I use an online platform for my hormone replacement therapy. It’s convenient, it fits my life, and I don’t have to lose half a day in a waiting room every time I need a refill. So when I started getting curious about GLP-1 medications, like so many women are right now, I logged in to see what they offered.
They offered two kinds. There were the brand-name, FDA-approved medications everyone has heard about, and right next to them were compounded versions that were cheaper, easier to get, and sitting on the same menu as though the difference barely mattered.
That gave me real pause. A compounded drug is mixed by a pharmacy rather than made by the company that ran the clinical trials, and it is not FDA-approved, which means no one at FDA reviewed that specific product for safety, effectiveness, or quality before it reached a patient. Compounding has legitimate uses, but I spend my working life arguing that patients deserve to know exactly what they’re getting, and I couldn’t answer that question about the cheaper option.
Then I read about the black market
A recent Washington Examiner op-ed made my hesitation feel a lot less abstract. It describes an experimental weight-loss drug, still in late-stage clinical trials and not approved anywhere in the world, being sold to Americans through TikTok, medical spas, and the mail. According to the piece, the raw ingredient is shipped from China under false customs labels, routed through other countries to hide where it came from, and relabeled here before it’s sold, often with a “research use only” sticker on the vial and dosing instructions tucked in the box.
The part that stopped me was who is buying it. The op-ed describes kids as young as 13 trading dosing tips online, teenagers posting before-and-after photos of rapid weight loss, and young people hiding vials from their parents in the family fridge.
The compounded product on my platform and a smuggled vial relabeled in an office park are not the same thing, and I don’t want to pretend they are. But they sit on the same spectrum, and the further a product drifts from FDA approval, the less anyone can promise you about what’s actually inside. A clean website with a checkout button doesn’t tell you where on that spectrum you are.
Why so many people take the shortcut
None of this happens in a vacuum. People reach for gray-market and black-market versions because the approved medications are expensive, often not covered, and wrapped in so many insurance hoops that plenty of patients give up before they start. I’m not going to tell anyone the answer is to simply stop wanting a treatment that might help them. If we want patients buying from legitimate sources, the legitimate door has to be one they can actually afford to walk through.
The op-ed makes a point I agree with: FDA already has authority to detain these shipments at the border, and 34 state attorneys general from both parties have asked the agency to use it. So far, enforcement has mostly meant warning letters, and vendors who get one can simply rename the product and keep selling. We don’t need a new law to fix this. We need the agencies to use the tools they already have.
What I’ve decided, and what I haven’t
I haven’t started a GLP-1. After everything I’ve read, I’m genuinely nervous about putting anything in my body that hasn’t been through FDA review, which is still the gold standard of approval processes, and I’m not willing to bet my health on a label I can’t verify. So if and when I do start, it will be with an FDA-approved medication.
That part feels settled. The bigger question for me right now has less to do with the medicine or the cost than with me: am I in the right headspace to start? No platform, pharmacy, or price tag can answer that one for me.
This isn’t a judgment of anyone who has made a different call. It’s what being the CEO of my own healthcare looks like for me right now, which means asking the uncomfortable questions before I click buy instead of after, including the ones I have to ask myself.
Before you click buy
If you’re weighing a GLP-1, or any medication you found online, these are the questions worth asking first.
Is this the FDA-approved product or a compounded version? Ask the platform directly, and if they can’t or won’t give you a clear answer, that tells you something.
Which pharmacy fills it, and is it licensed in your state? Your state board of pharmacy can confirm it, and FDA’s BeSafeRx program explains how to spot a legitimate online pharmacy.
Did a clinician actually evaluate you? A real prescription comes from a licensed prescriber who reviewed your health history, not from a checkbox quiz.
Does the label say “research use only” or “not for human consumption”? Then it was never meant for you, no matter what dosing chart comes with it.
Is the price too good to be true? Steep discounts and unusual payment requests, like payment apps or crypto only, are red flags.
If you’re a parent, it’s worth having a direct conversation with your teenager about what they’re seeing on social media. And if you or someone you love has a bad reaction to any of these products, report it to FDA through MedWatch so the agency can see what’s happening.
I’d love to hear from you. Has an online platform ever offered you a compounded version of a medication, and did you know what that meant before today?
Sources
Jennifer Nunez, “China is shipping ‘super-Ozempic’ to American teenagers. The FDA’s response? Stern notes,” Washington Examiner, September 18, 2026.