance coverage and how physicians can market and discuss the drug, not its legal status as a prescription medication.
That said, the broader social claim, that access to Ozempic before its mainstream moment was essentially a wealth-gated privilege, is credible. A 2022 report from GoodRx noted Ozempic's list price exceeded $800 per month without insurance, and off-label prescribing for weight loss was almost never covered by insurance pre-2021. That financial barrier is real. The creator deserves credit for identifying this as a class issue rather than just a celebrity gossip angle.
Her claim that thin people are using it purely for cosmetic thinness is unverifiable at the individual level. She's speculating about specific creators' medical situations, which she has no access to. Someone appearing thin may still carry metabolic risk factors or have a legitimate clinical reason for the prescription.
What should you actually know?
Semaglutide is approved for two distinct patient populations: adults with type 2 diabetes (Ozempic) and adults with obesity or overweight plus a weight-related condition (Wegovy). Using it outside those indications isn't illegal but it does represent an off-label use that carries real clinical considerations, including shortages that affect patients who need the drug for diabetes management.
The shortage issue matters here. The American Diabetes Association and endocrinology groups raised alarms in 2022 and 2023 about semaglutide shortages partly attributed to surging demand for weight loss use. Patients managing type 2 diabetes faced genuine supply disruptions. That's the concrete harm attached to the dynamic the creator is describing, and it's worth naming explicitly. If you're considering a GLP-1 medication, this is a conversation to have with a licensed medical provider, not a TikTok comment section.
The bottom line
The creator gets the broad story right: wealthy, thin people accessed semaglutide off-label before its obesity approval, off-label prescribing is real and legal, and public outrage about this is somewhat selective. The "legalized" framing is imprecise but not the kind of error that changes her argument. What's missing from her take is any acknowledgment of the supply consequences or the fact that visible thinness tells us nothing about a person's actual clinical picture. Credit where it's due, but the full story is more complicated.