Dr. Casey Greene, PharmD, IFMCP
Like the expectations of modern consumers that everything can be personalized, from their morning coffee to their online shopping experience, compounded medications for weight support can offer similar satisfaction. Custom formulations are tailored to specific patient needs, combining multiple active ingredients that can address a myriad of issues such as appetite suppression, the acceleration of fat metabolism, or hormonal imbalances.
GLP-1 Medication Shortages
In 2024, approximately 12% of U.S. adults reported having used GLP-1 medications,with 6% of Americans currently using them. The proportion of off-label use, GLP-1 users without FDA-approved indications, increased notably from 21% in 2019 to 37% in 2023.
The surge in popularity of GLP-1 medications has led to significant shortages, prompting regulatory bodies to address supply issues. This includes the strong demand for semaglutides and tripeptides. GLP-1s have gained popularity through the dual result of improving blood sugar control and spurring weight loss. They are typically conveniently dosed (i.e., weekly , and have shown indications of increased cardiovascular safety. As consumer awareness has grown, demand has followed.
Compounded medications have helped address GLP-1 shortages. With manufacturers such as Novo Nordisk and Eli Lilly and Company working to meet demand, compounding pharmacies are providing patients with custom alternatives utilizing the same active ingredients. They can also offer more accessible options for patients whose insurance may not cover branded versions of these medications, potentially delivering lower-cost alternatives through generic or tailored formulations.
Personalized GLPs
As with other medications, compounding pharmacies can create GLP-1 preparations in different strengths or formats than commercially available versions, allowing patients to use doses that better suit their requirements, especially if standardized doses are causing side effects. For GLP-1s, these can often include stomach cramps, bloating, indigestion, nausea, diarrhea, vomiting and constipation, which can be common, especially when starting the medication or increasing the dose. While reduced appetite is often a desired effect, standard dosing can sometimes be too strong, causing difficulties in maintaining proper nutrition.
Through compounding pharmacies, medications can be formulated based on the patient’s medical history, goals and preferences. While most GLP-1s are administered as subcutaneous injections, compounding pharmacies may instead formulate these, as allowed, into rapid dissolving tablets, or sublingual drops for patients who have difficulty with injections, as well as those who need different delivery methods due to medical conditions.
Other Weight Regulation Support
In addition to customized GLP-1 receptor agonists, personalized obesity control has evolved to include a variety of innovative options tailored to specific patient needs.
One approach is the blending of disparate medications that combine appetite suppressants, weight control catalysts, and essential vitamins to not only help with weight loss, but to boost energy levels (which can facilitate both the desire and stamina to exercise) and remedy nutritional deficiencies (some of which can be traced to the gut microbiome which, when addressed, can help improve digestion, bolster the immune system, and protect against harmful pathogens). In tailoring these formulations for each patient, the balance between effective weight management and overall health can be optimized.
For patients whose obesity may be linked to underlying hormonal imbalances, strategies can be customized further. For instance, thyroid hormone replacement therapy is a common approach for those with hypothyroidism (underactive thyroid), a condition that can lead to weight gain.
Bioidentical hormone therapies, such as those addressing insulin resistance or adrenal dysfunction, can be employed to correct imbalances that can lead to poor weight regulation. Menopause-related weight gain, often associated with hormonal fluctuations, can also be aided through personalized hormone preparations that help restore hormonal balance and improve metabolism. By addressing the root causes of weight gain, these personalized strategies provide a more holistic approach to weight regulation. This comprehensive care model enhances both the capability and sustainability of weight management options.
Disclaimer
The FDA does not review any compounded medication for safety or efficacy. The information contained in this article is not meant to diagnose or treat a specific healthcare condition but should be used as educational-only material.
