What to Know When Using a Telehealth Provider for Weight Management

Ozempic and Wegovy have become very popular for weight loss, but a shortage of these drugs has prompted some to look for prescriptions online.

Telehealth services such as Sequence (owned by WeightWatchers), Ro and Teladoc offer consultations with doctors to determine if they can prescribe weight loss drugs.

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

How Do Online Weight Management Services Work?

Most weight management services charge a monthly subscription fee, which may include consultations, training and prescriptions. Some offer GLP-1 agonists directly, but most do not. Programs are usually at least six months long and estimate that members can lose 510% of their body weight over time. Most programs are not covered by insurance but may be eligible for payment through HSA/FSA funds.

Many of these companies existed even before the rise in demand for drugs like Ozempic. They tend to prescribe less potent medications, such as metformin or naltrexone, as appropriate. They also offer diet and exercise plans and lifestyle coaching to support lifestyle changes that will maintain a healthy weight long term.

Rekha Kumar, MD, MS, an endocrinologist and chief of medical affairs at Found, said that while there is no substitute for a physical exam, many telehealth providers are able to approximate the level of diagnosis through lab work, family history and collaboration with the primary patient. attending physician

The standard in obesity medicine, in person or over telehealth, depends on a really solid clinical history family history, blood work, previous weight loss attempts, current medications, comorbidities, Kumar told Verywell. And today, even most of the academic weight management centers in the country deliver a significant percentage of their visits via telehealth.

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

At my practice in New York, a follow-up appointment can be three or four months after the initial visit because I can’t get in the patients, she said. Whereas with our telehealth platform, someone can be seen every month and even be seen in between, more urgently for a side effect consultation.

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. Wegovy is approved for chronic weight management in adults with obesity or overweight with at least one weight-related condition.

These recipes are usually not included in the basic costs. Not only are they expensive, but drugmaker Novo Nordisk expects shortages of Wegovy to last until 2024, making the drugs hard to come by.

While telehealth services often do not provide GLP-1 agonists, they do try to help their members find the right medications. Raoul Manalac, MD, senior director of clinical experience at Ro, told Verywell via email that Ro only prescribes GLP-1 agonists if they are needed, there is no guarantee of a prescription, or the fulfillment of one if they are given.

Manalac said the effects of GLP-1 deficiencies are being felt nationwide. While this shortage means it may be more difficult to access branded GLP-1 medications in the coming months, they are dedicated to providing patients with the support they need to navigate the shortage and are committed to helping them access medication as soon as it becomes available. .

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

Because of the scarcity, 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 by the FDA.

When a drug is on the FDA’s list of drugs that are in short supply, compounding is allowed, Kumar said. But technically these drugs are still patented and should not be compounded. They are not made by the manufacturer. We don’t know how they are made.

Kumar cautioned 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 does not come in a blue pen that is marked with a brand name, I would worry about it, she said.

Why Might Someone Prefer Telehealth Weight Care?

Some people who seek weight loss care might feel less judged when the care is almost delivered, Kumar said.

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

But while the stigma can be removed and patients can have more consistent access to care, Kumar said there’s little substitute for meeting an in-person provider.

I think telehealth can miss seeing the whole character to assess their gait, their balance. How does one 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 a huge value on the physical exam in my own practice, and I do well to see people via telehealth intermittently.