Med Spas, TikTok, Your Friend’s Hairstylist: The New GLP-1 Economy

15.09.2026, 19:36 allure.com

“Wegovy was the best thing I ever did,” Karen, a woman in her late 50s, says. “I lost 70 pounds in two years and I can finally move again, do stuff outside. Just wonderful, wonderful feelings. And then my insurance stopped covering it.”

Karen, who asked to be identified by only her first name, is one of the millions of people whose insurance has dropped coverage of their GLP-1 medications for weight loss since 2025, according to research by GoodRx. She’s also one of the many who, unable to afford the out-of-pocket cost at a pharmacy, started getting it from less official sources. (Or, as a friend who has taken GLP-1 medication texted me one morning, “People are literally buying it like a street drug.”)

Karen’s source: a friend of a friend who sold her pre-mixed, pre-filled syringes of what was supposedly a GLP-1 medication. “I think she was getting it from overseas,” Karen says, noting that she knows her source was buying it online, though she couldn’t confirm the drug’s exact origins.

What she did know for sure is that the friend who introduced her to her dealer, for lack of a better word, was seeing weight loss success using the same supplier. She also knew that it would be far cheaper than paying out of pocket: $188 for a four-week supply, compared with the $349 she has to pay now with a Wegovy savings card. Karen says she had zero hesitation about buying from this third-party source.

We are, as you may have heard, in the middle of a sort of peptide boom; GLP-1 (full name: glucagon-like peptide-1) medications are just one type of peptide-based drug that some people seem to be ordering unapproved versions of from arguably sketchy sources. But unlike many popular muscle-building, “age-defying” injectable peptides that a lot of Americans are currently experimenting with, certain GLP-1 agonists have FDA approval and doctors can legally prescribe them.

The gray market for GLP-1 drugs has probably existed for about as long as the drug category itself, which became a seemingly inescapable topic of conversation with the popularity of brands like Ozempic, Wegovy, and Zepbound. The term “gray market,” for the purposes of this story, refers broadly to the means through which people can obtain these drugs, including non-FDA-approved compounded versions, beyond the usual doctor-and-pharmacy system—and sometimes without a prescription or full medical assessment.

Suppliers on the gray market can include compounding pharmacies, med spas, and telehealth companies. Many of those sources may be following the applicable regulatory guidelines that exist; but it’s no secret to most of us that the laws governing the telehealth industry haven’t kept up with its rapid growth, and the same goes for med spas. Meanwhile, other GLP-1 sources—online sellers, overseas warehouses that sell the stuff in bulk, or yes, the friend of a friend of your hairstylist—are operating entirely outside the little regulation that is on the books.

Use of some GLP-1 medications—including among patients with type 2 diabetes and those who are overweight or obese—spiked dramatically between 2019 and 2022, with over 9 million prescriptions reportedly being written for some of these GLP-1s in just the last three months of 2022. Parts of this growing gray market really began to take off around that same time, as the FDA declared a shortage of semaglutide injection products, and later, tirzepatide injection products, due to increased demand.

Under federal law, when a drug is on the FDA shortage list, some restrictions are lifted, allowing qualifying compounding pharmacies to make versions that are “essentially copies” of the brand-name drugs. Like any compounded drug, those versions were not FDA-approved, meaning they didn’t go through the agency’s quality, safety, or efficacy reviews—but plenty of people say they still got the results they were looking for at less than the typical out-of-pocket cost. (Editor’s note: GLP-1s are not only weight loss drugs. They were originally developed and approved to treat diabetes, but some have since been FDA-approved to treat heart disease; and the category has shown tremendous promise in treating a wide range of other conditions, including substance use disorder. But it is the patients who have been prescribed the drug for weight loss only who seem to be, increasingly, losing insurance coverage, and that is the focus of this story.)

The FDA said the shortages were resolved in 2024 for tirzepatide and in 2025 for semaglutide. This meant compounding pharmacies were no longer allowed to regularly make and sell the “essentially copies” medications. (The grace period for pharmacies for both medications ended in early 2025.)

But this gray market continues to thrive. Some telehealth companies seem to be, at least for now, getting around the FDA’s rule against selling duplicates of commercially available drugs by selling “custom blends.” “That’s why they’re calling them ‘peptides.’ That’s why they’re putting vitamins in them,” says Sarah Finn, MD, section chief of obesity medicine at Dartmouth Health’s Walter and Carole Young Center for Digestive Health, and medical director of the Dartmouth Health Regional Weight Center in New Hampshire.

For example, B12 is a common additive, though the FDA seems to be cracking down on that workaround. In addition, since last September, the federal agency has sent three batches of warning letters—totaling over 100—to telehealth companies “for marketing false or misleading claims” about the compounded GLP-1 products they’re hawking.

For many patients, these moves by the FDA are just another barrier to accessing a drug that they feel has dramatically improved their lives, so they seek other sources. GLP-1-focused subreddits are brimming with comments from people who, after losing insurance coverage, are explicitly asking for information on how to navigate the expansive range of unofficial options safely. They get plenty of responses, too, including from people who enthusiastically recommend that they “go gray.”

Most of these subreddits have rules against specifically stating where you’re getting your compounded meds, so the advice is vague: Seek out GLP-1 groups on Facebook; browse glp1forum.com; scroll through TikTok long enough and you’ll find someone with an affiliate code. As with just about everything else right now, parts of the gray market, like some telehealth companies, have brand ambassadors that make a commission every time a new person signs up to get their GLP-1 meds through them.

Courtnay Kersh, who has more than 28,000 TikTok followers, is a registered nurse with nearly 20 years experience and is currently studying to be a nurse practitioner. “I've done literally everything in the way of nursing,” she says. “Every different specialty you can imagine, except for pediatrics.” In 2023, she gained about 100 pounds while pregnant with her daughter; when she was done breastfeeding, she still wanted to lose additional weight, so she started a GLP-1.

The catch: She never had insurance coverage for it. According to Kersh, her doctor recommended going the compounding route. She did so via a telehealth company and, in about 10 months, lost 70 pounds, even more weight than she had hoped to lose. (Editor’s note: While none of the doctors Allure spoke to for this piece said they recommend compounded GLP-1 medication, some of the patients interviewed said their own doctors were aware they were taking it.)

Kersh, who was thrilled by her success and eager to help others on their own weight loss journeys, decided to join a telehealth company’s affiliate network program, which allows “creators” to earn a flat fee for every new customer they directly refer. “It completely changed my life,” Kersh recalls. “I had a video go viral in July of last year… the commissions that I made were just out of this world.” She earned so much, in fact, that she quit her nursing job to focus on school and posting about her GLP-1 journey online, often referring back to her affiliate link in bio.

Kersh’s income fluctuates, and she declines to share an exact number, but her average monthly earnings are more than double the average monthly salary for a nurse in the United States. She’s quick to acknowledge that this type of financial success is by no means guaranteed. “I know that I am by far the minority in any and all affiliate sales,” Kersh says. “I get that this is not normal, but I'm so grateful that it has been this huge blessing for our family.”

Just as Karen had no qualms about getting a compounded GLP-1 from a friend of a friend, Kersh says she didn’t have any hesitation about or do much research into the telehealth company before signing up for its affiliate program. A friend had recommended it, plus “I knew that these medications changed my life,” she says. As a medical professional, she adds, she was also impressed with studies that indicate GLP-1 medications can help manage type 2 diabetes and reduce the risk of stroke and heart attack. “I knew that they were only going to get more and more popular,” she says. “It was like, if I don't do it now, I am going to be kicking myself in a year when it has blown up.”

Blow up they did. Recent surveys by KFF Health have found that nearly 1 in 5 adults have taken GLP-1 agonists at some point in their lives, and about a quarter of them have gotten the drug from a source other than their primary care doctor or specialist. The changes in insurance coverage are likely, at least in part, a big reason people are getting them elsewhere.

According to the digital marketing platform Semrush, the telehealth company that Kersh is an affiliate for saw a spike in estimated website traffic starting in December 2025 (about when many of these insurance changes were announced), followed by an even larger one in March 2026. Traffic has dropped substantially since that peak, but as of July, it remains around or above where it was before December.

According to the same platform, GLP1Forum’s es