Many telehealth platforms selling GLP-1s online prescribe the drugs without requiring a clinician to interact with the patient in real time, according to a secret shopper study conducted by researchers at Yale University School of Medicine and published July 6 in JAMA.
Lead author Ashwin Chetty — a medical student at Yale — posed as a 237-pound patient with high cholesterol, high blood pressure, prediabetes and sleep apnea, seeking prescriptions from 49 online sellers between August and December 2025.
Overall, 91.8% of sellers issued a prescription to the secret shopper. Just 13 platforms (26.5%) required a video visit with a clinician and three (6.1%) required a phone call before a prescription was given.
Nine sites, or 20%, prescribed medication after receiving only an upper-body photo despite the sellers requiring a full-body or scale photo. Two compounded prescriptions were issued in five minutes or less, and 34 sites (75.6%) automatically charged and shipped medication after prescription approval without waiting for patient confirmation. On three sites, the same clinician prescribed to Mr. Chetty more than once without recognizing him.
“It indicates that the clinicians are not paying attention to the patient,” he told The Washington Post. “It’s another piece of evidence that paints the picture. Prescriptions first, questions later — if that.”
The findings come amid mounting regulatory scrutiny of telehealth companies’ GLP-1 marketing and compounding practices.
