There is an alarming increase in the misuse of GLP-1 drugs as people look to cut costs or avoid the doctor’s office, experts are warning.
While prescriptions for GLP-1’s, and the usage of the drugs, continues to rise, that search for alternatives has led some to the secondary online market, but the consequences are staggering.
In just one year, calls to Illinois poison centers for overdose or side effects of injectable weight loss drugs have more than doubled. Since 2019, poison centers have managed nearly 23,000 calls across the country, which is a nearly 1,500% increase.
Common mistakes include taking doses too closely together or taking a higher than recommended dose at once, according to America’s Poison Centers. Some patients have reported accidentally taking ten times the recommended dose, according to experts.
“They think medications can’t be deadly, but they can,” said Dr. Reed Berger-Fleishman, a bariatrician at UI Health.
Berger-Fleishman says there’s a misconception among patients that they can’t overdose on weight loss medication, but she’s seen patients who’ve gotten very sick.
“The online medications are really not FDA regulated. They’re compounded, meaning they might have a little bit of the semaglutide or tirzepatide, but then other things that can be added are not regulated. So, that’s a risk,” she said.
Drug compounders stepped in during a shortage that began in 2022, driven by a surge in demand for the weight loss drugs. During that time, sales soared from $4 billion in 2022 to more than $11 billion in 2023.
The shortage ended in 2025, but many compounders kept marketing the unregulated products. In March, the FDA sent warning letters to 30 telehealth companies for making false or misleading claims.
The increase in usage of those drugs comes after obesity rates increased for more than 50 years, according to bariatric and metabolic surgery specialistDr. Mario Masrur, who works alongside Berger-Fleishman at UI Health.
“We [are] definitely seeing more younger patients that come to our clinic for consultation,” said Masrur. “The intervention may be different according to the specific situation of the patient, and we definitely want patients to get to places like UI Health academic centers to have a multidisciplinary team that overlooks the entire picture of patient situations.”
“A lot of patients are afraid to have surgery because they think that the GLP is the answer. But, I tell them, first of all, we have to see if it’s covered [by insurance]. Second of all, it’s an ongoing medication, it’s an ongoing cost,” added Berger-Fleishman.
Most major medical plans cover weight loss procedures, but medication coverage is much more restricted. Doctors say GLP-1 medications are meant to be used for a long time.
Myriam Davis says she experienced a major financial barrier when she turned to the drugs for help managing her weight during perimenopause.
“The only side effect was financial,” said Davis. “For the first two years, I had to pay for it out of pocket. And with the rebate, it was $650 a month.”
Davis made sacrifices in her budget and was able to pay for the medication until her insurance changed, but others can’t.
At their peak in 2024, Stanford Medicine found nearly one-in-three Americans taking a GLP-1 drug said they were getting it from a compounding pharmacy.
“Patients are more prone to overdosing on (compounded medications),” said Berger-Fleishman. “They’re not warned about the side effects.”
The versions of weight loss drugs sold by compounding pharmacies aren’t FDA approved, and in early 2026, the agency announced it was taking steps to combat misleading direct-to-consumer advertising.
“I think the most important message is to make sure that patients get proper medical consultation, and to get a better indication of what would be the best option in terms of weight loss,” said Masrur.
And, the FDA offered this advice to those looking for GLP-1 medication online:
-Avoid too good to be true prices, and companies that don’t require a screening or prescription.
-Stay away from companies that don’t have a licensed doctor available to answer questions after receiving the medication.
-Look for spelling errors on the label.
Stanford Medicine says if the medication has no expiration date, that’s also a red flag. Another red flag is a vague or proprietary ingredient list with products marketed as “personalized” blends with added vitamins.
Pharmaceutical companies are also legally required to list side effects in advertisements, experts warn.
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