Online Weight-Loss Doctors: How a GLP-1 Telehealth Visit Works and What It Costs

An online weight-loss doctor is a licensed clinician who reviews your health history, by video or through a written questionnaire, and decides whether a GLP-1 such as semaglutide or tirzepatide fits you. Compounded semaglutide plans we track cost a median $199 a month, usually with the prescriber included. Brand-name drugs cost more.

Programs differ most in three places: how the visit happens, what the monthly price covers, and which states they serve. This guide walks through each one, using the 591 telehealth programs we track and the federal guidance that applies to all of them, and ends with the warning signs the FDA tells patients to look for.

What happens in an online GLP-1 visit?

Every legitimate visit starts with a medical screening and ends with a prescriber's decision. The FDA lists a company that "does not require a screening and prescription by a licensed doctor before providing medicine" as a red flag¹.

The screening asks the questions the drug labels make necessary. Zepbound, for example, is approved for adults with obesity, or adults with overweight who have at least one weight-related condition⁶. It must not be used by anyone with a personal or family history of medullary thyroid carcinoma or with MEN 2⁶. The label says to stop it if you become pregnant, and it advises people on birth-control pills to switch to a non-oral method or add a barrier method for 4 weeks after starting and after each dose increase⁶. It also warns that low blood sugar is more likely when it's combined with insulin or a sulfonylurea⁶. So expect questions about your height and weight, your medical history, your family's thyroid history, pregnancy plans and every medicine you take.

How the clinician reviews your answers varies:

Neither format is better in itself. A written intake is faster to fit around your day, and a live visit lets you ask questions in the moment. What matters is that a licensed clinician looks at your answers and stays reachable afterward. The FDA also flags a company that "does not have a licensed doctor available to answer questions after you receive your medication"¹.

Is an online GLP-1 prescription legal without an in-person exam?

Yes, under federal rules. The federal requirement for an in-person evaluation before prescribing by telemedicine applies to controlled substances, and the DEA and HHS have extended the telemedicine flexibilities for those drugs through December 31, 2026⁵. GLP-1s aren't in that category. The FDA labels for both Zepbound and Wegovy list the DEA schedule as "None"^6,7.

States set their own rules on top of that. That's why some programs ask for a live video or phone visit in certain states and accept a written intake elsewhere, as the examples above show. A clinician can also ask to see you, or ask for recent lab results, if something in your history calls for it.

Do you need labs?

It depends on the program and on your history. Some programs include labs in the price. Sesame Care, for example, lists video visits, unlimited chat and labs in its care subscription. Others order labs only when the clinician thinks you need them, and some don't say either way.

Before you sign up, ask three things:

• Are labs included, ordered only when needed, or billed separately?
• Can you use recent results from your own doctor?
• Who reviews the results, and will that change your dose?

If you have diabetes, kidney disease or take several medicines, expect the clinician to want more information before prescribing.

What's included in the monthly price?

This is where programs differ most. Across the 591 programs we track, the median month-to-month price is $199 for compounded semaglutide (352 programs) and $273 for compounded tirzepatide (332 programs). For 17 programs, the listed price is a promotion, a prepaid plan, a bundle or a rate with no stated term rather than a plain month-to-month price. The billing model decides what that price includes:

To compare two programs fairly, add every fee to the medication price for the same dose and the same billing period. A plan billed every 28 days charges 13 times a year, not 12.

Can an online doctor prescribe brand-name Zepbound or Wegovy?

Yes. 171 of the 591 programs we track offer at least one FDA-approved brand-name GLP-1. You usually pay the program's fee plus the manufacturer's price for the drug. Lilly's LillyDirect pharmacy, for example, fills Zepbound but doesn't prescribe it: your clinician sends the prescription there, and you pay Lilly's self-pay price of $299 to $449 per 28-day fill depending on the dose⁸. Our LillyDirect Zepbound price guide lists every dose, and the brand-name GLP-1 board lists the programs that prescribe brand-name drugs.

If you have insurance, ask whether the program handles prior authorization. Sesame Care, for example, says its providers handle that paperwork for the medication.

Many programs sell compounded semaglutide or tirzepatide instead: 352 of the programs we track list a monthly price for compounded semaglutide. Compounded drugs aren't FDA-approved, and the FDA says they should only be used when a patient's medical needs can't be met by an FDA-approved drug¹. Our guide to whether compounded GLP-1 is legit and safe explains how to check the pharmacy behind a compounded prescription.

Which states are covered?

It depends on where the program's clinicians are licensed. Federal guidance says a health professional must be licensed, or otherwise legally permitted, to practice in the state where the patient is located³. Clinicians can cover more states through full licenses in each state, licensure compacts, or telehealth registration where a state offers it⁴. HHS also tells providers to confirm where the patient is before an appointment⁴, so answer the location question with where you'll actually be.

Of the 591 programs we track, 164 say they serve all 50 states, and 290 don't publish the full list of states they serve. If you split time between two states, or you're moving, check coverage for the state you'll be in when refills come due.

What are the red flags?

The FDA lists these warning signs for telehealth GLP-1 sellers¹:

• Claims that a compounded drug is the same as an FDA-approved drug
• Deep discounts, or prices that seem too good to be true
• Medicine that looks different from what you got before, or arrives broken, damaged or without instructions
• No screening and prescription by a licensed doctor before the medicine is sent
• No licensed doctor available to answer questions after it arrives
• Spelling errors on the label, or a wrong pharmacy address
• A pharmacy name on the label that you think might be fraudulent

The FDA's BeSafeRx campaign adds the signs of a safe online pharmacy: it always requires a prescription, gives a physical U.S. address and phone number, has a licensed pharmacist to answer questions, and is licensed by a state board of pharmacy². The FDA recommends filling any GLP-1 prescription at a state-licensed pharmacy¹.

How do you find a program that fits?

Start with what you need: brand-name or compounded medication, a live visit or a written intake, insurance help, and a monthly budget that includes every fee. The online GLP-1 programs board lays out programs factor by factor, and Sesame Care (Partner) is one example of a program where you choose your own clinician and get brand-name medication only.

The 2-minute quiz asks about your budget, medication preference, insurance and state, then shows the programs that match what you told it. The order reflects your answers, so a different set of priorities gives a different list.