How Ozempic infiltrated the queer community – and why off-brand diet drugs are replacing it

Why is Ozempic so popular among the queer community?

While there is limited research into Ozempic’s impact on the LGBTQIA+ community (shocker!), the connection is obvious when we look to queer pop culture. Celebrity drag queens Trixie Mattel and Katya have discussed the rise of queer Ozempic on their podcast, The Bold and The Beautiful, poking fun at the drug being “gay now” and expressing that “every [gay] they know is on Ozempic”. 

Some queer men using the weight loss tool call themselves “Ozempic daddies” on TikTok and the LGBTQIA+ artist Ari Dayan even created a song about Ozempic in 2023, ‘Ozempic Wegovy Mounjaro’, including lyrics like “I don’t care about my face, just a little tiny waist, put that shot in me” with the hashtag #prideanthem.

“Ozempic is as gay as listening to Charli XCX,” Malachi tells me. “I see so many TikToks that position [Ozempic] as an actual gay thing. I’ve seen so many drag shows poking fun at Ozempic and even been in gay bars where DJs play songs about it.”

At first, Ozempic worming its way into the LGBTQIA+ community might seem like no big deal. After all, plenty of straight people are taking it, right? But Dr Mark Perera, a London-based General Practitioner specialising in LGBTQIA+ care and best known as Instagram’s Doctor Gay UK, says there are “very high demands” for Ozempic from the LGBTQ+ community. Yet, he has concerns about queer peoples’ fascination with the drug.

Perera tells GAY TIMES that Ozempic works well for what it’s meant to do: it helps people who are overweight to lose weight. “The problem is a lot of LGBTQ+ people taking it are not an appropriate user for Ozempic.” Perera has seen a rise among his own patients of queer people – particularly gay men – requesting Ozempic when they’re already thin. “They want to either drop just a few pounds or they’re trying to maintain their thinness, [which isn’t what Ozempic is for],” Perera says.

“Ozempic is as gay as listening to Charli XCX.” 

26-year-old Dave, a dancer, is one of those“already-thin” Ozempic customers. “I started taking it because I just wanted to shift a few pounds and I really didn’t want to work that hard for it. All of my friends were taking it and said I had to get on it so… I did,” he explains. “It might seem like a dramatic measure for someone who is already thin but there’s a lot of pressure to maintain that, especially since I became single seven months ago, and it just seemed like the best option.”

Perera adds that some patients who are already a healthy weight want to get their hands on Ozempic so badly that they will “often try to falsify their measurements when they don’t meet the Body Mass Index (BMI) requirements to be eligible for it on prescription.” Multiple prescribers request either a photo of your body or a photo of the scale to show that you are the weight that you say you are, Perera notes, but patients simply lie when services don’t request evidence. There’s also not a lot in place to stop prospecting customers from using a photo of someone else’s body or scale results. 

Perera also says: “I know of both patients and personal [friends], who are accessing Ozempic from international prescribers in the Middle East where there’s more quantity and less regulation when they can’t get it in the UK.”

He believes this is, in part, due to the unrealistic body expectations in the queer community. This is true: when Attitude Magazine conducted a body survey in 2017, 84% of people said they felt under “intense pressure” to have a so-called “good body” and a study from the Journal of Eating Disorders tells us that gay, lesbian bisexual, and trans people are more likely to experience eating disorders than heterosexual and cisgender people.

What to know about Ozempic and bottoming 

Because of those pressures, queer people are uniquely positioned to be tempted by Ozempic. Yet, there’s an awful lot about the LGBTQIA+ lifestyle that just doesn’t mix well with the drug. An underreported side effect of Ozempic, for example, is the impact it can have on queer sex. Perera points out that for people with penises who enjoy receiving sex (i.e, a bottom), Ozempic is a complete nightmare.

Reddit is packed with panicked questions from queer users asking for advice on how to bottom while taking the drug. “You can’t, unless you’re into scat [a kink for faeces],” writes one Redditor, and although this was clearly written in jest, there’s, unfortunately, some truth to it.

“Medications like Ozempic have a huge side effect of gastrointestinal disturbance, which can be from the top-end like burping, nausea and vomiting, and the backend which is obviously flatulence and having a loose stool or diarrhoea,” Perera explains. For those reasons, he says anal sex and preparation techniques like anal douching become really difficult. 

It’s also more difficult to time when it’s best to have anal sex as your bowel habits will not be regular while taking Ozempic. “Some queer people follow a bottom- friendly diet [to avoid douching or just make things easier for anal sex] but this still won’t help. The side effects will occur regardless,” he advises.

35-year-old animation artist James tells GAY TIMES that he had to give up receiving anal sex when he started taking Ozempic, saying “there’s too much risk of having an accident” for him to even want to try it anymore. I also know it would basically be impossible. The [anus] area is constantly sore from going to the toilet so much that it sometimes hurts just to wipe. There’s no way I could douche, let alone take a dick,” he explains.

“It does suck because I’m not even a vers,” he laughs. “I pretend I am but I’m 100% a bottom through and through. I know not everything is about penetration and I’ve been doing other sex stuff with my partners but I do wish I could have anal sex.”

James, like many other gay men, desperately wants a hot body though and feels that Ozempic is the easiest way to get there. “I’m a twink and that comes with even more pressure to be tiny in my opinion – it’s a lot,” he says. “If I think about it too hard… I’m a bit ashamed that I chose being on Ozempic and getting the ideal body over sexual pleasure. Why am I missing out on sex I love?”

“The crazy thing is everyone just gets it,” James adds. “So many people in the LGBTQIA+ community are on Ozempic that I don’t have to say much more than “I’m on Ozempic” during Grindr hookups and they’re like ‘right, got it.’”

Unfortunately, the official medical advice for bottoming while on Ozempic is just… to not do it. Until you’re off of the medication, it’s a no-go. And while penetration certainly isn’t the be-all- or-end-all (according to one study, only around 40% of gay men have anal sex on the regular because of all the preparation involved), it has pretty drastic effects on queer people who do love anal sex.

Beware of Ozempic and unexpected chemsex interactions

Stomach disturbance isn’t the only way Ozempic could affect queer sex. It also has a profound impact on chemsex – referring to the use of illicit drugs to heighten sexual experiences. Jatinder Hayre, a medical doctor and health and social inequality researcher for NHS England, says chemsex already has its own health threats and is something the queer community is more likely to engage in.

Chemsex is associated – but not limited to – drugs like mephedrone, GHB, GBL, methamphetamine, cocaine and marijuana, and Hayre says the use of these drugs for sex is a complex and nuanced issue which requires “sensitive discussion to deconstruct and address”.

Each of these drugs come with their own host of effects (and side effects) but when we add Ozempic into the mix, the impact of those drugs becomes complicated. This is because Ozempic gets to work via the gut while we are eating, but also targets the brain. Interestingly, the drug has a different impact in each of those areas, and that changes the way that drugs affect us.

Hayre tells GAY TIMES that Semaglutide is part of a family of drugs called “CLP-1 agonists”, wherein they act on the brain’s chemical centres to reduce hunger and cravings. However, it does this by “acting along the gastrointestinal tract to increase insulin sensitivity, slow the GI tract and subsequent passage of food.”

This is how the drug reduces the fat absorbed from consumed food, and helps remove fatty tissue in the body. Research is still in its early days, but Hayre says “there’s a possibility semaglutide could reduce the stimulatory and psychological effects of drugs used in chemsex, similar to the way it dampens cues for food cravings.”

This means Ozempic could make it harder for you to feel high – which experts say could have a positive effect on addiction treatment much further down the line when more evidence is available – but it defeats the entire point of chemsex. 

As for the impact of mixing these drugs on the body specifically, Hayre says there’s a “scarcity of evidence”. With no extensive population studies, there’s no knowledge at all whatsoever of the potential harms. “There are some side effects of Ozempic including pancreatitis (inflammation of the pancreas) and palpitations, which overlap with some chemsex drugs, particularly cocaine, though it [occurs differently],” Hayre explains. However, whether or not this crossover is significant is unknown.

He adds that there is a “wealth of information we don’t yet understand about this intersection” and that, in itself, is concerning. “The medical advice is to never mix semaglutide with illicit substances, and to always seek medical guidance when introducing another medication alongside Ozempic,” Hayre says.

Ozempic and alcohol: a problematic cocktail

Additionally, Ozempic has a significant impact on alcohol tolerance. Perera explains that this is all down to calories. Ozempic reduces your appetite and fat intake which automatically means you’re consuming less calories on the drug. So when you drink alcohol, there isn’t enough inside you to cushion the alcohol’s blow. “It’s just like when you have a night out on an empty stomach and you get drunk very quickly,” he says. He adds that most alcohol itself is high in calories too, and the sudden influx after depriving yourself of them can dizzy Ozempic users.

This is something 32-year-old Angie who works in a gay bar in Manchester, hears at work all the time. “It’s become a running joke in the Manchester queer scene that all the Ozempic baddies have no tolerance whatsoever,” she tells GAY TIMES. If we see someone absolutely bladdered who needs our help, we will be like ‘ooo, Ozempic’.”

Of course, this means if you’re mixing alcohol and drugs, you’re going to experience very different effects from each: alcohol taking over and illegal drugs potentially barely hitting. That doesn’t exactly sound like a good time. Entering sex under this kind of state of confusion is also a recipe for disaster. With all kinds of sex – chemsex included – safe sex needs to be practised which not only includes regular sexual health screenings and/or condoms but potentially contraception and PrEP discussions.

So, regardless of what news you might hear about Ozempic’s safety levels, remember that the drug has not been manufactured or marketed with LGBTQIA+ people in mind and it’s simply too new and research too scarce to make any confident chemsex or partying calls.

With so little of the drug’s ramifications on queer people specifically being reported, its possible users could head into chemsex scenarios without this knowledge. Not knowing their drugs aren’t hitting as hard because of Ozempic could result in users increasing their doses, and with it their chances of harm.

Is Ozempic the new queer status symbol?

The expense of Ozempic – which retails at around £250 per month – also opens users up to other drug-related risks. Perera shares concerns that Ozempic’s pricey label has taken it from a mere medication to a status symbol.

Just recently, television personality Kelly Osbourne – who has recently made headlines for losing weight on Ozempic – was asked about the drug during an interview. She boldly claimed those who criticise it are “just jealous” because they “probably can’t afford it.”

Perera says positioning Ozempic as akin to a fancy car or designer watch can set a dangerous precedent. “A lot of gay people who can’t afford Ozempic but want that status symbol will use drugs like amphetamines and speed to lose weight instead,” he says.

“Most of my friends are not on Ozempic, but are on Ozempic’s uglier cousins.”

With social media offering more exposure to Ozempic, so many people in the queer community being on it and speaking to their friends about it, and the return of 2000s-style intense diet culture, Perera says there’s a huge pressure to access Ozempic – or something like it – at whatever risk.

He likens it to the Kate Moss era, when she famously said “nothing tastes as good as skinny feels” to the women’s fashion website WWD in 2009. There was a distinct yearning for skinniness, with people desperate to get celebrity-level skinny but couldn’t afford a lot of the stars’ expensive methods (liposuction or other cosmetic surgeries, for example) and would take drugs like speed instead, with even teenage girls partaking.

Dangerous Ozempic substitutes are taking grip

22-year-old Ciaran, an actor based in London, tells GAY TIMES that he takes speed to lose weight. “Ozempic is expensive as hell and speed basically does the same thing. My friend who is also an actor is on some unlicensed version of [semaglutide] that he gets from a mate. Most of my friends are not on Ozempic, but are on Ozempic’s uglier cousins.”

Perera says it’s not remotely safe to use speed or an unregulated or unlicensed version of Ozempic (which is likely to be an amphetamine anyway) to try to lose weight. He explains that people falsely view speed as a version of Ozempic, but “Ozempic is clinically produced, has gone through multiple phases of testing and is proven to be safe when properly prescribed to an appropriate user” – the same can’t be said for street drugs. Side effects of taking speed include, but aren’t limited to, increased blood pressure and nausea and long-term effects like changes to the brain, cardiovascular damage, malnutrition, anxiety and paranoia.

It’s possible that Ozempic could present as a gateway to less safe methods, and a renewed interest in diet fads among the queer community, such as taking diet pills, but Perera says it goes much deeper than that. Insidious diet culture intertwined with drug abuse and social pressures has long had a grasp on the queer community, and Ozempic is merely one version of that reality.

Malachi adds that, although he is taking it himself, he is “horrified” by the normalisation of Ozempic in the queer community. “It really does feel like a takeover, but it’s kind of an open secret. Everyone is talking about Ozempic, but not really discussing it. It’s a word we throw around, and obviously a drug lots of people are doing, but conversations about the effects and why so many of us are obsessed with it are simply not happening.” 

But with pharmaceutical companies and even some health professionals not always considering LGBTQ+ people and their specific lifestyles in drug manufacturing, marketing and prescribing, having these conversations with each other is more important than ever. 

Sluts, The Truth About Slutshaming and What We Can Do To Fight It by Beth Ashley (Penguin Random House) is out now.