Telehealth companies offering GLP-1 weight loss drugs face scrutiny over patient screening and monitoring
Telehealth companies prescribing GLP-1 weight loss drugs face intensifying scrutiny over inadequate patient screening and monitoring, with medical experts and regulators citing dosing errors and safety risks.
Objective Facts
Marc-Andre Cornier, an endocrinologist at the Medical University of South Carolina and the immediate past president of The Obesity Society, said not all telehealth companies are adequately evaluating patients before writing prescriptions. Patients with a history of pancreatitis should be counseled about potential complications, as should people with gastroparesis or those susceptible to medullary thyroid cancer, and some patients may benefit from blood work or muscle mass screening before starting a GLP-1. A KFF Health News analysis of the FDA's Adverse Event Monitoring System found medication errors with weight loss drugs exploded from just over 2,000 reports in 2020 to more than 25,000 in 2025, with frequent issues including administration of an extra or incorrect dose, communication problems, and prescribing errors. Patient Karleigh McClain of Hendersonville, Tennessee, was hospitalized after her telehealth provider prescribed her to inject nearly nine times the typical first dose of semaglutide. FDA Commissioner Martin Makary called the FDA's moves against pharmaceutical advertising creating misleading impressions an "action to correct decades of regulatory failure."
Left-Leaning Perspective
Medical experts and patient safety advocates emphasized regulatory gaps and compounding safety concerns. In coverage by KFF Health News and medical journals, regulators and clinicians highlighted the lack of FDA oversight: ingredients for compounded drugs are commonly sourced from overseas suppliers and not reviewed by the FDA for safety, with one expert describing the environment as "very much uncontrolled and poorly, if at all, regulated." FDA Commissioner Martin Makary, in a September 2025 JAMA Network Viewpoint, called FDA enforcement against misleading pharmaceutical advertising an "action to correct decades of regulatory failure." A physician survey found two-thirds of primary care doctors agreed telehealth GLP-1 prescribing may put patients at health risk, with top concerns being overprescribing and poor continuity of care including follow-up and medication tapering. The regulatory argument centers on inadequate screening and monitoring standards. Telehealth companies have not historically followed the same rules as drugmakers in disclosing medication risks in advertisements, though the FDA has started cracking down on misleading drug ads. An HHS spokesperson stated compounded drugs "should only be used in patients whose medical needs cannot be met by an FDA-approved drug." The left emphasizes systemic patient safety failures and the need for stronger oversight of direct-to-consumer telehealth marketing. Coverage from regulatory and medical sources largely omits discussion of access barriers—many uninsured or underinsured patients turn to telehealth because brand-name GLP-1s cost thousands monthly. The focus remains on regulatory failures rather than the insurance and healthcare access problems that drive telehealth demand.
Right-Leaning Perspective
The business and pharmaceutical industry perspective focused on compounded drug knockoffs and competitive distortion. Eli Lilly spokesperson Michael Jamison said telehealth companies sued by the drug manufacturer threaten "patient safety by falsely promoting supposedly 'personalized' compounded tirzepatide" and mislead "consumers about the safety, clinical testing and effectiveness of their compounded knockoffs." Novo Nordisk stated it has filed 130 lawsuits against "entities engaged in unlawful marketing and sale of knockoff semaglutide drugs" and is committed to "protecting patients from unapproved knockoff drugs made with foreign, inauthentic active pharmaceutical ingredients that pose significant safety and efficacy risks." The Trump administration sent warning letters in September and February to online companies such as Hims & Hers, SkinnyRx, Join Josie and Genesis Health International. The right-framing emphasizes legal enforcement and intellectual property protection over prescribing standards. When asked about the FDA warning, Hims & Hers pointed to a March statement announcing a shift away from compounded weight loss drugs and entry into an agreement with Novo Nordisk to sell name-brand versions. Alex Smith, CEO of Join Josie, said his company made changes in response to FDA letters, including removing Join Josie's name from medication vials, stating "because you don't want patients thinking you're the compounding pharmacy." The framing treats regulation as enforcement against illegal "knockoffs" rather than a systemic screening and monitoring deficiency. Right-leaning business coverage emphasizes regulatory hostility to telehealth innovation and compounding market disruption. Commentary noted that while Hims's "agility and first-mover advantage in telehealth-driven weight loss are commendable," the "regulatory environment is increasingly hostile." This perspective downplays specific patient screening failures as individual company compliance issues rather than structural problems with the telehealth model.
Deep Dive
The story's core tension reflects a gap in telehealth regulation that predates the GLP-1 boom. While the first GLP-1 was approved by the FDA more than 20 years ago to treat Type 2 diabetes, use of these drugs for weight loss took off in 2021 when Novo Nordisk received approval for semaglutide under the brand name Wegovy. By 2025, nearly 1 in 5 U.S. adults said they had taken a GLP-1. The demand outpaced supply and insurance coverage, creating conditions where telehealth companies could scale rapidly. The foundational problem Marc-Andre Cornier identified is that no government agency or medical society has written criteria to determine which providers are treating patients appropriately and which aren't. Both perspectives contain valid points: Medical experts correctly identify that some telehealth prescribing lacks rigorous pre-prescription evaluation and follow-up monitoring, evidenced by 25,000 medication error reports in 2025 versus 2,000 in 2020, with frequent issues being incorrect dosing and communication failures. Telehealth advocates, however, note that branded GLP-1 drugs are costly for uninsured patients, and compounded versions provide more affordable access despite not being identical, explaining why patients seek telehealth options. The regulatory response under the Trump administration focused on warning letters and enforcement against what it characterized as unlawful marketing and knockoff products. Yet enforcement against deceptive marketing does not directly solve the screening and monitoring problem that medical experts emphasize. Moving forward, the key unresolved question is whether telehealth GLP-1 prescribing will develop standardized patient screening and monitoring protocols that both improve safety and maintain access, or whether regulation will push prescribing back to traditional medical channels where insurance barriers and provider reluctance limit access for uninsured patients. Some evidence-informed telehealth programs in 2026 are increasingly integrating scheduled check-ins, symptom tracking, and monitoring plans with GLP-1 prescriptions, suggesting the possibility of hybrid models. The FDA's enforcement actions signal tightening scrutiny, but neither the agency nor industry has yet established uniform screening standards.