A secret shopper from Yale found it's easier than ever to get GLP-1s from telehealth companies

A group of Yale University researchers wanted to figure out how easy it is to get a prescription for a GLP-1 for weight loss.

It's easier than ever to get a prescription for a GLP-1 for weight loss - but that's not necessarily a good thing.

A Yale University researcher posed as a "secret shopper" and contacted 49 websites that prescribe official weight-loss drugs like Eli Lilly's $(LLY)$ Zepbound or Novo Nordisk's (DK:NOVO.B) (NVO) Wegovy or compounded versions of those medications. He ended up with 45 prescriptions, including 34 that were mailed to him.

According to the research letter, published Monday in JAMA, only one-third of the sites required the shopper to meet with a clinician, in person or by telehealth, before prescribing one of the medications; at least two compounded prescriptions were issued within five minutes; and three clinicians wrote prescriptions for him on two or more sites.

The findings added to the concerns that some critics have raised about compounding pharmacies and telehealth companies, which they say are too quick to prescribe. Some of these platforms have become key players treating the millions of Americans taking GLP-1s to lose weight, and they have helped democratize access to GLP-1 medications, which provide health benefits far beyond weight loss. Even Lilly has said that 80% of prescriptions for the Foundayo GLP-1 pill come through LillyDirect, its own telehealth platform, or through other telehealth services. Many telehealth companies and compounding pharmacies say they have strict prescribing rules in place.

"While direct-to-consumer platforms have increased patient access to GLP-1 receptor agonists, these findings suggest that some do so through impersonal care that prioritizes quick prescriptions over comprehensive care," the researchers wrote.

Given that only one "shopper" was involved, the research has its limitations, but it does raise questions about how easy it is for patients to obtain these medicines without the kind of clinical oversight that could help patients address common side effects like nausea or constipation, rapid weight loss or muscle loss.

These drugs have side effects that can be serious for some patients, and clinicians should have a full understanding of the patient's health history before prescribing them, experts say. Plus, about one-third of the compounded drugs had added ingredients like vitamin B-12, which have not been studied in clinical trials. In fact, an analysis that Lilly previously conducted found that adding vitamin B-12 to compounded Zepbound created a "previously unidentified impurity."

Adding additional ingredients is how companies that make compounded GLP-1s have skirted the law when those medicines are not in short supply. When a drug is listed on the Food and Drug Administration's shortage list, it can be legally compounded to fill the supply gap.

"Limited clinician engagement, especially when prescribing compounded GLP-1 receptor agonists with uncertain safety, efficacy, and quality, may increase risks of medical and financial harm," the researchers concluded.

The risk of financial harm is another consideration for patients. Just because they can get a prescription doesn't mean they'll be able to afford it in the long run, especially if it's less effective than it should be.

The market for weight-loss drugs in the U.S. doesn't function like a traditional pharmaceutical category, like asthma or Type 2 diabetes. Many patients trying to lose weight act more like consumers, willing to bypass the health-insurance system and put down their own credit cards to pay hundreds of dollars a month for these drugs for the foreseeable future.

-Jaimy Lee

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July 07, 2026 14:14 ET (18:14 GMT)

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