Quality Assessment of Medical Institutions' Websites Regarding Prescription Drug Misuse of Glucagon-Like Peptide-1 Receptor Agonists by Off-Label Use for Weight Loss: Website Evaluation Study

Background: Misuse of glucagon-like peptide-1 receptor agonists (GLP-1RAs) has emerged globally as individuals increasingly use these drugs for weight loss because of unrealistic and attractive body images advertised and shared on the internet.

Objective: This study assesses the quality of information and compliance with Japan's medical advertising guidelines on the websites of medical institutions that prescribe GLP-1RAs off-label for weight loss.

Methods: Websites were identified by searching Google and Yahoo! by using keywords related to GLP-1RAs and weight loss in August 2024. The quality of information on these websites was assessed using the DISCERN instrument. To comply with Japan's medical advertising guidelines, we evaluated whether the 5 mandatory items for advertisements of self-paid medical treatments involving the off-label use of drugs were stated and whether there were any exaggerated claims. The content of the exaggerated advertisements was categorized into themes.

Results: Of the 87 websites included, only 1 website stated all 5 mandatory items. Websites listing "ineligible for the relief system for sufferers from adverse drug reactions" had the lowest percentage at 9% (8/87), while 83% (72/87) of the websites listed exaggerated advertisements. Approximately 69% (60/87) of the websites suggested that no exercise or dietary therapy was required, 24% (21/87) suggested that using GLP-1RAs is a natural and healthy method, and 31% (27/87) of the websites provided the author's personal opinions on the risks of using GLP-1RAs. The mean total DISCERN score for all 87 websites was 32.6 (SD 5.5), indicating low quality. Only 1 website achieved a good rating, and 9 websites were rated as fair. The majority of the websites were rated as poor (72 websites) or very poor (5 websites).

Conclusions: We found that the quality of information provided by the websites of medical institutions prescribing GLP-1RAs off-label for weight loss was very low and that many websites violated Japan's medical advertising guidelines. The prevalence of exaggerated advertisements, which may lead consumers to believe that they can lose weight without dietary or exercise therapy, suggests the risk of GLP-1RA misuse among consumers. Public institutions and health care providers should monitor and regulate advertisements that violate guidelines and provide accurate information regarding GLP-1RAs, obesity, and weight loss.