What to Know When You Use a Telehealth Provider for Weight Management

Fact checked by Nick Blackmer

Key Takeaways

• Some telehealth services offer weight management subscriptions that include consultations, coaching, and prescriptions.

• Oftentimes, these providers won’t be able to prescribe GLP-1 agonist drugs like Ozempic and Wegovy. But they work with patients to provide less potent drugs and come up with a diet and exercise plan.

• Some compounding pharmacies or websites claim to offer generic versions of these drugs, which are not FDA-approved and may come with safety issues.

Ozempic and Wegovy have become hugely popular for weight loss use, but shortages of these drugs have prompted some to look for prescriptions online.

Telehealth services like Sequence (owned by WeightWatchers), Ro, and Teladoc offer consultations with physicians to determine whether they can prescribe weight loss drugs.

How do these telehealth weight management services work and are they as effective and safe as seeing a physician in person?

Takeaway

There are dozens of websites and online pharmacies that claim to sell “generic” versions of Ozempic, Wegovy, or Mounjaro—without needing a prescription. However, the Food and Drug Administration (FDA) has not approved any generic forms of the drugs. Make sure you speak to a licensed healthcare provider and only purchase these drugs from a legitimate pharmacy. The National Association of Boards of Pharmacy has a list of websites that sell unsafe and fraudulent prescription medications.

Related: 7 FDA-Approved Drugs for Weight Management

How Do Online Weight Management Services Work?

Most weight management services charge a monthly subscription fee, which can include consultations, coaching, and prescriptions. Some offer GLP-1 agonists directly, but most do not. Programs are typically at least six months long and estimate that members can lose 5–10% of their body weight over time. Most programs are not covered by insurance but may be eligible for payment via HSA/FSA funds.

Many of these companies have been around even before the surge in demand for drugs like Ozempic. They tend to prescribe less potent drugs, such as metformin or naltrexone, as appropriate. They also offer diet and exercise plans and lifestyle coaching to support lifestyle changes that will sustain a healthy weight in the long run.

Rekha Kumar, MD, MS, an endocrinologist and head of medical affairs at Found, said that while nothing replaces a physical exam, many telehealth providers are able to approximate the level of diagnostics through lab work, family history, and collaboration with a patient's primary care physician.

“The standard in obesity medicine, in person or over telehealth, relies on a really solid clinical history—family history, blood work, prior weight loss attempts, current medications, comorbidities,” Kumar told Verywell. “And today, even most of the academic weight management centers in the country are delivering a significant percentage of their visits over telehealth.”

While providers may not have the ability to do a full exam online, telehealth allows more frequent check-ins and better patient access to clinicians, Kumar added.

“At my practice in New York City, a follow-up appointment may take three or four months after the initial visit, because I can’t get the patients in,” she said. “Whereas through our telehealth platform, somebody can be seen monthly and even be seen in between that, more urgently for a side-effect consult.”

Related: How Obesity Is Treated

Can You Actually Get Ozempic or Wegovy Through Telehealth Services?

Ozempic is not FDA-approved to treat obesity, but some providers might prescribe it for off-label weight loss use. Wegovy is approved for chronic weight management in adults with obesity or overweight with at least one weight-related condition.

These prescriptions are typically not included in the baseline costs. Not only are they expensive, but drugmaker Novo Nordisk expects shortages of Wegovy to last into 2024, making the medications hard to come by.

While telehealth services often won’t provide GLP-1 agonists, they do try to help their members find the right medicines. Raoul Manalac, MD, senior director of clinical experience at Ro, told Verywell via email that Ro only prescribes GLP-1 agonists if they’re necessary—there’s no guarantee of a prescription, or the fulfillment of one if given.

“The impacts of the GLP-1 shortages are being felt nationwide,” Manalac said. “While this shortage means that it may be harder to access branded GLP-1 medications in the months to come, we’re dedicated to providing patients with the support they need through navigating the shortage, and are committed to helping them access medication as soon as it’s available.”

Currently, Wegovy is only available in higher maintenance dosages to allow patients who are already on the medication to continue their prescribed treatments.

Because of the shortages, compounding pharmacies are using a loophole to make these in-demand drugs with mixed ingredients and alterations, Kumar explained. Medicines made in compounding pharmacies are not subject to the rigorous safety and quality standards set forth by the FDA.

“When a medication is on the FDA’s list of medications that are in shortage, compounding is allowed,” Kumar said. “But technically these meds are still on patent and shouldn’t be compounded. They are not being made by the manufacturer. We don’t know how they are being made.”

Kumar warned that any GLP-1 agonist drug that comes in a vial or costs less than $900 is likely made in a compounding pharmacy.

“If it doesn’t come in a blue pen that is marked with a brand name, I would be careful with that,” she said.

Related: New Weight Loss Drugs Are on the Way That Could Upstage Wegovy and Ozempic

Why Might Someone Prefer Telehealth Weight Loss Care?

Some people seeking out weight loss care might feel less judged when the care is delivered virtually, Kumar said.

“If their visit was in person, they may feel like they’re disappointing the provider for some reason—maybe they gained weight between visits. They would be no-shows in a brick-and-mortar practice. So it’s actually helped with continuity and reduced the no-show rate in many practices that offer both,” Kumar said.

But while the stigma may be removed and patients may have more consistent access to care, Kumar said there is little substitute for meeting with a provider in person.

“I think telehealth can miss seeing the whole person—assessing their gait, their balance. How does somebody walk? Are they at risk of falling? How do they breathe? These are all things that are really important in obesity medicine, which is why telehealth should be seen as a complement to seeing a doctor,” Kumar said. “I place tremendous value on a physical exam in my own practice, and I’m OK with seeing people over telehealth intermittently.”

Read Next: Mounjaro Generic May Soon Join Wegovy as a Weight Loss-Approved Drug

What This Means for You

Not all telehealth platforms are created equally, and it’s important to look for a program that uses a whole-person view in their treatment plans. Reputable programs will include a medical consultation, patient history, and lab work, and may or may not result in the prescription of GLP-1 agonists. If GLP-1 agonists are prescribed, check to see where it comes from. Compounded versions of these drugs are not FDA-approved and may have quality and safety issues.

Read the original article on Verywell Health.