Illicit GLP-1s and Their Dangerous Marketing Must Be Stopped

By Joyce O’Riley Smith

Joyce O’Riley Smith is a board certified Family Nurse Practitioner from Buffalo.

Joyce O’Riley Smith

As a Family Nurse Practitioner, you learn very early on that medical providers bear a deep responsibility to our patients to protect their health and safety above all else.  

That’s why I feel compelled to speak out about the dangerous rise of a gray market of counterfeit GLP-1s that threatens the health and safety of our communities.

The CDC estimates that in 2023, the obesity prevalence among adults was 40.3%. This statistic represents a serious health challenge that we must address systemically. GLP-1s have been critical in our treatment of obesity – offering an important option for people struggling with weight loss. However, the increased demand for GLP-1s has also been accompanied by an increase in counterfeit GLP-1s, containing unregulated and unsafe active pharmaceutical ingredients (APIs). 

Branded medications come to market after extensive research and FDA compliance and approval. This is what makes medications safe to prescribe and to take. In specific cases like a drug shortage, pharmacies can create compounded variations of these drugs to fill a specific need. This is what happened with GLP-1s when due to unprecedented demand, the FDA placed them on its shortage list. Compounded GLP-1s were not FDA-approved and only served as a temporary solution to a temporary shortage. 

With the shortage now over, compounded GLP-1s are no longer necessary nor legal. Yet, companies have continued to illegally sell compounded GLP-1s, using ingredients imported from overseas. These ingredients are not subject to FDA approval or regulations. Bypassing FDA regulations increases the risk of exposure to untested and unsafe ingredients. Between September 2023 and January 2025, 239 shipments of counterfeit GLP-1 ingredients were sent to the U.S., with a shocking 82% being allowed into our drug supply.

Advertising their counterfeit products as more affordable, companies have taken to social media to sell these products and even sell individual ingredients for customers to mix themselves. This extraordinarily dangerous practice involves untrained customers attempting to create their own medicines with illicit and untested ingredients. The consequences are severe. Poison control centers report an 1,500% increase in calls related to potential overdoses from GLP-1s. 

As a community health advocate in Buffalo, and a Family Nurse Practitioner, I believe we have a responsibility to protect New Yorkers from these dangerous and predatory practices. Companies are exploiting real health concerns at the expense of people’s health and well-being. 

I urge New Yorkers and all Americans to think carefully and critically before purchasing a GLP-1 online. Without a doctor’s prescription and a comprehensive medical plan, GLP-1s should not be easily purchased and obtained. 

 While I support the FDA’s current efforts in stopping illicit APIs from entering the country, I believe further communication and coordination between state and federal agencies is essential to ensure that this illegal market is reigned in. The FDA must use its full enforcement authority to shut down compounders using these illicit APIs and New York Attorney General Tish James needs to hold companies selling these products accountable. We must all work at the state level to protect New Yorkers from these dangerous practices that take advantage of genuine health concerns for profit. Every New Yorker deserves access to legitimate and safe healthcare, and I’m committed to fighting for it.