7 Questions to Ask Any Online GLP-1 Provider Before You Pay

You've done the research. You know the clinical-trial numbers — the STEP-1 trial showed roughly 14.9% mean body-weight loss with semaglutide at 68 weeks, and the SURMOUNT-1 trial showed up to 20.9% mean body-weight loss with tirzepatide 15 mg at 72 weeks (Jastreboff et al., NEJM 2022). Those are figures from the tirzepatide molecule's clinical trials — not StaveMD patient data — but they're real, and they represent something that years of dieting never delivered for you. You also know that behind every promising medication there's a crowded market of telehealth companies, some legitimate and some not. Before you pay anyone, here are the seven questions that separate a real, monitored medical program from a prescription farm with a nice website.

Why this checklist matters: the bait-and-switch is real

If you've spent any time in GLP-1 communities online, you've read the receipts. Someone signs up for a low advertised price, gets a prescription approved in minutes with no labs reviewed, receives a package with no cold packaging, and then discovers a subscription trap they can't cancel without a 45-minute phone call. That pattern has a name: bait-and-switch. It's not paranoia to ask hard questions. It's the only rational response to a market that has earned significant skepticism. The questions below are the ones patients in those communities wish they had asked first.

Question 1: Is the provider actually licensed in my state?

Federal law requires a prescriber to hold an active license in the state where you, the patient, are located at the time of the visit. Ask the company directly: which states are your providers licensed in, and can you confirm the license number? A legitimate telehealth provider will answer without hesitation. A vague response about 'nationwide coverage' with no specifics is a red flag. Your state's medical board website can verify any license in about two minutes.

Question 2: Which pharmacy fills the prescription, and what is its license class?

Compounded semaglutide and tirzepatide are not FDA-approved finished drug products. They are prepared by US-licensed compounding pharmacies under a valid prescription. There is an important regulatory distinction between 503A pharmacies, which compound for individual patients on a per-prescription basis, and 503B outsourcing facilities, which operate under stricter federal oversight and may produce larger batches. Neither class produces an FDA-approved product, but both are subject to specific legal standards. Ask the provider: what is the name of the compounding pharmacy, and is it a 503A or 503B facility? If they won't name the pharmacy, that's a problem. If they can name it, you can look it up independently on the FDA's database of registered outsourcing facilities or your state board of pharmacy.

Question 3: Will a licensed provider actually review my labs and medical history?

GLP-1 medications are not appropriate for everyone. Contraindications include a personal or family history of medullary thyroid carcinoma, pancreatitis, and certain other conditions. A provider who approves a prescription in four minutes without reviewing any labs or health history is not practicing medicine — they're operating a pill mill. Ask specifically: will a licensed provider review my intake form and any relevant lab work before issuing a prescription? Will I have a way to communicate with that provider if I have side effects or questions? The answers should be concrete and specific, not just 'yes, we have doctors on staff.'

Question 4: What is the exact total price, and what does it include?

Transparent pricing is not a perk. It's table stakes. Before you pay, you should know the cost of the initial consultation, the cost of each dose tier as you titrate up, whether ongoing provider check-ins are included, and whether there are any fees for lab requisitions, shipping, or 'membership.' Ask for the full pricing schedule in writing. If the advertised price applies only to the lowest starting dose and the medication you'll actually need costs significantly more, you deserve to know that before you enter your payment information. Flat, upfront pricing protects you from the subscription trap.

• Initial consultation fee: is it separate or included?
• Per-shipment medication cost at each dose level (starting, mid-titration, maintenance)
• Shipping cost and whether cold packaging is standard or an add-on
• Any monthly or annual membership fees
• Cost of follow-up provider messages or check-ins
• Refund and cancellation policy — can you cancel online without calling anyone?

Question 5: How is the medication shipped, and what should I expect?

Compounded injectable GLP-1 medications require proper cold-chain handling to remain stable. Ask whether the medication ships with cold packaging, what the typical transit time is, and what to do if a shipment is delayed or arrives compromised. A provider that can give you a day-by-day shipping timeline and a clear protocol for damaged shipments is one that has actually thought through the logistics. Vague answers like 'standard shipping' for a temperature-sensitive injectable are not acceptable.

Question 6: What ongoing monitoring is included?

The research on GLP-1 medications — including the SURMOUNT-1 data on tirzepatide and the STEP-1 data on semaglutide — was conducted in the context of structured clinical trials with regular monitoring. Real-world use without monitoring is not the same thing. Side effects like nausea, vomiting, and gastrointestinal discomfort are common, especially during titration. More serious signals — changes in heart rate, pancreatitis symptoms, injection-site reactions — require clinical attention. Ask your provider: how do I report a side effect, who reviews it, and how quickly will I hear back? Ongoing monitoring is how a prescription becomes a medical program rather than a mail-order transaction.

Question 7: Can I actually cancel, and how?

This question sounds almost too simple, but it cuts to the core of whether a company respects you as a patient or treats you as a recurring revenue line. Ask directly: if I decide to stop, can I cancel online without calling anyone? Is there a cancellation fee? Will I be charged for a shipment that's already in process? The answer should be straightforward. If a company makes cancellation difficult by design, that tells you something important about how they view the relationship. You should be able to leave as easily as you joined.

One more thing worth saying out loud

If you've spent years being told to 'just eat less and move more' — if you did everything right and the scale barely budged — the research on metabolic adaptation actually vindicates you. Fothergill et al. (2016, NIH 'Biggest Loser' study) documented that sustained caloric restriction triggers persistent metabolic slowdown, meaning the body actively fights weight loss in ways that have nothing to do with willpower. GLP-1 medications work on a different axis: they reduce appetite signaling and slow gastric emptying at the biological level. Many patients describe the experience as the food noise going quiet for the first time — no longer negotiating with themselves at 9pm, no longer wondering why everyone else seemed to have more willpower. That experience has a mechanism. It's not a character flaw being fixed. It's a biological system being supported. You deserve a provider who understands that distinction and who treats your health history with that context, not dismissal.