Off-label Semaglutide & GLP-1 weight-loss medicine use for anti-ageing: A Netnography of older bodybuilders’ experiences and understandings

• GLP-1 weight loss medicines are increasingly being used off-label for their perceived antiageing benefits. • Older bodybuilders suggest GLP-1s reduce inflammation, enhance subjective feelings of youthfulness, and allow them to train as they did when they were younger. • Bodybuilders' understandings of GLP medicines are informed by emergent scientific studies suggesting they are promising anti-ageing drugs. • Forum folk pharmacology encourages new forms of use based on indications from emerging scientific research. • Transitions away from drugs like HGH towards GLP-1s for anti-ageing may be harm reducing, in discouraging higher risk drug use in favour of comparatively safer medicines. GLP-1 weight-loss medicines (e.g. Semaglutide; Tirzepatide) are increasingly prevalent, with many users accessing these drugs off-label through the internet for lifestyle purposes. However, to date there has been little research examining their use for anti-ageing purposes. This article fills this gap by examining the perspectives and experiences of older bodybuilders on forums regarding their use of GLP drugs for anti-ageing. This research was a netnography of the two largest bodybuilding and steroid specific forums on the web, exploring 12,392 unique posts from the top 160 threads, captured in 2024. Qualitative thematic analysis of posts was undertaken. GLP drugs were felt to have a number of benefits for anti-ageing, longevity and general wellbeing. Many older bodybuilders took them for their anti-inflammatory effects, which allowed them to train despite age-related joint pain and general inflammation. Further, many bodybuilders highlighted emerging scientific research regarding GLP medicines’ potential benefits for anti-ageing more broadly, including brain and heart health, and improving insulin sensitivity when older. The role of ‘expert’ users on forums sharing findings from scientific research encouraged forms of use beyond existing clinical guidelines, but also facilitated harm reduction by encouraging forum users to switch from higher risk drugs like HGH and growth hormone secreting peptides to GLP medicines for anti-ageing. It is clear that anti-ageing is a significant motivator for GLP use among older bodybuilders, and public health policy must understand and acknowledge older users’ distinct motivations and approaches to use in order to best serve this population. The role of forum folk pharmacology in both encouraging unapproved therapies, but also enabling harm reduction through encouraging safer approaches to drug use is also important to understand when considering public health approaches to this population.