The rising popularity of glucagon-like peptide agonists and the increased numbers of telehealth providers have not hurt the financial operations of traditional weight loss clinicians, but these trends are creating challenges.
Many endocrinologists already had long waiting lists, said Dr. Robert Lash, chief medical officer at Endocrine Society, an industry group. Now more patients are coming into traditional weight loss clinics looking for GLP-1s.
The popularity of GLP-1s, such as Novo Nordisk’s Wegovy and Ozempic, has led to a growing number of weight loss entrants in the virtual health industry. In the last year, digital health companies such as Teladoc and Noom have launched virtual weight loss businesses with GLP-1 medication prescription offerings. Traditional weight loss company WeightWatchers acquired a telehealth company to begin prescribing the drugs.
As the public’s knowledge of the drugs increases, more patients are arriving at appointments with preconceived ideas of how their treatment plans should look, said Dr. Caroline Messer, a New York City-based endocrinologist, clinical assistant professor at Mount Sinai School of Medicine and assistant professor at Hofstra School of Medicine. “They’re often not correct," she said.
The increased number of virtual weight loss companies has some traditional clinicians worried about the types of care being offered to patients via these platforms. Amid the hype, Messer is concerned that many clinicians prescribing the drugs are not endocrinologists or trained in weight loss medicine or in how to deal with GLP-1's side effects.
Lash agreed.
“There are only two GLP-1s approved for weight loss and taking a medication for an off-label reason is something patients and doctors need to be wary of,” Lash said. “I think it's very hard for patients to understand which digital health companies they can trust and which ones they can't.”
Dr. Anthony Millard, a physician at Chicago-based Northwestern Medicine’s Center for Lifestyle Medicine, said he sees patients who have started GLP-1s from telehealth providers as well as brick-and-mortar medical spa providers and have received varying degrees of counseling.
“There’s nothing inherently wrong with telehealth [but] you need to be able to provide the full cadre of services to help someone maximize the benefit that they could get,” Millard said. “I also worry that in those more fleeting interactions you’re less likely to develop enough of a relationship that gets people to stay on the medication long term.”
Most traditional weight loss doctors support the use of telehealth as a tool to manage patients’ weight loss efforts and deal with long waitlists.
But Dr. Amanda Velazguez, director of obesity medicine at Los Angeles-based Cedars-Sinai, said she requires patients to visit her practice in person before virtual appointments are permitted.
“From a clinician perspective, the type of rapport you can establish with someone in-person versus virtual is very different,” Velazguez said. “I think we can all relate to that after our experience with the COVID-19 pandemic.”
The need for weight loss clinicians, virtual or otherwise, won’t slow down any time soon. Obesity prevalence was 41.9% among adults in the U.S. in March 2020, according to the Centers for Disease Control and Prevention.
“There’s plenty of patients to go around,” Velazguez said. “I’m happy there are more and more resources. I just want to make sure those resources are evidence-based and come with multi-disciplinary services that are really going to support a patient long-term."
