Woman’s Nightly Kitchen Raids Lead to Weight Loss Drug Experimentation
Aileen Maritato concealed a peculiar nightly habit.
Each night, she would retire to sleep, only to awaken the following morning and find her kitchen in disarray, littered with remnants of late-night snacks – much to the bewilderment of her husband.
Suspecting he was not the culprit, her husband initiated a discreet observation of his wife’s nocturnal activities.
Uncovering Nocturnal Eating Habits
He observed that around 3 am each night, the 60-year-old mother of two would quietly descend to the kitchen and consume any edibles within reach, ranging from peanut butter sandwiches to Goldfish crackers and even blueberries.
Remarkably, she possessed no recollection of these episodes.
While not formally diagnosed with a specific sleep disorder beyond insomnia, Maritato suspects she suffers from nocturnal sleep-related eating disorder (NSRED), a parasomnia characterized by abnormal behaviors during sleep, estimated to affect approximately five percent of American adults.
To address her sleep and mood disturbances, she was prescribed the sedative Ambien and an antidepressant. However, her eating habits had already taken a toll.
Seeking Weight Loss Solutions
Frustrated by the weight gain on her petite 5’2” frame resulting from these nocturnal binges – reaching approximately 150 lbs – she resolved to take decisive measures to reduce her weight.
Aileen Maritato, 60, incorporated regular walks, a healthy diet, and weekly semaglutide injections, yet struggled to lose weight
At 5’2” and approximately 145 lbs, Mrs Maritato’s BMI of 28 fell short of the insurance requirement for weight-loss injection coverage, necessitating private purchase.
She adopted a regimen of nearly two-mile walks with her dogs every other day, increased her intake of whole foods, and, crucially, began weekly injections of a compounded semaglutide formulation – informally termed ‘Frankenzempic’.
Semaglutide is the active component in the weight management medications Ozempic and Wegovy, categorized as GLP-1 drugs. These medications mimic a naturally occurring hormone, slowing gastric emptying to prolong satiety, regulating blood sugar, and suppressing appetite.
‘I ceased sleep eating around six months prior, yet my weight remained static. Consequently, I considered exploring compounded options, given the widespread success and weight reduction observed with GLP-1 medications,’ she disclosed to the Daily Mail.
Disappointing Results with Compounded Semaglutide
Despite her efforts, her weight showed minimal change.
‘I may have shed 2lbs in the initial month, but thereafter my weight plateaued,’ Maritato recounted.
This outcome starkly contrasted with the impressive results reported by celebrities, family members, and clinical studies, which often cite an average body weight reduction of 20 percent.
The underwhelming weight loss intensified the burden of side effects, including persistent stomach discomfort, nausea, and diarrhea.
Maritato now expresses concern that she might have been administering an ineffective substance, potentially produced in unregulated settings.
The Rise of Compounded GLP-1 Medications
She is among millions of Americans who are utilizing, or have utilized, ‘compounded’ GLP-1 medications.
Compounded medications are custom-formulated drugs prepared by specialized pharmacies, marketed as containing identical active ingredients to FDA-approved drugs like Ozempic and Wegovy. However, their specific formulations undergo no pre-market review by the FDA.
‘Frankenzempic’ and similar compounded versions typically are provided in vials, requiring patients to self-administer doses using syringes, unlike the pre-filled pens of brand-name drugs.
Compounding pharmacies often incorporate a diluent, such as sterile water, to achieve the desired concentration of the active ingredient. Buffer solutions maintain pH balance, while preservatives, such as benzyl alcohol, inhibit bacterial growth in multi-dose vials. Stabilizers and tonicity adjusters are also used to ensure drug integrity and compatibility.
Cost Savings vs. Regulatory Concerns
The primary advantage of compounded weight-loss formulations is their significantly lower cost compared to branded products like Ozempic, Wegovy, and Mounjaro, which can reach approximately $1,000 per month.
However, due to less stringent FDA oversight compared to brand-name drugs, compounded medications carry potential risks of adulteration or unauthorized modifications. The FDA also lacks direct supervision over their preparation environments and methods.
Disturbingly, Novo Nordisk, the manufacturer of Ozempic and Wegovy, reports approximately 10 fatalities and 100 hospitalizations in the U.S. between 2018 and fall 2024 linked to off-brand, compounded semaglutide use.
Weight-loss injections are typically administered to the abdomen using a short needle and plunger-based dispensing.
Maritato obtained a compounded combination of semaglutide and tirzepatide (Mounjaro’s active ingredient) through an online platform known for distributing compounded generic Viagra. The platform has not responded to requests for comments.
These non-branded vials cost around $400 monthly, significantly less than the $1,200 for branded pre-filled pens.
While the medication seemed to curb Maritato’s appetite, she suspects her drastically reduced food intake may have slowed her metabolism.
‘I am not a large eater,’ she stated. ‘I probably consume around 800 to 1000 calories daily. Increased physical activity might have facilitated weight loss.’
Potential Placebo Effect and Weight Loss Variability
Maritato also questions whether she received a placebo instead of the active medication.
‘I monitored my weight weekly, observing no significant fluctuations.’
Her weight remained consistently around 145lbs.
At 5ft 2 with a BMI of 28, Maritato qualified as overweight, not obese. Her target weight loss was approximately 15lbs.
She believes this factor may be relevant, noting that many individuals experiencing significant weight loss with GLP-1 injections were considerably heavier.
‘For someone aiming to lose 100 pounds, a year-long journey to success is understandable. However, for individuals seeking to lose just 20 or 10 pounds, the effectiveness appears diminished. Perhaps the medication’s efficacy correlates with metabolic rate or adipose tissue volume. But I lack the scientific basis for this,’ she speculated.
‘It felt almost like a placebo, yet I experienced side effects, though these could have been psychosomatic,’ she added.
Prevalence of Compounded Semaglutide Use
The precise number of Americans using compounded semaglutide and similar weight-loss medications remains uncertain. Estimates suggest up to 20 percent of semaglutide prescriptions, particularly during brand-name shortages, may be for compounded versions.
If up to 12 percent of American adults are utilizing these medications, this could represent over six million individuals.
Mrs Maritato discontinued the medication after three months, from August 15 to November 15, with no weight change observed.
GLP-1 Drugs: From Diabetes Treatment to Weight Loss Trend
Ozempic, a pioneering GLP-1 drug, was initially developed for individuals with Type 2 diabetes and obesity.
Its expanded application as a widely sought-after weight-loss solution – and the subsequent development of comparable drugs – is a more recent phenomenon, generating considerable public interest upon market introduction.
Affluent and prominent figures were among the first to recognize the potential of these drugs as a relatively effortless means to reduce excess weight.
This surge in demand led to prolonged shortages, hindering access for patients with legitimate medical needs due to supply constraints.
FDA Concerns Regarding Compounded Semaglutide
When compounding weight-loss formulations, pharmacists determine dosage and ingredients to ensure product uniformity.
However, in July 2023, the FDA reported numerous adverse event reports, some necessitating hospitalization, linked to dosage inaccuracies with compounded semaglutide injectables.
Dosing errors resulting in adverse reactions requiring hospitalization have been documented.
The FDA has raised concerns about certain compounding pharmacies utilizing salt forms of semaglutide, such as semaglutide sodium or acetate, which differ from the active ingredient in approved drugs and lack established safety and efficacy profiles.
Uncertainty and the Pursuit of Branded Medication
It is possible Maritato is among the estimated 20 percent of patients exhibiting limited response to these medications.
However, she believes that utilizing a branded version, such as Wegovy or Mounjaro, might have yielded better results.
‘I have not encountered instances of failure with brand-name medications obtained from pharmacies. This leads me to question the true effectiveness of off-brand alternatives,’ she expressed.
‘Despite my consistent routine, this medication had no discernible impact.’
‘The unregulated nature of production raises concerns. Unlike FDA-monitored quality controls, the sourcing and manufacturing processes of compounded drugs remain opaque,’ she concluded.
Insurance Barriers and Future Plans
Maritato attempted to secure access to a brand-name semaglutide medication, citing co-morbidities such as hypertension and kidney disease that would benefit from treatment.
However, her insurer, Blue Cross/Blue Shield, denied coverage because her BMI was marginally below the required threshold.
Amidst ongoing pressure to reduce medication costs and broaden access, Eli Lilly reduced the price of its GLP-1 Zepbound by nearly 50 percent in August 2024 to compete with compounded options.
It is now priced between $399 and $549 monthly, down from $1,059.
In November, the Biden administration proposed expanding Medicare and Medicaid coverage to include GLP-1s for weight loss, but the future of this proposal under President Trump remains uncertain.
Seeking Insurance Appeal
Aileen Maritato remains hopeful. This spring, she intends to consult her primary care physician – opting for a traditional medical setting over online pharmacies – to request an appeal of the insurance company’s denial.
A 2021 study indicated that approximately 49 percent of healthcare-related denial appeals are successful.
‘It’s undoubtedly worth pursuing,’ she affirmed.