Choosing an online service

What the website flow usually looks like

Services vary, but many follow a similar order. You create an account, answer a health questionnaire, add your insurance or payment details, and wait for a clinician to review your answers. Some then hold a video or phone visit. If the clinician prescribes, the order goes to a pharmacy, and you get messages about shipping and follow-up.

None of that is an official standard. Treat it as a map, and check each step on the service you are looking at.

Questions to ask before you sign up

• Who reviews my answers, are they a licensed clinician, and are they licensed where I live?
• Do I get a live conversation, or only a questionnaire review?
• Which medicine would I be prescribed? Is it the FDA-approved brand-name product or a compounded version?
• What is the total monthly cost, including the visit, the medicine, shipping and any renewal fee? How do I cancel?
• Who do I contact about side effects, and how quickly do they answer?
• How often are follow-up visits, and what happens at dose increases?
• How is my health information stored and shared?
• Will you send records to my regular clinician if I ask?

Why the medicine source matters

A compounded medicine is made by a specialty pharmacy rather than the manufacturer, and it is not the same product as the FDA-approved brand. During shortages from 2022 to 2024 many people used compounded versions. A 2025 study of more than 153,000 patients in a primary-care database found compounded use documented for about 8% of them, while surveys suggested about 23% were getting these medicines outside regular care. The authors note this can leave regular clinicians unaware of what people are taking.

The rules on compounding were being wound down in 2025. In March 2026 the FDA announced warning letters to 30 telehealth firms over misleading marketing of compounded GLP-1 products, and the rules may have changed again since. Ask the service to tell you exactly what you would receive, and check current FDA information.

Signs to slow down

These are the Atlas's reading of the American College of Physicians guideline, which stresses a real discussion of history, harms and costs. They are not a rating of any company.

• No questions about your health history before a prescription.
• A promise of a specific amount of weight loss.
• Pressure to buy a long plan up front.
• Not telling you which medicine you would get, or who makes it.
• No clear way to reach a clinician after you start.

Questions to ask

• What does the total cost look like over the first six months?
• Can you send my records to my regular clinician?
• What do I do if I have a reaction outside business hours?

What is still unknown

• The Atlas has not found research comparing the quality of care across online services.
• Compounding rules and prices change frequently.