GLP-1 drugs such as Ozempic and Mounjaro are a revolution, not a trend. These weight loss drugs are one of the hottest markets in healthcare, and there’s been a dramatic surge in the number of Americans using them in February 2025. Many people incorporated these medications into their New Year’s resolutions to achieve weight loss goals.
Reports suggest around 26% of Americans plan to use GLP-1 medications for weight loss. UBS estimates that 40 million people will be on GLP-1s by 2029, with 44% in the US. This translates into $126B in sales by 2029, a 2023-2029 sales CAGR of 30%.
Hims & Hers’ Super Bowl commercial that featured its compounded weight loss offerings resulted in a 650% spike in engagement with record-high customer registrations, according to data that the company shared with Fierce Healthcare. In December, Elon Musk posted a picture of himself on ‘X’ and captioned it “Ozempic Santa.” The post comes two weeks after Musk said on X, “Nothing would do more to improve the health, lifespan, and quality of life for Americans than making glucagon-like peptide-1 receptor (GLP-1) medications like Ozempic and Mounjaro super low cost to the public.” (GLP-1 medications can cost Americans around $1,000 per month if they are uninsured.)
According to Dr. Dan Henderson, a primary care and obesity medicine physician in Boston, three main trends drive the GLP-1 explosion: “First, the newer generation of GLP-1s are incredibly effective at supporting weight loss, and patients and providers love having such a powerful weapon against obesity. Second, when you have medicines that produce such big results, it generates a lot of headlines in medical research. Since obesity affects every organ system and the vast majority of chronic conditions, we’re seeing jaw-dropping results in a wide range of conditions. Nobody is surprised that diabetes medications improve diabetes or even heart disease. What has surprised the medical community are the positive results in late-stage trials for sleep apnea, knee arthritis, and kidney disease. Each medical journal headline adds to the momentum. Third, I think COVID played a role in highlighting obesity as a risk factor for serious complications, even death. It changed the conversation about obesity.”
The Consumerization of Weight Loss Drugs
There is a growing awareness and accessibility of GLP-1 drugs and cheaper compounded versions for weight management because of VC-backed telemedicine brands aggressively trying to acquire customers via digital and traditional advertising. Ahara recently emailed prospective customers saying, “Get a 4-month weight loss plan for as low as $45 a month with Affirm in 5 minutes.” The list of DTC companies offering compounded GLP-1 drugs is long and includes but isn’t limited to: Ahara Med, Hims & Hers, Ro, 23andMe, Eden, Midi, Henry Meds, Skinny Rx, Eden, and Noom.
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The venture capital and private equity investors of direct-to-consumer (DTC) compounded GLP-1 brands like the recurring revenue of these largely cash businesses, many of which don’t deal with the expense and bureaucracy of health insurance. Most patients don’t stop taking the GLP-1 drugs because the weight they lose will return if they stop taking the drugs. High customer retention and consistent recurring revenue streams are key factors for sustainable growth.
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A Recurring Revenue Subscription Business
The venture capital and private equity investors of direct-to-consumer (DTC) compounded GLP-1 brands like the recurring revenue of these largely cash businesses, many of which don’t deal with the expense and bureaucracy of health insurance. Most patients don’t stop taking the GLP-1 drugs because the weight they lose will return if they stop taking the drugs. High customer retention and consistent recurring revenue streams are key factors for sustainable growth. Moreover, the returns are even better when manufacturing is vertically integrated versus outsourcing the drugs from a compounding pharmacy. Accordingly, Hims & Hers acquired a US-based 503B outsourcing facility and peptide facility, enabling it to produce vertically integrated (in-house) versions of these drugs from start to finish while maximizing margins.
GLP-1 Supplements & Boosters
There are also DTC companies offering natural supplements that mimic GLP-1s, such as Supergut’s GLP-1 Booster, Kourtney Kardashian’s Lemme’s GLP-1 Daily, Arrae, Codeage, and Pendulum, a gut health startup with $149 million in venture funding, a celebrity backer and a high-profile set of advisers. These supplements offer a non-prescription drug alternative and a cheaper subscription for consumers. These supplements cost less than the prescription GLP-1 drugs, and their development and operating costs are also less since telemedicine isn’t required and there is no FDA regulation of supplements.
Compounded Versus Branded GLP-1s
The most significant impact GLP-1s have had is on the compounding pharmacy industry, which has nearly doubled its market share due to the initial shortage of drugs. There is more investment interest in the industry now than ever because of demand, consolidation, and awareness.
Though they have the same active ingredient as big pharma’s branded weight loss drugs, compounded GLP-1s are not required to undergo the FDA’s rigorous approval process. Since they are not FDA-approved, they do not have standardized FDA-required labeling, including side-effect warnings, boxed warnings, or risk evaluation and mitigation strategies that apply to approved drugs. However, they are still subject to state board of pharmacy oversight and must comply with USP compounding standards and Sections 503A and 503B of the Federal Food, Drug, and Cosmetic Act, according to the Alliance for Pharmacy Compounding.
In response to Hims & Hers’ Superbowl ad, Novo Nordisk placed an ad titled, “Check Before You Inject,” the next day in the New York Times and US Today warning consumers about the significant dangers of illegitimate compounded ‘semaglutide’ drugs, which have been shown to contain impurities, ingredients dangerous to patients, and incorrect dosages.
Shaun Noorian, Founder & CEO of Empower Pharmacy, the largest compounding pharmacy in the US, said, “Compounding pharmacies can quickly innovate with personalized versions of the drugs at different concentrations with the addition of ingredients to potentially subside nausea and also offer new oral formats of the drug. Empower Pharmacy offers a pill version of Tirzepatide, which is cheaper to produce and distribute. More importantly, compounding pharmacies democratize expensive drugs and make them more accessible to patients who would not be able to afford them, especially without insurance coverage. Since the drugs can be personalized by compounding pharmacies, patients may experience better outcomes.”
Telemedicine’s Role in Prescribing Compounded GLP-1 Drugs
The rise of GLP-1s has coincided with another healthcare revolution – telemedicine. In an Omada Health survey of 2000 primary care physicians (PCPs), two-thirds of the PCPs said that they are concerned about the risk of patients using third-party telehealth prescribers to get weight loss drugs due to potential health risks; they were mainly concerned about overprescribing, clinically ijnappropriate prescribing (cited by 56% of doctors), continuity of care such as follow-up visits, lack of holistic care, medication interactions, side effect management, titration, and/or tapering off the medication. They also believe compounded GLP-1 medications are less regulated, less consistent, and less safe than branded medications.
Noorian says that the traditional healthcare system is slow, bureaucratic, and riddled with insurance roadblocks that make it difficult for patients to get the treatments they need, and telemedicine cuts through that red tape. Patients complete a medical questionnaire, have their responses reviewed by a licensed provider, and receive a prescription for GLP-1s in a fraction of the time it would take to go through a traditional clinic. There’s no wait for a specialist referral, no arguing with insurance companies over prior authorizations, and no driving across town for a 10-minute appointment. Once prescribed, the medication is shipped directly to the patient’s doorstep.
“Telemedicine is not just about convenience – it’s about compliance. When getting a prescription is easier, patients are more likely to stay on therapy, leading to better health outcomes. It’s also often more affordable, eliminating the hidden costs of in-person visits, lab fees, and co-pays. The old system isn’t built for the scale of demand GLP-1s have created, but telemedicine is,” exclaimed Noorian. He also mentioned that in-person physician visits are often only 5 minutes, so they aren’t necessarily more holistic.
“I think the telehealth explosion is a mixed bag,” says Dr. Henderson. “The growth and profitability goals of many of these business models create powerful incentives to cut corners. Especially with obesity medicine, there is so much more to discuss than with hair loss, birth control, erectile dysfunction, or even high blood pressure. I worry about safety and proper decision-making. Still, there would be no business model if it were easy to see a primary care or obesity medicine provider, and the lack of access many people face is a problem that’s not going away anytime soon.”
FDA Regulation of Compounded GLP-1s
Last Friday, the FDA announced that Wegovy and Ozembic, the commercially manufactured medications that contain the active ingredient semaglutide, are no longer in short supply, and compounding pharmacies will not be permitted to produce copies of FDA-approved drugs. It’s bad news for compounding pharmacies, outsourcing facilities, and telehealth companies such as Hims & Hers selling cheaper alternatives to branded weight loss drugs. Hims & Hers said Monday that it will likely stop offering compounded copies of commercially available semaglutide on its platform after its first quarter, although some patients may still be able to access personalized doses if clinically applicable.
Empower Pharmacy CEO Noorian isn’t worried and says, “This isn’t the end of compounded GLP-1s. It’s just a shift. Compounding pharmacies can still serve patients with unique needs by offering differentiated formulations, ensuring access to personalized treatment options. This differentiation can be achieved through variations in dosage form, strength, or combinations, provided there is a documented medical need for such modifications.” This pathway allows compounding pharmacies to serve patients with specific requirements not met by the standard FDA-approved medications. Noorian says that it’s important to note that while the national shortage has been declared resolved, the FDA acknowledges that patients and prescribers may still experience intermittent and localized supply disruptions as products move through the supply chain.
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Recently these GLP-1 drugs have been marketed beyond obesity management for perimenopause/menopause weight gain management, cosmetic weight loss, and achieving optimal weight with microdosing.
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Ripple Effects In Other Industries
GLP-1s are much more than a drug breakthrough. They affect so many aspects of daily life, while transforming how consumers spend money, industries operate, and how society thinks about obesity, health and wellness. Recently these GLP-1 drugs have been marketed beyond obesity management but also for perimenopause/menopause weight gain management, cosmetic weight loss, and achieving optimal weight.
Betting on a widespread GLP-1 adoption, some private equity investors are practicing an investor version of the ‘Ozempic diet’ and are refraining from investing in consumer companies (such as snackmakers, alcohol brands, or restaurant chains) that could be negatively impacted by the GLP-1 boom, believing that profits will get squeezed as GLP-1 users no longer crave them and/or obesity rates fall. “Even if the types of foods don’t change for someone on a drug like Ozempic, the amount of consumption usually does,” one PE investor explains to Axios.
Food & Groceries
In its survey of 300 patients and report titled “Could obesity drugs take a bite out of the food industry?,” Morgan Stanley found that GLP-1s lead to a reduction in calorie intake per patient of between 20% and 30%. According to Grocery Doppio’s research, 97% of GLP-1 users reduced their grocery spending by 11% on average. Snacks, confectionaries, baked goods, and soda/sugary beverages were the products that they cut out most frequently. Users added an increase of lean protein, meal replacements, and healthy snacks to complement their new health consciousness. To capitalize on this behavioral and purchasing shift, 77% of grocers plan to expand and deepen their assortment, 71% plan to increase their digital marketing efforts promoting food as medicine, and 43% plan to provide in-store nutrition education.
Thistle, a healthy meal delivery company, already offers meals that meet the recommendations for a diet that complements taking GLP-1s – very high in fiber, protein, veggies, fruits, whole grains and healthy fats. CEO Ashwin Cheriyan says they are actively exploring a dedicated line of meals that offer even more variety and personalization for GLP-1 customers and expect to start rolling those out later this year.
WeightWatchers, which recently acquired Sequence, a telehealth company that prescribes GLP-1 medicine, created a special diet plan for those on the drugs. Weight-loss brand Atkins, Nestlé, and the nutrition arm of healthcare brand Abbott have created food products designed for GLP-1 agonist users.
Health & Wellness
Function Health, a membership-based healthcare platform that provides comprehensive, personalized health testing and insights, warns of long-term effects of GLP-1d over time and listed 33 lab tests to stay ahead of possible side effects in its latest IG posts.
Weight management wellness brand SoWell, which was founded by Dr. Alexandra Sowa, an Internal Medicine physician focused on obesity treatment, launched a GLP-1 Support System which includes packages of fibre, protein, and electrolyte powders meant to help ease common side effects like nausea and dizziness.
Gyms
Upscale gym chains including Equinox and Life Time have rolled out strength-focused training plans for members on GLP-1 drugs to combat muscle loss; Life Time launched a “performance and longevity” subscription program that includes a in-gym clinic with doctors who can prescribe GLP-1 drugs when appropriate, metabolic blood testing, meetings with a dietitian, and personal training.
Botox & Medspas
There’s been an increase in Botox and filler treatments due to “Ozempic face,” which is the loss of facial fat from GLP-1s. Interestingly, many medspas that offer Botox and filler treatments have added compounded GLP-1 meds to their offerings, which make up about 15% of their business.
Fashion
Fashion luxury resale sites have seen a significant surge in plus-size women’s apparel listings in the past two years while clothing rental site Rent the Runway is seeing more smaller sizes being rented. Neil Saunders, Managing Director of Globaldata’s Retail Division, stated in an interview with Vogue Business that resale platforms need to analyze supply and demand patterns, especially with the potential influx of plus-size clothing. Saunders said, “The issue of managing an inventory imbalance — stemming from Ozempic-induced weight loss or otherwise — could saddle resale marketplaces with the challenge of aligning their inventory with shifting consumer demand.”
A GLP-1 App
Shotsy is a first-of-its-kind app for personalized tracking the dosage, weight loss, energy levels, and symptoms of GLP-1 medications like Ozempic and Wegovy. It crossed 100,000 downloads in 8 months after launching and closed $2.25 million in seed funding.
The Social Impact of GLP-1s on Public Health
GLP-1s aren’t just transforming individual lives – they’re reshaping public health. For the first time in decades, obesity rates in the U.S. are declining, with research in JAMA crediting GLP-1s as a major contributing factor. These medications aren’t just helping people shed pounds; they’re preventing the downstream effects of obesity-related conditions like heart disease, stroke, and joint degeneration.
Current estimates suggest that 50.4% of U.S. adults qualify for GLP-1 therapy under existing and emerging guidelines. If big pharma succeeds in limiting access to compounded GLP-1s, millions of patients will be left without affordable options. “If the goal is to reduce healthcare costs and improve public health, restricting access to GLP-1s makes no sense,” says Noorian.
Noorian added that “a healthier population means fewer hospitalizations, lower long-term healthcare spending, and a workforce that stays active and productive longer. The economic benefits are massive. If more Americans can access GLP-1s affordably, taxpayers save billions in Medicare and Medicaid expenditures. Instead of burdening the system with expensive chronic disease management, patients can pay cash prices through compounding pharmacies, avoiding the bureaucratic costs associated with insurance reimbursement.” Jan Hatzius, chief economist at Goldman Sachs, predicts that if 60 million people take the medications by 2028, GDP would be boosted by 1% — or several trillion dollars. Hatzius’s based his analysis on the idea that healthier people mean a healthier workforce and, in turn, lower health-care costs.
“As an obesity and lifestyle medicine doc who prescribes many of these medications, I feel a duty to discuss GLP-1s with patients who might benefit. Some days, that’s with literally every patient I see. There are many important questions to discuss with patients, and most of all, affordability. These drugs are one part of the acceleration in health insurance costs. Even at full price, I think they more than pay for themselves when prescribed correctly. If we consider the number of people affected by obesity and the effects these meds deliver, GLP-1 drugs might be the most important therapeutics since anti-retroviral medications for HIV.”
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