| Few areas of health care have changed as quickly as the market for GLP-1 weight-loss drugs, which continue to attract new patients while transforming the business and politics of obesity treatment. More Americans than ever are taking GLP-1s for weight loss, according to a Gallup research poll released on Tuesday. The survey, which polled just over 5,000 adults representative of the U.S. population, found that 11 percent are taking GLP-1s to lose weight — a jump from 3 percent in 2024. Overall, 15 percent of those polled reported having ever taken these medications for weight loss. That mirrors the results of a KFF poll from this past fall, which showed that about 12 percent of Americans are taking GLP-1 drugs for weight loss and that 18 percent have tried them. Why it matters: The findings underscore how rapidly the market has expanded in just a few years, even as questions remain about who can access the drugs, how they’re prescribed and who ultimately pays for them. A decline in the obesity rate is also intensifying the debate about whether higher costs for the drugs in the short term ultimately lead to longer-term savings. The booming market is continuing to evolve, though, with new drugmakers trying to find products that can compete for new patients. The market leaders, Eli Lilly and Novo Nordisk, are also innovating their own next-generation weight-loss products that can help people lose even more weight or curb common side effects of GLP-1s, such as stomach upset and nausea. Here are three things to watch in the GLP-1 space: 1. Easy access A secret-shopping study from researchers at Yale University found that many online providers prescribing weight-loss drugs offer little clinical oversight, raising new concerns as demand for GLP-1 medications continues to grow, Christopher Rowland reports from The Washington Post newsroom. The study, published Monday in JAMA, chronicled efforts by Yale medical student and researcher Ashwin K. Chetty to pose as a 237-pound patient seeking a prescription from 49 telehealth sites. Forty-five ultimately prescribed a GLP-1 drug, but fewer than one-third required a video visit, and only three required a phone call. More than two-thirds prescribed the drugs without any live interaction with Chetty, who is described as having a trim build. Researchers also found that patient information was rarely verified. Many providers relied solely on online questionnaires, and nine out of 11 sites that said they required full-body photos or a picture of a person on a scale had approved prescriptions using only upper-body images. On three separate websites, the same clinician prescribed medication to Chetty multiple times without recognizing him. Why it matters: The findings raise questions about whether the rapid growth of virtual prescribing has come at the expense of basic safeguards, such as screening for side effects, confirming appropriate dosing or identifying patients with eating disorders. The study authors did not link names of the online GLP-1 vendors or individual providers to specific findings in the study. But they gave Christopher the list, which included whether each required a video meeting with a doctor or physician assistant. The largest, most heavily marketed weight-loss sites — including Hims & Hers Health, Ro and Noom — did not require video exams, according to the findings. Noom told Christopher that it uses “evidence-based protocols,” and Hims & Hers said that it provides access to licensed clinicians, while the American Telemedicine Association said that telehealth providers are expected to meet the same professional standards as in-person clinicians. Most prescriptions were for lower-cost compounded GLP-1 drugs, which expanded during temporary shortages of the branded medications. Researchers say patients are increasingly turning to online providers because of the high cost of brand-name drugs and limited insurance coverage. Read the full story: “How easy is it to get weight-loss drugs online? Secret shoppers from Yale found out.” 2. Compounded versions Copycat compounded versions of semaglutide and tirzepatide, the drug names for Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound, respectively, continue to proliferate despite backlash from manufacturers and rebuke from federal regulators. Just 68 percent of people who reported taking GLP-1 medications for weight loss used Novo Nordisk- or Eli Lilly-branded products, according to the newly released Gallup poll. Nineteen percent said they were using compounded or custom-mixed versions, and 12 percent didn’t know. (However, the margin of error for the compounded group, Gallup said, is higher than the other results — plus or minus 10 percent.) Telehealth platforms that prescribe the compounded versions insist that they’re safe — and are sometimes customized to address specific patient needs — but the two drug companies that make them have been pushing back. Novo Nordisk and Eli Lilly, for example, have been lobbying heavily in statehouses nationwide to push for laws that would prohibit the sale of compounded variants of their drugs. About 10 states have moved to rein in compounding pharmacies with proposals that would tighten rules or prohibit the practice for certain products, according to Bloomberg Law. While many of the legislative efforts were unsuccessful in the 2026 legislative session, many are expected to return next year. The Food and Drug Administration has also issued several warnings about compounded GLP-1s, which have some oversight but are not FDA approved. Novo Nordisk and Eli Lilly have met with regulators on the issue in recent months. 3. Cost and coverage Paying out of pocket for Wegovy and Zepbound can set patients back up to $499 per month if they’re paying out of pocket. It’s a big discount from the four-figure prices drugmakers initially charged when the medications first hit the market, but still out of reach for many patients without insurance that covers them. —Private insurance coverage remains inconsistent. Many employer plans require patients to meet body mass index thresholds, document obesity-related health conditions, complete lifestyle modification programs or try less expensive treatments first before approving coverage. Earlier this year, the industry association Business Group on Health surveyed more than 100 of its employer members about GLP-1 coverage in health plans for their workers. While 67 percent said they currently offer some kind of coverage for GLP-1s used to lose weight, 10 percent of those employers said they would probably end that coverage in 2027. The companies that don’t already offer weight-loss treatments are unlikely to add it in the future, the survey found. “Against the backdrop of anticipated double-digit health care cost increases, fueled to a large degree by GLP-1s and overall prescription drug costs, companies cannot ignore the reality that GLP-1s have significant implications for health care budgets — and overall affordability,” Ellen Kelsay, president and CEO of Business Group on Health, said in a statement about the survey results. — The Trump administration launched a temporary pilot program to offer GLP-1 coverage for certain patients in Medicare starting in July. Patients who qualify can get the medications for just $50 per month. KFF estimates that nearly 4 million older Americans could have new access to GLP-1s to treat obesity. The program opens up drugmakers to a previously untapped market, as Medicare is generally prohibited from covering obesity treatments. The experimental 18-month pilot allows the federal government to get around the law by temporarily testing the payment policy. The Wall Street Journal cites estimates from Evan Seigerman, of BMO Capital Markets, that show that a modest uptake of the Medicare pilot generates roughly $3 billion in new sales for Eli Lilly and Novo Nordisk. It’s a hefty sum, but a fraction of the combined $80 billion the companies are already earning annually from the medications. → What happens in 2028 when the program ends? That’s unclear. The federal government had invited health insurance companies to pick up some of the tab for the Medicare experiment but couldn’t garner enough interest, so it’s unclear whether it could be extended. Many did back-of-the-envelope math and figured that it would raise costs — and monthly premiums — too much for all patients, as Health Brief previously reported. There has also been a narrow effort in Congress to pass legislation that would allow Medicare to cover obesity treatments, but the potential price tag has been a factor in it languishing. The pushback against a Trump administration plan to overhaul federal grant rules is growing, with a bipartisan chorus of lawmakers deriding it as executive branch overreach. Sen. Susan Collins (R-Maine), who leads the Senate Appropriations Committee, is asking the Office of Management and Budget to withdraw some of the proposed changes to the grant process, arguing that they would create uncertainty for research institutions and could harm biomedical research. On Monday, Collins sent a letter to White House budget director Russell Vought objecting to provisions of the proposed rule that would: - Allow agencies to terminate discretionary grants, cooperative agreements and other federal awards at any time, should they determine doing so is in the agency’s interest, including to align with agency priorities or the “national interest,” while limiting the ability of recipients to appeal those decisions.
- Require senior political appointees to review grant awards after the scientific review process to determine whether they align with President Donald Trump’s policy priorities, which Collins argues could inject politics into scientific and biomedical research funding.
- Require grant recipients to submit written justifications with every payment request, creating new paperwork that Collins says would hit small institutions and rural communities the hardest.
- Give greater weight to presidential policy priorities in grant decisions without clearly ensuring they remain consistent with Congress’s intent.
OMB did not comment on the letter. But it comes days after Senate Democrats penned their own letter to Vought, asking him to withdraw the proposed rule entirely. The letter, signed by every Democrat in the chamber, argues that the rule would exceed OMB’s authority. The agency has received more than 82,000 comments on the proposed rule so far, with some comments as short as a few sentences. The comment period ends on Monday, though Collins has asked the agency to extend the comment period by at least 90 days because she has heard from interested parties that the 45-day deadline is “inadequate.” Vought told lawmakers last week during a House Appropriations panel hearing that “probably record numbers of comments have come in.” “We’re going to assess each one of those comments and make any changes that we need to,” Vought said as reported by Politico. “Trump’s One Big Beautiful Bill has cut food assistance for millions of Americans,” The Post’s Hannah Knowles and Mariana Alfaro report. “Copay Assistance Is Meant To Defray Patient Drug Costs. Some Insurers Keep It Instead.,” Daniel Chang reports at KFF Health News. “Illinois prison healthcare still poor as state goes 1 year without long-term medical provider,” Kaitlin Washburn reports at the Chicago Sun-Times. “Ascension to buy Tennessee system Williamson Health in $1B deal,” Rebecca Pifer Parduhn writes at Healthcare Dive. This newsletter is published by WP Intelligence, The Washington Post’s subscription service for professionals that provides business, policy and thought leaders with actionable insights. WP Intelligence operates independently from The Washington Post newsroom. Learn more about WP Intelligence. | 
