The news: Many telehealth platforms that prescribe weight loss drugs fail to adequately evaluate a patient's full clinical context before determining whether the medication is appropriate, according to a secret shopper study published this week in JAMA. Researchers created a simulated patient profile that met the criteria for a GLP-1 and used it to seek prescriptions from 49 virtual care websites between August and December 2025.

Digging into the details: 45 of the 49 telehealth platforms issued a prescription for the simulated patient, mostly for compounded GLP-1 medications.

While nearly all the websites asked about the patient’s medical conditions, medications, and allergies, many skipped other key screening questions:

• Nearly half failed to ask about eating disorders.
• About two-thirds did not request patient-reported clinical measures such as blood pressure, blood glucose, or cholesterol.
• Only about one-quarter required a video visit, and some prescriptions were approved within minutes, even when supposedly required full-body photos of the patient were not provided.

Why it matters: Inadequate pre-prescription screening is a major concern for physicians because it reinforces fears that online GLP-1 providers are not taking the necessary clinical precautions before prescribing these drugs. Just 8% of clinicians said they are "very confident" that nontraditional GLP-1 providers offer the oversight needed for appropriate medication management, according to a December 2025 Sermo survey.

Patient self-reported information has its own limitations, but insufficient screening on top further raises the risk of prescribing GLP-1s to people who don’t actually need them or overlooking important contraindications, such as eating disorders, which can complicate treatment.

At the same time, many companies selling compounded GLP-1s may be overstating the extent of physician involvement. Websites marketing compounded weight loss drugs commonly emphasize personalized consultations, claiming clinicians will review a patient's goals and medical history before determining the best course of treatment. But the secret shopper study found that physicians prescribing GLP-1s through telehealth often failed to gather complete patient information before writing prescriptions, raising questions about how consistently these companies deliver on their promises of individualized care.

Implications for telehealth companies and marketers: While many telehealth companies have balanced consumer demand for speed with appropriate clinical counseling, others have exploited this shift by prioritizing the ease of getting prescriptions and appointment volume as core business objectives.

As evidence exposes telehealth companies for engaging in misleading marketing and questionable patient care practices, regulators are likely to intensify scrutiny. So far, enforcement has largely consisted of FDA warning letters targeting deceptive marketing claims, such as suggesting compounded GLP-1s are equivalent to brand-name drugs. The FDA's authority is largely limited to regulating drugs marketed and sold online, not the broader businesses of telehealth companies. But lawmakers are paying closer attention to virtual prescribing patterns and “pill mill” models, which could ultimately pave the way for stronger enforcement.