Virtual weight management care models are exploding to meet consumer demand for new anti-obesity medications (AOMs). Partnerships are forming to create direct access to in-person and virtual care providers, coaching, prescribing, medication fulfillment, clinical monitoring, and more. These new direct-to-consumer models are arising from all points of the healthcare ecosystem.   

Recent announcements from Mayo Clinic, Transcarent, and Eli Lilly, with its LillyDirect channel, detail the launch of varying models of convenience and care for patients. This disruptive trend toward direct-to-consumer access is unchartered and with it comes important clinical considerations. 


The fulcrum point: Physician considerations 

As the practice of widespread medication use for weight loss is still emerging, not all primary care providers (PCPs) are convinced that prescribing AOMs is the answer.  However, many early adopters are navigating the challenges presented by a direct-to-consumer model.    

Physicians are inherently under pressure to prescribe medications when affiliated with a weight management partner. Specific AOM and GLP-1 therapies are advertised on retail health websites indicating their availability and elevating the perception that a patient may easily access these medications. Medical appropriateness is a potential friction point and must be managed against patient expectations.  Provider autonomy is in the spotlight, highlighting the importance of proper assessments, screenings, and related patient safety. 

A related consideration is the increased volume of care coordination required between third-party prescribers and patient care teams. Access to prior medical history and sharing of information between providers is essential to safe care. Without close coordination, it is easy to foresee risk, suboptimal outcomes, and poor patient experiences—unintentionally creating more silos of care. 


Achieving stability: Clinical care team considerations 

Successful virtual weight management models employ a care team approach, which consists of functions that include registered dietitians (RD), supervising MDs, exercise therapists, and pharmacists. Once patients are prescribed a GLP-1, clinicians play an important role in providing requisite ongoing comprehensive obesity care and clinical support for sustainable weight management, covering:  

  • Personalized treatment plans 
  • Injection (for GLP-1s) and pen usage 
  • Dosage and titration 
  • Patient safety and managing side effects 
  • Medication action 
  • Lifestyle management and behavior change support 
  • Managing medication plateaus 
  • Financial resources 


The addition of care teams makes coordinating overall patient care increasingly complex and raises a range of considerations to address in the fine print: 

  • How long does a third-party clinician continue oversight—for a few months, or for the duration that a patient is prescribed the medication by the virtual care program?  
  • If only for a few months, and the patient continues the medication, who manages the ongoing clinical oversight of the patient on the GLP-1? How does that handoff work? What if the patient does not have a PCP? 
  • How will care teams manage the unexpected interruption in medication adherence, which can be driven by a variety of factors like supply shortages, changes in insurance coverage, lack of efficacy, side effects, high deductibles, and other financial issues?  
  • Can we rely on patients to know when to raise their hands for help with their medication in a patient-initiated support model?  


Demand is high for direct-to-consumer virtual weight management care and therapies, creating opportunities for emerging solution providers and new partnerships. There will be many lessons learned, but we predict proactive clinical oversight, close collaboration between care teams, and comprehensive patient support will be defining factors for direct-to-consumer models—and all virtual care models—to succeed.