A new secret shopper study published in JAMA found that many websites offering GLP-1 medications issued prescriptions with little or no direct interaction between the simulated patient and a clinician.

Researchers approached 49 websites offering branded or compounded GLP-1 receptor agonists. Forty-five, or 91.8%, issued a prescription, and 34 mailed medication. Only 26.5% required a video visit, while 6.1% required a telephone call. Two compounded GLP-1 prescriptions were issued within five minutes.

Although nearly all websites asked about medical conditions and current medications, other areas received less consistent attention. Only 55.1% asked about eating disorders, 53.1% asked about diet and physical activity, and 36.7% requested clinical information such as blood pressure, glucose or cholesterol values. Just 18.4% asked whether the patient had a primary care clinician.

The study also found signs that some safety and verification requirements were not meaningfully enforced. Nine websites issued prescriptions after receiving only an upper-body photo, despite requesting a full-body photograph or an image of the patient standing on a scale. Three clinicians prescribed medications to the same simulated patient through more than one website.

The findings do not suggest that telemedicine itself is the problem. Virtual care can expand access to effective obesity and diabetes treatment. The concern is whether online prescribing includes a thorough medical evaluation, appropriate screening, informed discussion and continuing follow-up rather than functioning primarily as a rapid medication sale. Obesity medicine specialist Dr. Katherine Saunders has emphasized that a GLP-1 prescription is only one part of treatment, not a complete treatment plan.

The researchers concluded that some online platforms appear to prioritize fast access to prescriptions over comprehensive clinical care, potentially increasing the risk of medical and financial harm.

The Bottom Line

GLP-1 medications can provide substantial health benefits, but they also require appropriate patient selection, monitoring and support. Faster access should not come at the cost of meaningful clinical care.

Sources

JAMA
"Online Prescribing of GLP-1 Receptor Agonists"

Healio
"‘Secret shopper’ study: Most websites prescribe GLP-1s without clinician visit"

Katherine Saunders, MD, FTOS, LinkedIn Commentary
“A GLP-1 Prescription Is Not a Treatment Plan”