How Telehealth GLP-1 Programs Work

Step 1: Sign up and medical intake (Day 1)

You create an account, enter your state (to confirm the provider is licensed there), and complete a medical questionnaire. Expect questions on:

• Height, current weight, BMI
• Weight-loss history and prior GLP-1 use
• Medical conditions: diabetes, PCOS, thyroid disease, pancreatitis, gallbladder, kidney disease
• Contraindications: personal or family history of medullary thyroid cancer, MEN 2 syndrome, pregnancy or breastfeeding, hypersensitivity to GLP-1s
• Current medications and allergies
• Recent labs (some providers require A1c or basic metabolic panel; others don't)

Intake usually takes 10–20 minutes. Be honest — hiding contraindications is dangerous and grounds for rejection later.

Step 2: Clinician review (Day 1–3)

A US-licensed clinician reviews your intake. At a physician-led provider (PlushCare, Sesame), an MD reviews. At most async-first providers, a nurse practitioner or physician assistant reviews under physician oversight. Some providers require a brief video visit; others don't.

Expected outcomes:

• Approved: Prescription written, medication ordered from pharmacy.
• Approved with modifications: Approved for a different drug (e.g., you asked for tirzepatide, approved for semaglutide) or a lower starting dose.
• More info needed: Clinician asks for recent labs, medical records, or clarification.
• Declined: Contraindication, BMI below threshold, or safety concern. Reputable providers refund immediately.

Step 3: Pharmacy fulfillment and shipping (Day 3–10)

Once approved, your prescription goes to the provider's partner pharmacy — either a 503A compounding pharmacy (for compounded semaglutide/tirzepatide) or a retail specialty pharmacy (for branded Wegovy, Zepbound, Mounjaro). The pharmacy fills, packs the vial or pen in an insulated cooler with cold packs, and ships overnight or 2-day.

Most shipments require a signature. Ship to an address where you can accept a refrigerated package during business hours.

Step 4: First injection and titration (Week 1–16)

Your first dose is the lowest starting dose (Wegovy 0.25 mg, Zepbound 2.5 mg, or compounded equivalent). You inject weekly and message the care team if side effects are significant.

Dose escalations happen every 4 weeks:

• Wegovy: 0.25 → 0.5 → 1.0 → 1.7 → 2.4 mg
• Zepbound: 2.5 → 5 → 7.5 → 10 → 12.5 → 15 mg
• Compounded semaglutide/tirzepatide: similar step-up schedule

You can hold at a tolerable dose longer if side effects are rough; that's a normal clinical decision, not a failure.

Step 5: Ongoing care and refills

Refills ship automatically on a monthly cycle. Async messaging handles most day-to-day questions. Most providers have live chat or phone support for urgent issues. Serious side effects always go to your local ER or your prescriber's on-call line — not chat.

Step 6: Pause, cancel, or switch

Reputable providers let you pause between refills, cancel with prorated refund, or switch to a different drug (semaglutide → tirzepatide) with a new prescription and no re-intake. Read the refund terms before you sign up.

What good vs. bad looks like

• Good: Response to messages within 24 hours, transparent about pharmacy name, dose changes explained clearly, no pressure to escalate.
• Bad: Slow or robotic responses, refuses to name pharmacy, pushes highest dose immediately, hidden fees on cancellation.

FAQ