Question of the week
The rapid rise of GLP-1 prescribing, particularly through online and direct-to-consumer programs, has reshaped how weight loss is approached. While these medications have demonstrated meaningful clinical benefits, their growing availability has raised important questions about oversight, safety, and continuity of care—especially for patients with complex comorbidities.
When GLP-1 therapy is initiated outside of a comprehensive care model, responsibility for monitoring labs, adjusting chronic medications, and managing downstream effects often becomes unclear. On Healthcasts, clinicians shared their perspectives on prescribing GLP-1 therapies in isolation and whether they’ve seen this approach successfully support patient outcomes.
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Post:
The rise of GLP-1 mediation and weight loss programs is seen in patients in my practice. A lot of online clinics are prescribing GLP-1 medication in isolation without managing any of the other chronic conditions that a patient has or secondary conditions to obesity.
Questions for consult
Has anyone seen GLP prescribing done well in isolation to managing other chronic conditions? If so, what did they do differently?
Comments
Key takeaways about prescribing GLP-1 therapy in isolation:
- GLP-1 therapy should not be prescribed in isolation
Clinicians raised concerns that GLP-1s are often initiated without labs, full evaluation, or coordination of chronic conditions. Fragmented prescribing—particularly through online platforms—creates gaps in oversight and continuity of care. - Medication alone does not guarantee outcomes
While some report improvements in weight, A1c, blood pressure, and other comorbidities, others see limited benefit when lifestyle factors like nutrition and exercise are not addressed alongside treatment. - Primary care often becomes the safety net
When GLP-1s are started elsewhere, primary care clinicians frequently assume responsibility for monitoring labs and managing comorbidities. Effective use appears to depend on integrated, longitudinal oversight—not the prescription alone.
Internal Medicine
"I believe it is an overpriced way of losing weight. I have a lot of patients on this medication, and for some, there is weight loss and improvement in their HgA1c but for the mass majority, I believe it is more placebo. No real weight loss and no real improvements in HgA1c. I believe there are too many other variables that are not controlled, such as calorie restriction and exercise, which many do not adhere to."
Nurse Practitioner
"I have not. If I know my patient is using a GLP-1 for weight loss, I suggest they let me monitor their chronic conditions and labs more closely so 'we' can make sure things go well on their weight loss journey."
Family Practice
"I certainly feel like GLP-1s help not only with blood sugars, but with other disease states, just with the significant weight loss associated with them. Overall, disease states are improved, including sleep apnea, blood pressure, and cholesterol, among other things. I also feel like it may help with PCOS, although I think studies would be beneficial there. It already has app approval for certain cardiovascular outcomes as well."
Family Practice
"I have no idea how all these prescribers are giving out GLP1s without doing any labs or further evaluation. It is wild to me that anyone can go online, see an online teledoc, and get the GLP1 prescription without knowing any of the patient's labs. I am very concerned."
Family Practice
"I have seen patients generally either managed to narrowly with the GLP one being prescribed in a vacuum of the patient’s other overall health and medical problems, or the opposite end of the spectrum or patients are going to a wellness clinic, they get a GLP one but they also get a ton of supplements, unproven and expensive lab panels in addition to nutritional counseling. Most of the time, as the PCP, I try to take over management of the GLP-1 medication with a nutritionist referral if needed."
Have your patients received GLP-1 prescriptions from DTC brands? Visit the full post on Healthcasts to share your experience and read other comments from the community.
