How Telehealth Companies Are Standing Between Patients and Obesity Medications

The Hidden Role of Telehealth Companies in Obesity Drug Coverage

When most people think about telehealth companies offering weight loss support, they imagine a helpful service designed to maximize patient success. The reality, however, is far more complicated — and for many patients, far more frustrating.

While telehealth providers do offer lifestyle coaching and clinical guidance for people using GLP-1 medications like Wegovy and Zepbound, they are increasingly being hired by employers with a very different priority in mind: controlling how much money gets spent on these expensive drugs.

One Patient's Struggle to Access a Prescribed Medication

David Davis, a 57-year-old power plant worker from Aptos, California, knows this frustration all too well. His primary care physician had already written him a Zepbound prescription back in December to address his obstructive sleep apnea — a condition that was leaving him completely drained every single morning.

Before he could even fill that prescription, his employer changed the rules. He was now required to obtain a new prescription exclusively through Vida Health, an online telehealth platform his company described as a "cardiometabolic weight loss solution" and presented as a benefit to employees.

Davis complied. He completed new bloodwork, answered detailed health questionnaires, and attended video consultations with a Vida Health nurse. The nurse acknowledged he was a suitable candidate for Zepbound — but insisted he first try naltrexone and bupropion, medications primarily used to treat alcohol dependency, opioid use disorder, and depression. Neither drug carries approval for treating obstructive sleep apnea.

"I thought, 'All right, I'll jump through their hoops,'" Davis said. "The more they wanted, the more frustrated I would get."

When Davis reached out to his insurer's patient advocate to question the requirement, the advocate expressed surprise — saying it wasn't an established rule at all. Exhausted by the process, Davis ultimately gave up on getting his insurance to cover the medication and began paying out of pocket for a compounded version through an online pharmacy.

Vida Health declined to address questions about Davis' specific case, even after he agreed to waive his patient privacy rights. In a general statement, the company said its providers follow clinical eligibility criteria and plan sponsors' coverage policies, and that delivering "personalized, clinically appropriate care" remains its top priority.

Blue Cross and Blue Shield of Texas, which administers Davis' insurance plan, issued a statement affirming its commitment to safe and appropriate care, but declined to comment on the specifics of his situation.

A Booming Industry Built Around Cost Control

Telehealth companies offering metabolic health services aren't new. According to Jayne Hornung, chief clinical officer at MMIT — a pharmaceutical market data firm — these platforms originally focused on Type 2 diabetes prevention and management. The explosive growth of GLP-1 obesity drugs, however, created an enormous new market opportunity.

"They've seen this opportunity in the larger market with the GLP-1s and all the wraparound services that they could provide," Hornung explains. "And it's just exploded."

The numbers reflect that growth. Omada Health, one of the leading players in this space, recently reported a 51% membership increase over the past year, surpassing one million members. The company also disclosed that it had supported more than 150,000 members on GLP-1 medications by the end of 2024, up from roughly 50,000 the year before.

Omada's president, Wei-Li Shao, pushes back on characterizations of his company as a barrier to medication access. "Omada is neither a gatekeeper of GLP-1s nor are we a vending machine," he says, describing the platform as providing evidence-based care with providers who understand individual plan coverage.

Hornung, however, frames the situation differently. She argues that while these services can genuinely benefit patients, they also allow employers to exercise "utilization management under the guise of lifestyle intervention." The underlying goal, she says, is to eventually move patients off GLP-1 drugs entirely — because employers simply do not want to fund these treatments indefinitely.

Physicians Raise Alarms Over Patient Safety

For doctors who specialize in obesity medicine, this trend is deeply concerning. Dr. Catherine Varney, obesity medicine director at UVA Health in Charlottesville, Virginia, has watched telehealth companies encourage her patients to discontinue obesity medications — advice she considers both medically inappropriate and potentially harmful.

"They're offering medical advice outside the scope of their practice," she says. "The evidence from clinical trials is clear: when patients stop these medications, they regain approximately two-thirds of their lost weight. It's no different than stopping blood pressure medication and watching your blood pressure climb back up."

A Real Patient Pays the Price

Penny Byer, a 64-year-old homemaker from Stuarts Draft, Virginia, and mother of five, experienced exactly that outcome. After starting Wegovy in April 2024, she reached a healthy body mass index for the first time in years. Then, Virta Health — another telehealth provider — was added to her family's employee benefits package. By December, Virta had discontinued her prescription.

Within weeks, her weight and cholesterol levels climbed back to where they had been before she ever started the medication.

"Everything's come back with a vengeance," Byer says. Despite weeks of appeals, paperwork, and persistent communication with Virta, the answer never changed. "No matter what I done or papers I brought them — nothing mattered."

Virta Health maintains that its own research supports the idea that patients can sustain weight loss after discontinuing GLP-1 drugs — a position that contradicts findings from larger, broader clinical studies.

What This Means for Patients Seeking Coverage

The growing influence of employer-hired telehealth companies over GLP-1 prescriptions raises serious questions about where medical decision-making authority truly lies. As obesity drugs become increasingly central to treating not just excess weight but related conditions like sleep apnea, heart disease, and diabetes, the tension between cost containment and patient-centered care is only likely to intensify.

For patients navigating this landscape, the message is sobering: getting a prescription from your doctor may only be the first hurdle in a much longer process.