Telehealth Booms As Demand For GLP-1s Surges and Questions Mount About Safety, Oversight
A rise in GLP-1 weight loss medication errors has led to patient hospitalizations, with FDA data showing reports jumping from roughly 2,000 in 2020 to over 25,000 in 2025. Medical experts and federal agencies warn that some telehealth providers may be bypassing critical screenings and prescribing incorrect dosages of compounded drugs to patients.
Karleigh McClain, a 31-year-old from Hendersonville, Tennessee, was admitted to the hospital in January after receiving a first dose of semaglutide from a telehealth provider. McClain reported uncontrollable vomiting and stated her prescribed dose of 2.21 milligrams was nearly nine times the typical starting amount.
In a similar case, 54-year-old Leslie Gammon of Wendell, North Carolina, was hospitalized in Raleigh after a refill from Amble Health instructed her to inject three times her previous volume. Gammon reported waking up in the middle of the night vomiting every 20 to 25 minutes, resulting in a medical bill exceeding $9,000.
Why are medication errors increasing with GLP-1 drugs?
Medication errors involving semaglutide, tirzepatide, dulaglutide, and liraglutide have surged, according to a KFF Health News review of FDA data. The National Poison Data System reported a nearly 1,500% increase in calls related to injectable weight loss drug overdoses or side effects since 2019.
Arthur Caplan, a bioethics professor at New York University’s Grossman School of Medicine, said some patients may self-administer higher doses to accelerate weight loss before events like weddings. America’s Poison Centers noted that some users accidentally took 10 times the recommended dose due to confusing syringe measurement units.
How does telehealth change the prescription process?
Some telehealth companies use “asynchronous” evaluations, where patients fill out intake forms and questionnaires without a live conversation with a provider. Nicholas Samonas, a spokesperson for Ro, stated the company requires real-time conversations when requested by a clinician or required by state law.
Dr. Marc-Andre Cornier, an endocrinologist at the Medical University of South Carolina, warned that virtual care may be insufficient for these drugs. He noted that patients with histories of pancreatitis, gastroparesis, or susceptibility to medullary thyroid cancer require specific counseling and potential blood work before starting treatment.
Elizabeth Krupinski, an experimental psychologist at Emory University, said some online companies market these drugs as easy weight-loss tools without emphasizing exercise and healthy eating. She stated that writing prescriptions while skimping on care “is not in the Hippocratic oath.”
What are the risks of compounded weight loss drugs?
Many telehealth firms act as intermediaries for compounding pharmacies that mix active ingredients, often sourced from overseas, with additives. These formulations are not reviewed by the FDA for safety. Emily Hilliard of the Department of Health and Human Services stated compounded drugs should only be used when medical needs cannot be met by an FDA-approved drug.
Dr. Jamy Ard, a researcher at Wake Forest University School of Medicine, described the compounded drug environment as “uncontrolled and poorly, if at all, regulated.” He stated there is currently no standard of care for these prescriptions.
What legal and regulatory actions are being taken?
Pharmaceutical giants Eli Lilly and Novo Nordisk have filed lawsuits against telehealth companies for promoting compounded versions of their drugs. Eli Lilly alleged that Mochi Health used “deceptive” business tactics, while Novo Nordisk has filed 130 lawsuits against entities selling “knockoff” semaglutide.
The FDA has issued warning letters to companies including Hims & Hers, SkinnyRx, Join Josie, and Genesis Health International for making false or misleading claims. In response, Hims & Hers announced a shift away from compounded weight loss drugs to sell name-brand versions through an agreement with Novo Nordisk.
What may happen next for telehealth prescriptions?
Regulatory scrutiny could increase as the FDA continues to crack down on misleading advertisements. Telehealth companies may be forced to implement more rigorous, synchronous screening processes to avoid further legal challenges from drug manufacturers.
Consumers may see a shift in how these drugs are delivered, as the Department of Justice and FDA continue to monitor companies that imply compounded products are identical to FDA-approved versions. A possible next step involves the development of government or medical society criteria to determine which telehealth providers are treating patients appropriately.
Frequently Asked Questions
What are GLP-1 medications?
They are a class of drugs, including semaglutide and tirzepatide, originally approved to treat Type 2 diabetes and later approved for obesity treatment.
What is the difference between name-brand and compounded GLP-1s?
Name-brand drugs are FDA-approved. Compounded versions are created by pharmacies mixing ingredients and are not reviewed by the FDA for safety.
What are the potential side effects of GLP-1 drugs?
According to pharmaceutical listings, side effects can include nausea, vomiting, changes in vision, low blood sugar, and, in rare cases, thyroid cancer.
Do you prioritize the convenience of telehealth or the oversight of an in-person visit when managing medication?