Inside the thriving market for alternatives to brand-name weight loss drugs

Prescription weight loss drugs have become so popular in the United States that suppliers have struggled to keep up. Jean Readdy, a retired teacher living in Sinking Spring, Pennsylvania, is among the one in eight Americans who have tried a GLP-1 drug for weight loss or diabetes, more commonly known by brand names like Ozempic and Wegovy.
Readdy, who has struggled with her weight for most of her life, told CBS News her weight affected her self-esteem and how she moved through the world.
“I didn’t like going out places,” Readdy admitted.
She reached her highest weight last October, right as her son was about to be married.
“I was embarrassed for him and I was embarrassed for myself,” said Readdy. 
Now, she’s one of a growing number of people turning to compounded drugs: reformulated versions the FDA has permitted pharmacies to distribute during an ongoing shortage of brand-name drugs.
Readdy’s decision to switch from a name brand to a compounded drug came down to price and availability. Paying $1,200 a month for the name-brand drug Zepbound wasn’t sustainable, and it was becoming impossible to find, she said.
And she’s not alone.
Readdy turned to online communities where thousands of people shared resources and where to find the drugs in short supply. On a Reddit forum, she read about the side effects, learned about alternatives, and eventually came across a spreadsheet with dozens of telehealth providers for prescription drugs used for weight loss. After weighing the risks and calling dozens of pharmacies, she eventually found one that provided her with injectable tirzepatide, the same active ingredient found in Zepbound. Readdy now pays $399 a month for her compounded medication.
CBS News identified more than 100 companies advertising access to tirzepatide or semaglutide, both active ingredients in name-brand GLP-1 drugs that regulate insulin and suppress appetite.
LegitScript, an organization that monitors and certifies online businesses, said it saw a 94% increase in companies applying for its healthcare certification since 2023. More than half of its recent applicants had a weight-loss focus on their website.
However, compounded drugs aren’t reviewed for efficacy and safety by the FDA.
“There is not a tremendous amount of oversight,” said CBS News medical contributor Dr. Celine Gounder. “There is a wide range in terms of the quality and the risks.”
Researchers who ordered and tested compounded semaglutide found some were contaminated and others contained more of the active ingredient than advertised.
Compounded drugs typically come with a needle and a vial, rather than a pre-filled pen, as the brand-name medications do. This can make them harder to administer and lead to potential dosing errors. The FDA issued warnings about administering the proper dosage of the drugs and the risks of using compounded semaglutide.
Still, many of the telehealth companies advertising compounded weight-loss drugs present them as the same as or “generic” versions of the brand-name medications. Nearly a quarter of the websites that CBS News identified did not disclose the drugs they were advertising were compounded. 
There is no FDA-approved generic version of brand-name weight loss drugs since pharmaceutical companies still hold patents on the medications. Some of the companies falsely claimed the drugs were FDA-approved. A few even allowed direct purchases without the required prescription.
The FDA is working closely with drugmakers and may restrict the manufacturing of compounded drugs as more versions of approved drugs come off the shortage list.
Last month, Eli Lilly announced it would reduce the cost of the lowest dose of its drug Zepbound to around $400 a month. It also launched its own telehealth company, LillyDirect.
Readdy, who has lost more than 50 pounds, said she intends to continue using her compounded medication.
“We’re very afraid actually that the drug is gonna be taken away,” she said. “I think it’s a miracle drug.”