Elon Musk credits Wegovy for his weight loss in a post that put a GLP-1 drug in front of millions

On October 1, 2022, Elon Musk answered a question about how he had gotten in shape with one word: "Fasting." Just after midnight the next day, he added a second answer: "And Wegovy" ^[1].

The exchange, on the platform then called Twitter, put a prescription weight-loss drug in front of a mass audience. The "Fasting" reply drew 82,978 likes and 3,360 retweets. The "And Wegovy" follow-up, posted at 12:26 a.m. on October 2, 2022, drew 1,543 likes and 65 retweets ^[1].

Wegovy is Novo Nordisk's injectable form of semaglutide, the same GLP-1 drug used in the company's diabetes medicines Ozempic and Rybelsus ^[2]. The FDA approved Wegovy in the summer of 2021 for chronic weight management in adults who have obesity, or who are overweight with at least one weight-related condition such as high blood pressure, Type 2 diabetes or high cholesterol. The label covers adults with a BMI of 27 or more plus such a condition, or a BMI of 30 or greater ^[2].

Musk did not say what dose he took, how long he had taken it, whether a doctor prescribed it, or whether he met the label's criteria. Novo Nordisk said it did not know about his use before he posted. "We were not aware of Elon Musk's use of Wegovy before he shared this information publicly," a company spokesperson told Fierce Pharma Marketing ^[2]. Musk is not a spokesperson for Novo Nordisk ^[2].

Fierce Pharma noted that it "isn't clear whether Musk should, according to the drug's approval, in fact be using the drug," and that unexpected endorsements from people who do not match a drug's approved population can be a double-edged sword for the company that makes it ^[2].

The post came during a year of rising celebrity attention to this drug class. Earlier in 2022, a Variety report said a number of celebrities were paying high prices to use Ozempic, a diabetes drug, at a different dose to get its weight-loss effects ^[2]. Wegovy was expected to become a blockbuster later in the decade, and Eli Lilly had begun a rolling FDA submission for its rival drug tirzepatide in obesity. Tirzepatide was already approved as Mounjaro for Type 2 diabetes ^[2].

Why it matters for patients

Wegovy is a prescription medicine with a defined approved population, but a public figure talking about using it does not tell a patient whether that use matched the label. Musk's posts left out the details that matter for judging that: dose, duration, prescriber involvement and whether he had a weight-related condition ^[1][2].

The episode also drew attention to a practice the FDA approval does not cover: using a diabetes drug such as Ozempic off-label for weight loss. The Variety report described celebrities doing exactly that at a different dose ^[2]. Wegovy and Ozempic contain the same active ingredient but are separate products with separate approvals ^[2].

A celebrity mention can also have practical effects that patients feel. Novo Nordisk was not told in advance and did not arrange the posts, so nothing in the exchange reflects company guidance about who should take the drug or how ^[2]. Whether the posts changed demand for Wegovy, or how clinicians and patients talked about GLP-1 drugs afterward, has not been reported in these accounts.

What happens next

When Fierce Pharma reported the story on October 13, 2022, the report said Lilly's obesity submission for tirzepatide was rolling into the FDA that month, with no decision date given ^[2]. The same report described Musk as Twitter's "soon-to-be owner," meaning his purchase of the platform had not yet closed ^[2]. Neither Musk nor Novo Nordisk said at the time whether he would say more about his use of the drug ^[1][2].