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Expert Opinion - The Undisclosed Risks of Off-brand Ozempic and Other Weight Loss Products

The popularity -- and price -- of brand-name injectable drugs like Ozempic, Wegovy, Mounjaro, and Zepbound has skyrocketed. But the soaring demand for these drugs -- used for weight loss as well as to control blood sugar levels and reduce the risk of heart disease -- and the limited supply as well as lack of generic options has also led to a flood of non-brand alternatives in the market. In a recent article for The Conversation, UConn expert C. Michael White, Distinguished Professor of Pharmacy Practice, issued a warning to consumers about the potential undisclosed risks of these off-brand products: High demand is driving GLP-1 wannabes The dietary supplement market has sought to cash in on the GLP-1 demand with pills, teas, extracts and all manner of other products that claim to produce similar effects as the brand names at a much lower price. Products containing the herb berberine offer only a few pounds of weight loss, while many dietary supplement weight loss products contain stimulants such as sibutramine and laxatives such as phenolphthalein, which increase the risk of heart attacks, strokes and cancer. The role of compounding pharmacies Unlike the dietary supplements that are masquerading as GLP-1 weight loss products, compounding pharmacies can create custom versions of products that contain the same active ingredients as the real thing for patients who cannot use either brand or generic products for some reason. These pharmacies can also produce alternative versions of brand-name drugs when official drug shortages exist. Since the demand for GLP-1 medications has far outpaced the supply, compounding pharmacies are legally producing a variety of different semaglutide and tirzepatide products. These products may come in versions that differ from the brand-name companies, such as vials of powder that must be dissolved in liquid, or as tablets or nasal sprays. Just like the brand-name drugs, you must have a valid prescription to receive them. The prices range from $250-$400 a month – still a steep price for many consumers. Compounding pharmacies must adhere to the FDA’s sterility and quality production methods, but these rules are not as rigorous for compounding pharmacies as those for commercial manufacturers of generic drugs. In addition, the products compounding pharmacies create do not have to be tested in humans for safety or effectiveness like brand-name products do. Proper dosing can also be challenging with compounded forms of the drugs. Companies that work the system For people who cannot afford a compounding pharmacy product, or cannot get a valid prescription for semaglutide or tirzepatide, opportunistic companies are stepping in to fill the void. These include “peptide companies,” manufacturers that create non-FDA approved knockoff versions of the drugs. From November 2023 to March 2024, my team carried out a study to assess which of these peptide companies are selling semaglutide or tirzepatide products. We scoured the internet looking for these peptide companies and collected information about what they were selling and their sales practices. We found that peptide sellers use a loophole to sell these drugs. On their websites, the companies state that their drugs are for “research purposes only” or “not for human consumption,” but they do nothing to verify that the buyers are researchers or that the product is going to a research facility. By reading the comments sections of the company websites and the targeted ads on social media, it becomes clear that both buyers and sellers understand the charade. Unlike compounding pharmacies, these peptide sellers do not provide the supplies you need to dissolve and inject the drug, provide no instructions, and will usually not answer questions. Peptide sellers, since they allegedly are not selling to consumers, do not require a valid prescription and will sell consumers whatever quantity of drug they wish to purchase. Even if a person has an eating disorder such as anorexia nervosa, the companies will happily sell them a semaglutide or tirzepatide product without a prescription. The average prices of these peptide products range from $181-$203 per month. Skirting regulations Peptide sellers do not have to adhere to the rules or regulations that drug manufacturers or compounding pharmacies do. Many companies state that their products are 99% pure, but an independent investigation of three companies’ products from August 2023 to March 2024 found that the purity of the products were far less than promised. One product contained endotoxin – a toxic substance produced by bacteria – suggesting that it was contaminated with microbes. In addition, the products’ promised dosages were off by up 29% to 39%. Poor purity can cause patients to experience fever, chills, nausea, skin irritation, infections and low blood pressure. In this study, some companies never even shipped the drug, telling the buyers they needed to pay an additional fee to have the product clear customs. If a consumer is harmed by a poor-quality product, it would be difficult to sue the seller, since the products specifically say they are “not for human consumption.” Ultimately, consumers are being led to spend money on products that may never arrive, could cause an infection, might not have the correct dose, and contain no instructions on how to safely use or store the product. Dr. C. Michael White is an expert in the areas of comparative effectiveness and preventing adverse events from drugs, devices, dietary supplements, and illicit substances. Dr. White is available to speak with media -- click on his icon now to arrange an interview today.

VP Debate Recap

Dr. Meena Bose, professor of political science, executive dean of the Public Policy and Public Service program, and director of the Kalikow Center for the Study of the American Presidency, was interviewed by WNYW Fox 5 to give a recap of the October 1 vice presidential debate between Tim Walz and J.D. Vance. Bose is a professor of political science, executive dean of the Public Policy and Public Service program, and executive director of the Kalikow Center for the Study of the American Presidency.

Ghoulish discovery: Exploring YouTube's role in the rise of belief in the paranormal

In recent years, YouTube has become an influential platform for various communities, notably for enthusiasts of the paranormal and ghosts. Paul Brewer, University of Delaware communication professor, set out to see how this happens and what we can learn from this in terms of how individuals perceive other messaging that may sit at the fringes of mainstream belief. During the 1990s, a big wave of research erupted on how media messages might influence people's belief in paranormal topics with popular television shows like “Alien Autopsy” and “Crossing Over with John Edwards.” A second wave of research occurred in the mid-2000s in response to cable television series such as “Ghost Hunters” and “Finding Big Foot.” Since then, the media landscape has evolved beyond traditional outlets like print, television and radio to include multimedia, such as YouTube, TikTok and other platforms. In his latest work, published in the journal Cyberpsychology, Behavior and Social Networking, Brewer looked beyond consuming paranormal television to include the use of social media, especially YouTube. “If you think about the paranormal, YouTube is a platform that seems like an especially plausible candidate to shape people's beliefs because seeing is believing—and it is a very visual storytelling medium,” said Brewer. "It’s not just a fun, kooky idea to study. About half the public believes in UFOs and almost half the public believes in ghosts and haunted houses, even though these phenomena aren't recognized by mainstream science." By way of example, Brewer pointed to a fictional documentary-style show that claimed the National Oceanic and Atmospheric Administration (NOAA) knew about mermaids and was hiding evidence for them, including real video footage. The show included disclaimers, but viewers ignored them, revealing an important detail about the power of belief. Brewer is available to speak more broadly on the topic and his findings. He can be contacted by emailing mediarelations@udel.edu.

Democrats Sue Georgia Election Board

James Sample, professor of Constitutional Law, appeared on Scripps News to discuss the lawsuit filed by the Democratic National Committee and Democratic Party of Georgia to block that state’s controversial ballot hand-count rule from going into effect in the upcoming presidential election. James is available to speak with media - simply click on his icon now to arrange an interview today.

Repairing Boeing's relationship with the FAA

The Boeing Corporation is the recognized pioneer in aviation and aircraft manufacturing, but significant quality control concerns have mounted in light of near disasters associated with Boeing's planes, including notably the Alaska Airlines door flying off in January. David Primo, professor of political science and business administration at the University of Rochester, is available to tackle some of the regulatory, crisis management and reputational questions related to Boeing's safety and production problems, including regaining the trust of the Federal Aviation Administration: “The challenge Boeing faces is how do they rebuild safety, rebuild the relationship with the FAA, but keep the business going? And that’s a very tough balancing act. The FAA is going to give Boeing much less in the way of the benefit of the doubt when it comes to the design of planes, which could very much constrain its production system. So it’s going to mean that planes might take a little longer to get off the production line and into the hands of airlines."

Hurricane Milton: Second major storm in two weeks could multiply danger on Florida's Gulf Coast

Now a Category 5 hurricane, Milton is making a beeline toward Tampa Bay and other parts of Florida's western coast. But it will also hit some of the same areas that Hurricane Helene decimated less than two weeks ago, amplifying the danger and need for an on-point disaster response. Experts in the University of Delaware's Disaster Research Center can talk about several facets of this developing situation: Jennifer Horney: The mental and physical impacts of multiple disasters; environmental impacts of disasters and potential public health impacts for chronic and infectious diseases. She can talk about both Milton and Helene – Horney is a native of North Carolina and has done fieldwork in the state. Victor Perez: Can talk about known environmental justice issues in the Gulf Coast region that interact with climate change impacts, like hurricanes. Sarah DeYoung: Conspiracy theories and misinformation during disasters; pets in emergencies, infant feeding in disasters, decision-making in evacuation and community cohesion. DeYoung is from western North Carolina and can draw parallels from Milton to Helene. Jennifer Trivedi: Can talk about long-term recovery after large scale events – including compounding events – as well as challenges during disasters for people with disabilities, vulnerable communities and decision making. Tricia Wachtendorf: Evacuation decision-making, disaster response and coordination, disaster relief (donations) and logistics, volunteer and emergent efforts, social vulnerability. James Kendra: Disaster response activities, volunteers, and emergency coordination. A.R. Siders: Expert on sea level rise and managed retreat – the concept of planned community movement away from coastlines and flood-prone areas and the "expanding bullseye" that is contributing to the rising disaster costs in the U.S. Shanjia Dong: Research looks at smart and resilient urban systems; infrastructure systems, critical infrastructure protection, effective disaster preparedness and response, and equitable resilience planning and climate change adaptation. Joe Trainor: Post-storm housing decisions and insurance.

In the aftermath of Hurricane Helene - WCU's experts on the ground assisting

Hurricane Helene brought record levels of devastation, damage and death along America's eastern coast. Massive recovery efforts are underway and WCU's Lisa Briggs and her team were featured in an in-depth piece of coverage by USA Today. Lisa Briggs, director of emergency and disaster management at Western Carolina University, and Onna, a 6-year-old full German Shepherd, are pictured getting off the water craft. The pair is part of a search operation at the French Broad River deployed after the devastation caused by Hurricane Helene. Photo: Gaby Velasquez, USA TODAY 'Humbled by the river' Hampton and his crews are organized through the Madison County Sheriff’s Office, not FEMA. Finding bodies is one challenge — extracting them from the river is another, he said. Sometimes, the bodies are fastened to the boats and paddled to a safe opening in the shoreline, where they’re placed in body bags and driven over to county officials. Other times, the bodies need to be hiked out of a particularly dense stretch of wilderness. The dogs are trained and led by Lisa Briggs, director of the Emergency and Disaster Management program at Western Carolina University and a regional leader in training cadaver dogs. At the start of the day, she gave a command, "Hunt up!" and Onna, the cadaver dog, excitedly pranced toward the raft. At a shoreline littered with downed trees, roof siding, and shards of ripped clothes, Onna crisscrossed the sandy area, squeezing between branches and passionately sniffing the ground. Later, she jumped back in the raft and the team drifted downriver. On that day, Hampton’s raft covered the right shoreline while another of his rafts with his twin brother, Jack, and other volunteers covered the left. They paddled and drifted down more than five miles, until around 5 p.m., when they pulled the boats. It was a rare day: No bodies were found.  October 07 - USA Today Onna, a 6-year-old full German Shepherd cadaver dog, gets off the shaft to sniff the ground along the river during a search and rescue operation at French Broad River on Friday, Oct. 4, 2024, in the aftermath of flooding caused by the remnants of Hurricane Helene. Photo: Gaby Velasquez, USA TODAY The work of the WCU team has been tremendous - and if you are interested in learning more about the role of cadaver dogs, how they are trained or the other work Lisa Briggs is taking on at Western Carolina University - then let us help with your coverage. Lisa Briggs is the director of WCU’s emergency and disaster management program. She is available to speak with media any time - simply click on her icon now to arrange an interview today.

DIY’ing Grief: How Modern Memorials Help Us Navigate the Death of Loved Ones

Americans really don't want to talk about it: Everyone dies, and everyone will experience the death of a loved one. Grief is a universal human experience – and a very challenging one – with its range of difficult emotions and processes. Baylor University researcher Candi Cann, Ph.D., has made it her life’s work to study death and dying. In fact, the associate professor of religion in the Baylor Interdisciplinary Core, is known as a “death scholar,” with media outlets ranging from NPR’s Science Friday to the Washington Post seeking her expertise about the impact of remembering (and forgetting) in shaping how lives are recalled, remembered and celebrated. Cann is the author of “Virtual Afterlives: Grieving the Dead in the Twenty-first Century,” and her research on modern grief has found that some Americans – in a move away from organized religion – have lost the grieving framework that prayer and Christian practices traditionally offered. She calls that framework the “syntax of grief” – the common language once rooted in religious practices – that has evolved over the generations, prompting people to seek more personal ways of expressing grief and memorialization customs. “This new language of mourning is being defined by the culture, rather than religious ritual,” Cann said. “And these new practices are emerging at the grassroots level in response to a popular need to express grief through more personal expressions in almost a do-it-yourself or DIY approach.” These DIY or modern remembrances – such as virtual memorials, tattoos and using cremains in creative ways – can help individuals navigate the grieving process. Virtual memorialization With contemporary grieving practices shifting from the physical to the online world, Cann said these virtual memorialization spaces, such as social media and memorial websites, are just as real and meaningful as physical spaces and can offer a shared space for more people to share in their grief. For example, Cann said funeral services have evolved to incorporate digital services such as a virtual memory page or guest book or live-streaming wakes. Social media profiles and websites are created as virtual locations for people to remember and mourn those who have died. “The internet can democratize grief. It allows people a way to have these conversations about the dead that they may not be able to do on an everyday basis,” Cann said. “You know, you’re at work and you’re grieving, but it’s not really an appropriate conversation. In this way, you can go online and leave a message and find a community of people who are also grieving with you.” Tattoos Tattoos have become a popular way for individuals, especially younger people, to carry their grief with them, Cann said. The inked images can function as a badge or emblem for the person, they tell stories, honor meaningful moments and allow people to carry their grief with them in both literal and virtual ways. "Tattoos allow people to occupy the space as a mourner, while also continuing to carry on with their everyday activities. Many people get tattoos to symbolize their first loss, like their grandparent or pet,” Cann said. “Though the body has disappeared, is remapped onto living flesh to become a symbol of mourning in a world where mourning is denied.” Use of cremains A growing trend is incorporating cremains (cremated remains) into various objects like tattoos, jewelry, records or even fireworks. This practice offers a portable and customizable way to keep a connection with the deceased, which is not an option with burials, Cann said. “Cremation has become much more widely accepted and much more widely practiced because it's cheaper, more economical, but also because of the options of what can be done with cremains in memorial,” Cann said. “Cremains are portable and divisible, so you can share them with other people. Plus, you can carry them in ways that disguise the fact that they are ashes, such as putting cremains in a locket.” The conversation These more personal expressions and do-it-yourself solutions to memorialize a death allow people to find places where they can feel and experience their grief more readily and move from the loss into a place of restoration, Cann said. While death is complete and universal, finding ways to grieve – from the traditional to the contemporary – helps process the loss, but it’s just as vital to have that difficult conversation about preparing for the death of loved ones. “I encourage everyone to have difficult conversations about death and discuss your wishes with your loved ones about what you want when you die,” Cann said. “Allowing death to be part of regular discussions can help your family and your friends deal with their sorrow when you die because the everyday practical matters of sorting through your estate or figuring out what you would have wanted are not compounding the grief. Talking about death is ultimately and way to show how much you love someone.” Looking to know more? We can help. If you're a journalist interested in speaking with Candi Cann, simply click on her icon now to arrange an interview today.