Juliana Simonetti, MD, a codirector of the comprehensive weight management program at the University of Utah in Salt Lake City, says it is “absolute insanity” that insurance companies so often deny coverage for injectable weight loss drugs to people with obesity, even for patients who have used these medications to get prediabetes under control. She understands what’s driving people to seek alternatives.
But, she says, there is no way to know for sure the conditions that compounded drugs are created in, adding that anyone buying compounded drugs from a dubious source runs the risk of using medications that pose safety risks and may not even be sterile.
“I’m very clear in telling my patients to not get compounded versions. I feel their pain and desperation, but I’m telling them not to do it because these are dangerous practices,” she says.
Andrew Kraftson, MD, the director of the weight navigation program at Michigan Medicine in Ann Arbor, believes strongly in the value of medications like semaglutide and understands why people are scrambling to get the drugs. He points out that obesity is highly stigmatized and undertreated.
“There’s this sense of urgency that’s driving people to make rash decisions,” he says. “They say, ‘This is out there now. I should have been on it yesterday.’”
But without FDA oversight, Dr. Kraftson says, compounded versions are too risky. “It’s problematic that there is this inherent conflict of interest,” he says about providers who might be willing to compromise safety in pursuit of profit.
Plus, he says, people who buy weight loss medications on the cheap aren’t typically getting the nutritional counseling to ensure that they’re staying healthy when drastically cutting calories.
“Food as medicine is an important component here,” Kraftson says. “Anyone could lose weight on 800 calories a day in the form of Twinkies, but it doesn’t mean they should.”
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