Clinicians caution that the surge in non-healthcare and subscription-based drug offerings is moving faster than necessary clinical protections.
Once tightly controlled medical treatments, GLP-1 weight-loss injections are now being marketed far beyond specialist clinics. With these drugs increasingly offered by non-healthcare providers and through subscription-style programs, clinicians warn that the rush to scale is outpacing the safeguards needed to keep patients safe.
“The meds themselves are not the villain,” said Ali Hashemi, co-founder and CEO of metabolic.health (GluCare). “When they’re prescribed properly, with proper screening and follow-up, they’re among the most meaningful tools we’ve had for metabolic health in a long time. The problem arises when people treat them like a convenience product: click, pay, deliver.”
GLP-1 medications have gone mainstream at unprecedented speed, fueled by visible weight-loss results and social media attention. Hashemi says this has created a market where demand is high, outcomes are rapid, and programs are easily packaged as subscriptions — drawing in businesses ill-equipped to manage long-term medical care.
“We’ve seen GLP-1s marketed through a variety of non-traditional channels,” he said, including wellness businesses offering IV drips and aesthetic treatments, online-only subscription programs with minimal clinical review, and informal social media or messaging funnels where the “consultation” amounts to little more than a questionnaire.
In recent weeks, GLP-1 weight-loss services have even appeared in consumer apps primarily known for home cleaning and spa bookings, with promotional banners advertising obesity treatments alongside cleaning, salon, and maintenance services.
Avoidable setbacks, not rare complications
Hashemi said GluCare has seen patients experience avoidable setbacks after starting GLP-1 treatment outside structured medical programs. He stressed that these issues are rarely exotic complications.
“They’re practical and avoidable,” he said. “Doses escalated too quickly, inadequate education on side-effect management, limited screening for contraindications, and no real follow-up.”
The result, he explained, is often significant nausea, vomiting, dehydration, constipation, and fatigue, with some patients also experiencing anxiety and distress because they feel unwell and unsupported.
“What we see is a stop-start pattern,” Hashemi added. “Patients stop because they feel awful, then restart, or bounce between providers trying to get a different dose or a different drug. That creates a lot of misery, and it also fuels the narrative of ‘it didn’t work for me,’ when in reality the care model failed them.”
Muscle loss: the quieter risk
Beyond immediate side effects, Hashemi highlighted muscle loss as an underreported consequence of poorly managed GLP-1 treatment.
“People lose weight quickly, and everyone applauds,” he said. “But if the program doesn’t actively focus on protein, resistance training, and preserving lean mass, patients can end up weaker, more fatigued, and with worse body composition than they expected. They’re lighter, but not necessarily healthier.”
He noted that this element is often skipped in fast-scale GLP-1 programs, despite its importance for long-term metabolic health and physical function.
From clinical discipline to commercial add-on?
Hashemi warned that the current boom risks turning obesity medicine into a commercial add-on rather than a proper clinical discipline.
“This is a proper clinical discipline, and it should be treated like one,” he said. “If GLP-1s become an ‘add-on service’ rather than part of structured care, we’ll see more side effects, more discontinuation, more rebound weight gain, and more public mistrust — even though the underlying science is strong.”
He also raised concerns about inconsistent medication sourcing when GLP-1s are offered outside recognized medical and pharmacy channels.
What responsible care looks like
While critical of retail-style shortcuts, Hashemi emphasized that he is not opposed to innovation or non-traditional delivery models. Access, he said, is important — especially for patients who have long felt dismissed.
“Telemedicine can be excellent,” he said. “The line is whether the care is accountable. If it’s built like healthcare, with standards, it can scale safely. If it’s built like e-commerce, you eventually get harm.”
According to Hashemi, a serious GLP-1 program includes:
- Basic medical screening
- A clear titration plan
- Early follow-up, particularly in the first eight to 12 weeks
- Proactive side-effect management
- A plan to preserve muscle mass
- A long-term maintenance strategy
“None of this is glamorous,” he said. “But it’s the difference between safe scale and messy scale.”
For patients considering GLP-1 treatment, he encouraged asking direct questions about who is prescribing the medication, how side effects are managed, how often follow-ups occur, and where the medication is sourced.
“If the answers are vague, or if follow-up isn’t built in, patients should be cautious,” he warned.
While the hype around GLP-1s may eventually settle, Hashemi cautioned that misuse could leave lasting consequences — from avoidable adverse events to widespread mistrust in effective therapies.
“The opportunity here is real,” he said. “But it needs clinical discipline to match the scale of demand.”
