Good morning. Welcome to Axios today. It's Wednesday, February 15th. I'm Nyla Boudou.

Today, last week's earthquake becomes Turkey's deadliest in 100 years.

Plus, human intervention is keeping manatees alive in Florida, but for how long?

But first, hyped weight loss drugs are raising supply and equity concerns.

That's today's one big thing.

In 2022, more than 5 million prescriptions were written for diabetes drugs like ozembek to be used for weight loss.

That's up from about 230,000 in 2019. The demand spiked because of social media influencers and celebrities touting the benefits.

But the widespread off-label use of these diabetes drugs is raising concerns about cost and shortages.

Axios' Tina Reed has been covering the story. Tina, how did drugs like ozembek work for weight loss?

So these are a class of drugs that are known as glucagon like peptide-1 egnus or GLP-1s for short.

And they are basically drugs that mimic a hormone in the body that can regulate appetite and blood sugar levels.

These drugs were initially approved by the FDA for use in type 2 diabetics with the side-effective being able to help people lose weight.

They were so effective in helping people lose weight that they were later approved in a different formulation that was also approved by the FDA for weight loss.

And how did it gain popularity for people who don't have diabetes to use it?

So this actually became one of Hollywood's worst kept secrets and a lot of doctors in general actually were so impressed by the safety profile of these drugs and their effectiveness that a lot of not endocrinologists were actually starting to prescribe these.

They got really popular on social media that's played a large role with people posting stories about their weight loss with before and after photos and touting their benefits.

So some of those before and after photos also talk about this so-called ozemic face people get.

Yes, essentially people have lost weight so quickly that it almost creates a facial drooping, a gaunt look in the face.

People have talked about this actually being a bit numbing in their face and kind of a weird sensation.

This is just one of the side effects that can be quite disturbing for people on these, they can cause nausea, diarrhea.

So these drugs are not without side effects when people are taking them.

They're also expensive. Ozemic can cost up to $1,400 a month out of pocket without insurance.

...