Telehealth GLP-1 companies face scrutiny over patient screening
Telehealth GLP-1 companies face renewed scrutiny over inadequate patient screening and dosing errors, with medical experts citing lack of standardized evaluation criteria.
Objective Facts
The rapid expansion of telehealth has facilitated increased access to GLP-1 weight loss medications, but has also led to a surge in medication errors, adverse events, and concerns about inadequate patient evaluation and follow-up. Dr. Marc-Andre Cornier, an endocrinologist at the Medical University of South Carolina and immediate past president of The Obesity Society, noted that not all telehealth companies are adequately evaluating patients before writing prescriptions, and that there aren't criteria written by a government agency or a medical society to determine which providers are treating patients appropriately. Medication errors have become severe—one patient received nearly nine times the standard initial dose, leading to hospitalization. The FDA announced issuance of 30 warning letters to telehealth companies for making false or misleading claims regarding compounded GLP-1 products offered on their websites.
Left-Leaning Perspective
Medical researchers and patient safety advocates have raised concerns about telehealth GLP-1 prescribing practices. Emory University psychologist Elizabeth Krupinski criticized telehealth companies for marketing weight-loss drugs as easy solutions while emphasizing healthy eating and exercise, noting that while they may follow the letter of the law, writing prescriptions while skipping proper care "is not in the Hippocratic oath." Physician Amanda Banks published research in The New England Journal of Medicine noting that the proportion of GLP-1 prescriptions written for people not meeting traditional obesity criteria increased from 4.5% in 2018 to 17% in 2023, calling this trend "troubling" and expressing concern that easy online access could exacerbate existing eating disorders or create new cases of anorexia. Both experts highlighted the absence of meaningful patient evaluation before prescriptions are issued. The concern centers on the structural incentive problem: telehealth companies offer quick prescriptions, often sell the medications directly to patients, and provide minimal follow-up care. Some telehealth providers market GLP-1s with celebrity endorsements without emphasizing the need for proper medical evaluation or behavioral changes. Critics argue this business model prioritizes speed and revenue over patient safety, particularly given that certain patient populations—those with pancreatitis history, gastroparesis, or thyroid cancer risk—require specific counseling before GLP-1 therapy. Left-aligned coverage emphasizes that regulatory standards need to be established to ensure telehealth companies conduct proper baseline evaluations, blood work screening, and ongoing monitoring. The concern is not that telehealth itself is problematic, but rather that unaccountable direct-to-consumer models prioritize access and convenience over medical appropriateness, creating avoidable patient harms.
Right-Leaning Perspective
FDA Commissioner Marty Makary, operating under the Trump administration, issued enforcement actions against telehealth companies making misleading marketing claims about compounded GLP-1s. Makary declared in March 2026 that "It's a new era" of proactive monitoring to eliminate deceptive claims across media channels, stating "We are paying close attention to misleading claims being made by telehealth and pharma companies across all media platforms—and taking swift action." The FDA emphasized that while compounded drugs can be important for meeting unique patient needs and overcoming shortages, "compounders should not try to compound drugs in a way that circumvents FDA's approval process." The enforcement response focused on the specific violation of false marketing—telehealth companies claiming their compounded products were equivalent to FDA-approved drugs when they had not undergone FDA safety and efficacy review. HHS leadership referred Hims & Hers to the Department of Justice for investigation, signaling serious enforcement intent. The Trump administration approach framed the issue as combating misleading advertising and ensuring companies "play by the rules," rather than restricting patient access to lower-cost options. HHS Secretary Robert F. Kennedy Jr. suggested the administration was considering reclassifying certain peptides to permit legitimate compounding within proper regulatory channels, framing this as moving peptide therapy into "formal, regulated clinical channels" away from unregulated online sources. This approach suggests regulatory clarity and legitimate pathways for compounding, not blanket restrictions on telehealth or compounding. However, in May 2026 Makary was removed from his position, with reporting indicating Trump administration frustration over various FDA decisions unrelated to the GLP-1 enforcement.
Deep Dive
The telehealth GLP-1 patient screening scrutiny reveals a genuine tension between expanded access and appropriate clinical evaluation. The supply shortage of brand-name GLP-1s from 2023-2024 created conditions where compounding became necessary and price-competitive telehealth platforms flourished by offering rapid, affordable prescriptions. This addressed a real market gap—traditional primary care has historically underserved weight-loss treatment, and many patients couldn't access or afford branded drugs. The specific failures documented—overdose prescriptions, lack of baseline bloodwork, no monitoring for contraindications—are unambiguous safety violations. Karleigh McClain's 9x overdose dose is not a gray area of clinical judgment but rather a measurable error. However, the structural debate persists: does the problem lie with (a) telehealth's inherent inability to conduct proper evaluation remotely, (b) specific companies cutting corners for profit, or (c) absence of binding standards that would allow responsible remote prescribing? Medical experts favor explanation (c) combined with (b)—many telehealth companies lack accountability mechanisms and baseline evaluation standards, but remote prescribing itself is not inherently unsafe for uncomplicated patients. The concern is selective screening and follow-up to minimize costs. The Trump administration's FDA enforcement under Makary focused narrowly on false marketing claims (companies implying compounded products were FDA-approved when they weren't) rather than broader access restrictions. This suggests a pragmatic regulatory approach: correct misleading advertisements, establish which compounding is legitimate vs. circumventing FDA approval, and rely on enforcement rather than blanket restrictions. What remains unresolved is whether establishing standardized evaluation criteria for telehealth GLP-1 prescribing would address the core problem. Marc-Andre Cornier's question—"whose job is it to police that?"—points to a regulatory gap: no government agency or medical society has published binding patient screening criteria for telehealth GLP-1 prescribing. The Obesity Society could establish guidelines, state medical boards could enforce telehealth standards, or Congress could impose requirements, but as of June 2026 this gap persists. The FDA enforcement wave appears focused on marketing claims and supply-chain integrity rather than patient evaluation protocols.