Online bodybuilders use GLP-1 drugs off-label for physique enhancement with folk pharmacology guiding harm reduction | Research

The takeaway

Qualitative analysis of bodybuilder forums reveals off-label GLP-1 drug use for physique enhancement, with users developing folk pharmacological knowledge about dosing, cycling, and harm reduction strategies outside medical supervision.

Off-label physique use growing
Bodybuilding communities develop folk pharmacology for GLP-1 drugs—unsupervised dosing and cycling protocols that healthcare providers need to understand for harm reduction

What the researchers found

Off-label GLP-1 use in bodybuilding: semaglutide, tirzepatide. Folk pharmacology: user-developed dosing/cycling protocols. Risk: unsupervised use, experimentation. Harm reduction: community-developed strategies. Online forums: primary information source.

Why it matters

A growing population is using GLP-1 drugs without medical supervision. Understanding their practices enables healthcare providers to engage these users with evidence-based guidance rather than driving them further from medical care.

How the study worked

Qualitative analysis of online bodybuilding forum discussions about GLP-1 drug use for physique enhancement.

What this study cannot tell us

Qualitative study—cannot quantify prevalence. Online forums may not represent all users. Self-reported practices. No outcomes data.

How to read the evidence

Qualitative research. Good for understanding user behaviors and practices.

When this study was published

Published in 2025.

The bigger picture

GLP-1 drug off-label use is extending beyond weight loss into physique-oriented communities. Healthcare providers must engage with these users proactively to prevent harm.

Questions still open

How prevalent is bodybuilding GLP-1 drug use?
Are bodybuilder dosing protocols safe?
Should harm reduction guidelines be developed for off-label GLP-1 users?

Common questions

Are bodybuilders using GLP-1 drugs?

Yes—increasingly. This study documented how online bodybuilding communities share information about using semaglutide and tirzepatide for physique enhancement, often without prescriptions. Users develop their own dosing protocols and harm reduction strategies based on shared experience rather than medical guidance.

Is off-label GLP-1 use by bodybuilders safe?

It carries risks. Without medical supervision, users may take inappropriate doses, combine with other substances, and miss important side effects. This study highlights the need for healthcare providers to engage these users constructively rather than driving them away from medical care.

Read the original research

Off-label GLP-1 weight-loss medicine use among online bodybuilders: Folk pharmacology, risk and harm reduction.

The International journal on drug policy, 142, 104854

View on PubMed ↗Publisher’s paper ↗

Citation

Turnock, Luke A; Hearne, Evelyn; Germain, Jennifer; Hirst, Mikey; Townshend, Honor D; Lazuras, Lambros. (2025). Off-label GLP-1 weight-loss medicine use among online bodybuilders: Folk pharmacology, risk and harm reduction.. The International journal on drug policy, 142, 104854. https://doi.org/10.1016/j.drugpo.2025.104854