Comment: Take action against counterfeit weight-loss drugs
Published 1:30 am Saturday, January 17, 2026
By Sandra Christensen / For The Herald
I began my practice to offer compassionate, evidence-based and destigmatized care for patients struggling with obesity rather than relying on a one-size-fits-all treatment.
The increased availability, safety and efficacy of FDA-approved GLP-1 medications have been an essential pillar of my comprehensive treatment plans, along with nutrition therapy, physical activity and behavioral counseling. This type of holistic and personalized approach to weight management is core to my practice, and I’ve dedicated my life to obesity education, reducing weight bias and advocating for access to evidence-based treatment.
That’s why I’m incredibly concerned by the rise of illegally compounded GLP-1s and illicit active pharmaceutical ingredients (APIs).
Compounding is a process by which pharmacies mix APIs to create a specific medication based on a patient’s needs. This is only legal when a patient cannot take a branded drug or when the the U.S. Food and Drug Administration places a drug on a shortage list. In these cases, compounded drugs are filling a specific need. While many GLP-1s were on the FDA’s shortage list, as of earlier this year, the FDA has removed them, meaning that the compounding of GLP-1s should have stopped.
Yet, some pharmacies, telehealth companies, and “med-spas” have continued to illegally compound GLP-1s and offer them at low prices to potential customers. There are considerable concerns with this practice. Compounded GLP-1s are not FDA-approved, which means they do not undergo the same rigorous safety inspections. Additionally, these drugs may contain illicit APIs.
Illicit APIs typically originate from overseas, particularly from China and India, and have not undergone FDA testing for safety or purity. Between September 2023 and January 2025, 239 shipments of counterfeit GLP-1 ingredients were sent to the U.S., with 82 percent being allowed into our drug supply. This is deeply troubling. We’re allowing untested, unregulated substances into medications that patients are injecting into their bodies.
Compounded GLP-1s with untested ingredients are not the only issue. Some companies are directly selling APIs to customers, allowing them to make their own GLP-1s at home. Companies target customers through social media platforms, offering accessible and affordable APIs. But with no medical experience and no guarantee of the safety of these ingredients, these customers are exposed to serious risks to their health and well-being. As someone who works with patients struggling with obesity every day, I understand the vulnerable place that many of my patients are in. Exploiting this vulnerability for profit exposes customers to dangerous medical practices and is not a solution to obesity.
Let me be clear: GLP-1s should be used only when FDA-approved and prescribed as part of a comprehensive, medically supervised treatment plan. This level of care is impossible with illegally compounded drugs or illicit APIs purchased online.
Our federal and state governments must work together to stop counterfeit GLP-1s and illicit APIs. While Members of Congress, including U.S. Rep. Marilyn Strickland, D-Wash., urged the FDA to ramp up enforcement on imported counterfeit GLP-1s and illicit APIs, we must continue to do more. The FDA must use the full weight of its enforcement authority to ensure that shipments of counterfeit GLP-1s and illicit APIs are stopped before they even make it into our drug system.
Obesity is a complex, chronic medical condition that requires comprehensive, compassionate, and evidence-based treatment. Illegally compounded GLP-1s and illicit APis are serious threats to the care that patients need and deserve.
Sandra Christensen, an obesity specialist, is the president of the Washington Obesity Society and is its clinical director, and is a trustee for the board of the Obesity Medicine Association.
