Retatrutide, the most powerful weight-loss drug in development, is not expected to hit the U.S. market before next year, at the earliest. But Adil Kalam, a 37-year-old in Brooklyn, already has 20 vials of it in his freezer.
Mr. Kalam used Bitcoin to purchase the drug from an online retailer selling $99 vials labeled “for research purposes only.” His first order arrived in a cardboard box, the vials of powdered medication packaged in bubble wrap.
“It didn’t really inspire confidence,” Mr. Kalam admitted.
Mr. Kalam and eight of his friends order the drug in bulk. He understands that there is a risk in taking a drug that has not been approved by the Food and Drug Administration. But he didn’t want to wait for the regulatory process to play out if he could take it sooner.
Mr. Kalam is tapping into a thriving black market for retatrutide, a peptide medication developed by Eli Lilly. On social media, influencers and medical spas advertise the drug using code words like “ratatouille” for retatrutide or “peps” for peptides to skirt restrictions on advertising drugs online. More dedicated users buy in bulk from China, trading recommendations for sellers over conversations on Reddit, Discord and WhatsApp, and pooling their resources to get third-party testing.
There are no clear estimates of how big this market is, but the information experts do have suggests it is sizable. An analysis of F.D.A. data by the Partnership for Safe Medicines, a nonprofit coalition linked to the pharmaceutical industry, showed that 15 pounds — perhaps hundreds of thousands of doses — of retatrutide have flowed into the country between January and April 2026. Some of those doses may have been shipped to scientists studying the drug. But a portion of that is probably going to the illicit market, said Shabbir Imber Safdar, the executive director of the nonprofit.
“The bottom line is, the demand is fully there,” said Timothy Mackey, a professor at the University of California San Diego who studies counterfeit medications. “And there are lots of ways to get it.”
Eli Lilly has warned that products claiming to contain retatrutide may be contaminated or contain other substances entirely. “Any claim that black market retatrutide is the same as Lilly’s genuine medicine as studied in clinical trials is false,” Michael Jamison, a spokesman for the company, wrote.
A Murky Marketplace
The black market for retatrutide is an extreme example of consumers flouting the traditional medical system to get their hands on potent new weight-loss drugs. Millions of people have sought out unapproved compounded versions of these drugs from telehealth companies and medical spas as they look for cheaper and more accessible alternatives to brand-name versions.
While there is no way to fully capture who is seeking out retatrutide online, customers for the drug seem to include people looking to lose more weight than they can with drugs already on the market, as well as bodybuilders and biohackers who also use other peptides.
Many of the people taking what they believe to be retatrutide buy it from online storefronts, which list the drug as a research chemical that is not for human use — a disclaimer that may let them take advantage of a loophole in drug regulation.
These websites often ship the drug as a powder that customers prepare and inject.
Other users buy the drug from WhatsApp, Telegram and Discord groups. In one Telegram chat, a user posted dozens of videos a day showing a fridge stocked with vials for sale. In another Telegram group, this one with over 1,400 members, users replied to messages showing boxes that claimed to contain retatrutide and asked whether they could pay in Bitcoin.
These groups are often run by middle men who place bulk orders of what they say is retatrutide, typically from Chinese labs, and then repackage it or use it to fill empty injection pens, said Luke Turnock, a senior lecturer in criminology at the University of Lincoln in England who studies peptides. Some sellers add their own branding and logos, like illustrations of molecules, that give a scientific sheen to their products.
Some people have even bought these medications from health providers. In April, a federal grand jury indicted a Utah physician who had allegedly sold vials of retatrutide and other peptides to more than 200 patients. According to the indictment, that doctor made his own labels and did not disclose to patients that the medications had been ordered online from a company in China.
In some cases, patients have been able to fill prescriptions from providers at compounding pharmacies. The F.D.A. has warned companies that make drug ingredients to stop selling retatrutide to compounders. The agency cited one of those companies for unsanitary conditions, including “black chunks” in some of its pharmaceutical ingredients.
Investigators have tried to contain the flood of illicit retatrutide. Between December 2025 and March 2026, customs agents in Ohio caught more than 5,000 shipments of peptides, including retatrutide, smuggled in from China. But border agents can only examine a fraction of the packages that come into the country, said Dan Burke, who previously served as chief of the Investigative Services Division in the F.D.A.’s Office of Criminal Investigations.
Easy Access, Little Certainty
The traditional process to get a drug approved by the F.D.A. takes years. Beyond clinical trial results, the agency reviews the drug’s ingredients and manufacturing process, including how the drugmaker plans to ensure the medicine is made safely. Investigators also inspect the facilities that will make the new drug. By the time a medicine makes it to market, doctors, statisticians, toxicology specialists and other experts have rigorously examined it.
People ordering retatrutide online, by contrast, have few ways of knowing whether they are getting the actual drug, or whether it’s sterile and safe to take.
There are a number of third-party labs that now market their services to test retratrutide and other peptides, charging hundreds of dollars to analyze a single sample. Some of these labs are legitimate, Mr. Burke said. But others are less legitimate — and more akin to “someone that does this on the side in their basement,” he said.
Mr. Jamison, the spokesman from Eli Lilly, said that proving that two drugs contain the same active ingredient required exhaustive testing, “not just the rudimentary tests commonly reflected on so-called ‘certificates of analysis.’”
Dr. Mackey said that some websites claiming to offer retatrutide might just be sending vials of other weight-loss drugs that are currently on the market, like semaglutide. It’s also possible that labs are making retatrutide, since the molecular structure of the drug is publicly available, Dr. Turnock said. But the average buyer is not using a testing service to confirm that, he added.
“Unless you actually went to China and went to these labs, probably, you’d have no way of knowing,” he said.
Even if a vial does contain retatrutide, the dearth of oversight means there are a number of other risks that can arise. The drug could be contaminated, or contain an incorrect dose.
An F.D.A. database showed that 40 people have reported having adverse reactions to retatrutide since 2024, including cardiac issues, appendicitis and blurred vision. Of these patients, 14 were hospitalized, and four were described as having “life-threatening” responses.
Jacob Hanzel, 31, has been buying what he believes is retatrutide from a WhatsApp group since last year.
Mr. Hanzel first tried to get retatrutide in a clinical trial. When he wasn’t successful, he started shopping online. He felt he desperately needed to lose a significant amount of weight. When he started taking the drug, he weighed 447 pounds.
Mr. Hanzel has asked his doctor to regularly check his heart rate, blood sugar level and other bloodwork to make sure there are no warning signs of issues from the drug. Rather than “blindly trusting” the seller, he said, he also sends every batch to a lab to make sure it is pure, dosed correctly and doesn’t contain heavy metals.
“I was willing to take this risk,” he said. “While knowing it’s still a risk.”
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