Online weight loss medication: are you getting the treatment you need?

Online websites that prescribe weight management medication are taking the world by storm. These online programs are highly variable, from comprehensive, high-quality obesity management, to prescribing platforms that provide quick access to medication without providing integrated, holistic care. While it would be ideal for every person to be prescribed medication through traditional doctor-patient care, the reality is that some people have difficulty accessing that care, some feel bias and stigma when they try to talk to their doctors about weight, and some prefer the convenience and/or anonymity of the online experience.

If you are going the route of online care to get your weight management medication, here are some of the checkpoints to make sure you are getting the care you need, many of which are discussed in a recent, excellent Obesity Pillars article. Note that your own personal needs are unique, and that this list may not be comprehensive.

Does the prescribing doctor understand your medical history?

Some online platforms take your medical history via click-box or algorithmic intake forms. Has the prescribing doctor reviewed and explored this history with you? This is important not only to understand causes and contributors to elevated weight, but is also critically important in safety of prescribing treatment.

Does your care plan include more than just the medication?

Weight loss medications should be prescribed alongside any other needed support (psychological, nutrition, physical activity). A conversation around preventing/managing potential side effects is also important.

Have potential side effects, including prevention and management, been thoroughly discussed?

Discussing potential side effects is an important part of informed consent for starting any treatment. Discussing strategies to reduce the risk of gastrointestinal side effects can be particularly beneficial (as we published, here).

Have weight-related health issues been asked about and discussed?

There are over 200 health issues that can be associated with elevated weight, some of which often go undiagnosed (eg obstructive sleep apnea), and some of which are very difficult to diagnose without seeing a patient in person. Any program prescribing weight loss medications should be enquiring about possible related health issues. Ideally, every person seeking care should be seeing a doctor for physical examinations (if not integrated with the program, then separately, eg through family doctor care).

Is there transparency in cost, coverage, and choices?

A program should have access to prescribe any obesity medication approved in that country (though very fair to recommend one specific medication if that particular treatment is best for your individual treatment needs).

Has the prescribing doctor carefully evaluated other medications you are taking?

There are many medications that can cause weight gain (eg some diabetes meds, antidepressants, antipsychotics, and many more – see here), which can often be exchanged for similar medications that don’t cause weight gain. There are many medications that may need adjustment with the use of weight loss medications, like blood pressure or thyroid medications (as blogged previously). Some weight management medications can interact with, or affect absorption, of other medications (see our 2025 Obesity Canada pharmacotherapy guidelines for more on this).

Are you being prescribed health agency approved medication?

Brand name and generic versions of those are approved by national health agencies (eg FDA in USA, Health Canada). Compounded medications have emerged in the marketplace, as a result of cost and shortage of branded medications. There are no studies or safety checks on their content, quality, safety or efficacy. We recommend specifically against taking compounded preparations in our 2025 Guideline (see Recommendation #13).

Is the program communicating with your other doctors/health care team?

It’s crucial that any health care professional involved in your care knows what medications you are taking. It’s also important that doctors caring for other health issues can help support any changes that may be needed to your other treatments as you embark on weight loss journey (eg medication adjustments as above). If you are taking a GLP1-based medication and having a surgery or a procedure that requires conscious sedation, it’s important to discuss your preop management with that team. These are just a few examples of why communcation is so important!

Is the program providing or arranging follow up care?

Prescribing weight loss medication is not a one-stop transaction. Long term care is important to evaluate success of treatment, encourage long term adherence, and navigate side effects. This can be handed back to the family doctor once stable, but having a plan for continuity of care is important.

BOTTOM LINE: Online prescribing of weight management medication is here to stay, and it’s growing in access and popularity. As health care professionals and people seeking care, let’s work together to make sure it’s done in a responsible, reliable, appropriate, and sustainable way!

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