An Allure investigation traces how GLP-1 weight-loss drugs moved out of the doctor's office and into telehealth storefronts, med spas and person-to-person sales. The reporting follows patients who lost insurance coverage and went looking elsewhere, and the creators who now earn a commission every time one of them signs up.

The drugs in question are semaglutide (sold as Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound), glucagon-like peptide-1 agonists that are FDA-approved and legally prescribable. What Allure calls the gray market is everything outside that route: non-FDA-approved compounded versions, overseas sellers, and prescriptions issued without a full medical assessment.

Why the coverage cliff matters

Millions of people have had GLP-1 coverage for weight loss dropped since 2025, according to GoodRx research cited in the piece. One woman interviewed, identified only as Karen, paid $188 for a four-week supply from a friend of a friend, against $349 out of pocket with a Wegovy savings card.

The price gap is the whole story, and no amount of clinical disapproval closes it. KFF Health surveys cited by Allure found nearly 1 in 5 adults have taken a GLP-1 agonist at some point, and about a quarter of them got it from somewhere other than a primary care doctor or specialist.

The word peptide is doing work

When the FDA declared semaglutide and tirzepatide shortages resolved in 2024 and 2025, compounding pharmacies lost the legal opening to sell near-copies. Some telehealth companies responded by selling "custom blends" with additives such as B12, and Sarah Finn, MD, of Dartmouth Health told Allure that is exactly why the products are being labeled peptides.

The agency has pushed back. Since last September it has sent three batches of warning letters, more than 100 in total, to telehealth companies over false or misleading marketing claims about compounded GLP-1 products.

Where the affiliate money comes in

Courtnay Kersh, a registered nurse with more than 28,000 TikTok followers, told Allure she lost 70 pounds in about 10 months on a compounded GLP-1 and then joined a telehealth affiliate program. She says her average monthly earnings now more than double the average monthly salary for a US nurse, while acknowledging she is an outlier among affiliates.

Chika Anekwe, MD, obesity medicine clinical director at Massachusetts General Hospital, called that promotion unethical and noted there is no assurance of the safety or efficacy of what these companies dispense.

What is not established

The FDA has raised concerns about compounded GLP-1s and received reports of adverse events, but Allure also found patients who report satisfaction with products from US telehealth companies and overseas manufacturers. Nobody has a count of how many people are buying directly from another person, and that gap is the point.

Bottom line

The regulatory fix has been aimed at sellers while the demand driver, lost coverage, has gone untouched. Until that changes, the enforcement letters are chasing a market that reconstitutes itself under a new label.