Exploring Perspectives on Ozempic: A Netnographic Qualitative Evaluation of the Pro‐Eating Disorder Community on X (Formerly Twitter)

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OBJECTIVE: Eating disorders (EDs) are complex conditions with medical and psychosocial implications. Social media (SM) exposure has been associated with increased body image concerns and maladaptive eating behaviors. Pro-eating disorder (pro-ED) communities exist across SM platforms and often perpetuate ED-related identities and behaviors. As Ozempic gains prominence as a weight-loss medication, online discourse surrounding its use has grown considerably. This study aims to characterize attitudes and perspectives toward Ozempic within the pro-ED community on X. METHOD: Using netnography, publicly available tweets containing the terms "Ozempic" and "edtwt" posted between August 2024 and July 2025 were retrieved. Content analysis was conducted by two independent reviewers using an iterative, consensus-based approach to analyze naturally occurring online discourse without direct user engagement. RESULTS: The initial search yielded 451 tweets; after applying exclusion criteria, 255 were included in the analysis. Three main categories were identified: personal narrative, information sharing and risk warning, and attitudes and perceptions. Personal narratives reflected curiosity and information seeking (19.2%), desire or intent to use (11.8%), access (9.0%), and active use or experimentation (11.4%). Information sharing and risk warnings accounted for 3.5% of posts. Attitudes and perceptions included ethical and moral judgments (8.2%), normalization and cultural saturation (28.6%), and rejection and critique (8.2%). DISCUSSION: The findings demonstrate that Ozempic is actively integrated within pro-ED discourse on X, where discussions often normalize its use for weight loss and express sustained interest in its use. This highlights the need for greater awareness of how these medications are circulated within vulnerable online communities.

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