Electronic word-of-mouth and off-label use of Ozempic and other GLP-1 medications.

Obesity is widespread in the U.S., and off-label use of GLP-1 medications like Ozempic for weight loss is rising. This study applies the Health Belief Model to analyze electronic word-of-mouth (eWOM) on social media related to GLP-1 medications and proposes a conceptual hybrid model for co-creation in social networks. A reflexive thematic analysis of three YouTube videos by patient influencer @TheHangryWoman and 3,748 corresponding comments was conducted, revealing that eWOM intensifies fears around obesity and promotes GLP-1 benefits like appetite suppression, weight loss, and improved body image. Users also share strategies of how to navigate barriers such as cost, side effects, and medication shortages. The findings show how eWOM and algorithms drive awareness and may normalize off-label use, raising concerns about misinformation and public health risks. This research contributes to health behavior theory in digital contexts and highlights the need for critical engagement with unregulated information online.