Texas patients turn to clinics for compounded weight loss drugs
It was photos from a cruise trip that finally pushed Joelle Potter to the breaking point in her weight loss journey.
She’d gone on the trip with a close friend and excitedly had done a photo package where she could pick out 100 photos. There was just one problem — she hated all of them.
“They just showed how big I was,” she recalled.
When she came home from the trip, which she’d taken in December 2022, she decided that she’d had enough. She had a daughter who was about to turn four and twin sons who were about to turn 14 at the time.
“I just said, ‘I need to do something that’s going to help me lose weight but also correct some health issues I have’,” she said.
Potter has polycystic ovarian syndrome, a hormonal disorder that can cause weight gain and insulin resistance, she said. But stress and a string of deaths in the family, she said, pushed her 4 11 frame to 186 pounds.
When working out, dieting and even turning to other medications didn’t help, she decided to try something different: compounded semaglutide treatment. It’s helped her lose almost 50 pounds in 17 months, weight she struggled to lose through traditional dieting and exercise.
After Ozempic and Wegovy burst onto the market in 2021 after gaining FDA approval for weight loss, 1 in 8 Americans have tried the pricey medications to cut pounds and overcome fights with obesity according to a Kaiser Family Foundation study. The drugs utilize a key ingredient — semaglutide — that has worked so effectively that there have been shortages of Ozempic and Wegovy across the country.
Those eager to utilize experience have turned elsewhere — to compounded semaglutide treatment, advertised as a combined version of the key ingredient found in next-generation weight loss drugs like Ozempic and Wegovy with vitamins, saline or other additives.
But doctors and medical professionals are advising caution about the non-fdaapproved compounded versions of weight loss drugs, offered at a fraction of the price of their brand name counterparts, even while demand soars. The compounded versions of these drugs, which help lower appetites and have resulted in major weight loss in many users, have seen scant testing.
Doctors can prescribe compounded treatments, but in the Dallas-fort Worth area, multiple medical aesthetic spas, or medspas, and telehealth clinics have responded to the growing demand for compounded semaglutide.
WHAT ARE MED SPAS AND HOW CAN THEY PRESCRIBE COMPOUNDED SEMAGLUTIDE TREATMENTS?
Potter receives her compounded semaglutide treatment via D-fw-based telehealth clinic Trimmoff, but another common place patients can go to receive compounded treatments are medical spas, which handle nonsurgical aesthetic medical procedures.
Dr. Praveen Guntipalli opened Sanjiva Medical Spa in late 2022 after working in leadership at a hospital. He started looking into med spas about five years ago and was inspired by friends who said they had poor experiences with procedures like lip fillers, Botox injections and IV infusions. Guntipalli, who estimates the spa has 1500 patient visits annually, says 20 to 30% of his patients are using semaglutide for weight loss.
“When it comes to skincare, when it comes to other injectables, Dallas is one of the top markets,” Guntipalli, an internal medicine physician certified in obesity medicine, said.
That’s in part because D-FW is one of the fastest-growing metroplexes in the country, Guntipalli said, and also simply because people in the area want to look good. A little more than a third of Dallas County residents were obese as of 2021, according to data from the Centers for Disease Control.
Josanne Stephens is the owner of Spa in the City on West Lovers Lane. Like Guntipalli, Stephens said that Spa in the City has seen 10 to 20% year-over-year growth since its opening in 2010.
About a tenth of Spa in the City’s clients gravitate toward compounded semaglutide treatments, Stephens said. She said that while the spa follows prescription guidelines, there are people who want semaglutide treatments because they “think they need to lose five pounds and want to do it with semaglutide.”
“But that’s not something we do,” she added.
Something that people might not also realize is that even while taking the drug, it’s important to “put in the work,” said Carolina Vigil, who is the co-founder and chief operating officer of Trimmoff where Potter consults for her injections. Although Vigil is not a doctor, she has used semaglutide treatment for weight loss.
“Instead of that fast food, get something healthier, put some fruit in there, add some vegetables and then do some type of exercise,” she said.
When she talks to people who want to book consultations and are curious whether they will gain weight after they stop using the drug, Vigil said she always says it’s important to change lifestyle habits for sustainable weight loss — and to keep the weight off.
“It’s about treating this medication as an assistant to help you form those healthy habits,” she said.
WHAT ARE SEMAGLUTIDE AND COMPOUNDED SEMAGLUTIDE TREATMENTS?
Semaglutide is the active ingredient in weight loss drugs like Novo Nordisk’s Ozempic and Wegovy, which have been hailed as “miracle drugs” for not only treating obesity but also treating weight-related ailments like diabetes and high blood pressure. It works as an agonist — “a substance that mimics the actions of a neurotransmitter or hormone,” per the Health Research Board’s National Drugs Library — to the brain’s GLP-1 receptors, which regulate the body’s blood sugar levels, by stimulating the production of insulin to convert glucose, or sugar, into energy.
The ingredient was also found to help in the gut by slowing down digestion and in the brain by making “you feel fuller faster,” said Kathryn Litten, a clinical assistant professor of pharmacy practice at the University of Texas at Austin College of Pharmacy.
Patients must have a body mass index over 30 or over 27 with a weight-related condition for doctors to prescribe the drug. Roaring demand for brand-name semaglutide treatments like Ozempic or Wegovy, however, has led to short supply.
The drugs can be expensive, too — without insurance, for instance, a month’s worth of Ozempic can cost almost $1,000. In some cases, insurance doesn’t even cover brand-name semaglutide formulations. Even for those with insurance, more than half say Ozempic and Wegovy are “very difficult to afford.”
“So many things go into developing a drug,” Litten said. “And so when it comes on the market, it is expensive to help pay for all of the research and the development that went into that drug.”
Litten said that high prices for drugs can typically last for the 20 years that manufacturers have to market the drug under their brand before genetic products are allowed to hit the market.
Compounded semaglutide treatments are also, however, much cheaper than brandname semaglutide formulations. Potter said she spends less than $150 a month for her treatment, though she said it’s important to consider that she’s a long-time user and requests a three-month file.