Are your patients getting GLP-1s online without telling you?

Increasing numbers of patients are taking glucagon-like peptide 1 (GLP-1) receptor agonists solely for weight loss, and many aren’t telling their doctors.

According to a recent KFF poll, 12% of adults say they have taken a GLP-1. Of that group, 62% said they took the drug to treat a chronic condition such as diabetes or heart disease — either alone (39%) or in combination with losing weight (23%) — and 38% said they took the drug solely to lose weight. While most patients taking a GLP-1 (79%) said they received the prescription from their primary care or other physician, nearly 1 in 5 reported getting the prescription from another source: an online provider or website (11%), a medical spa or aesthetic medical center (10%), or somewhere else (2%).

In a separate survey by Omada Health in partnership with Sermo, more than two-thirds (67%) of primary care physicians expressed concern about patients accessing GLP-1 prescriptions for weight loss through a third-party telehealth provider, saying it may put their patients' health at risk. Their concerns were categorized as follows:

• Overprescribing (clinically inappropriate prescribing): 56%
• Compromised continuity of care (e.g., follow-up visits, titration, tapering off medication): 50%
• Lack of complete medical history: 47%
• Medication interactions and/or side effect management: 43%
• Lack of transparency to the patient’s broader care team: 32%
• Prevalence of compounded GLP-1s/GIPs: 32%
• Lack of holistic support of weight management: 24%

Researchers have raised marketing and safety concerns about compounded and counterfeit GLP-1s, and the FDA recommends that patients "obtain a prescription from their doctor and fill the prescription at a state-licensed pharmacy." However, patient demand for these drugs is likely to persist due to their significantly lower costs. The FDA has said it will allow compounding to continue at least in the short-term, even as GLP-1 shortages resolve.

Given the rise of telehealth-provided GLP-1s, what can physicians do to protect patient safety?

1. Encourage open communication with patients.

In addition to conducting regular medication reconciliation to identify what prescription medications, non-prescription medications, and supplements a patient is taking, take steps to build trust and rapport. Assure patients they can be open and honest with you about their health concerns and any medications they might be taking or considering. Look for teachable moments during patient interactions, and use non-judgmental language to engage them.

2. Educate patients.

Emphasize the importance of obtaining prescriptions from a trusted physician who knows their health history and can provide comprehensive, ongoing care. You may also need to educate patients on the potential dangers of health-care influencer marketing. If patients still choose to use an online provider or pharmacy, the FDA’s BeSafeRX campaign offers tips for patient safety and a database of state-licensed pharmacies.

3. Provide ongoing care. 

Patients taking GLP-1s via an online provider may still need your help managing side effects, monitoring comorbidities, making behavioral changes, or changing medications due to price, supply, or other reasons. To provide adequate time and support for these issues, consider offering weight-prioritized visits.

Posted on March 3, 2025, by FPM Editors