Should you get your GLP-1 at a med spa?

You’re laying down on a cozy treatment table for a much-anticipated massage when, seemingly out of nowhere, the provider asks: Are you interested in Zepbound?

Upsells used to be face cream. Or a laser facial. Maybe an infrared sauna session. But a GLP-1 weight-loss drug? Recently, these medications have become another line item on the menu of boutique beauty and health med spas across the country. But should they?

The rise (and rise) of GLP-1s

GLP-1s (short for glucagon-like peptide-1 receptor agonists) are a class of medications originally developed for people with type 2 diabetes. They mimic a natural hormone in the body that helps regulate blood sugar levels and slow down gastric emptying, which reduces appetite and leads to weight loss. The FDA eventually approved a number of GLP-1s for weight loss, including Saxenda, Wegovy, and Zepbound.

Demand for them has remained sky high — because these meds work really well. Take tirzepatide (the active ingredient in Zepbound). In clinical studies, people taking this drug lost 15-22.5% of their body weight over 72 weeks. That is a powerful outcome for someone living with significant overweight.

Beyond simple efficacy, however, their popularity has also been buoyed by Hollywood buzz, with high-profile celebs singing their praises. And that has turned GLP-1 drugs into highly glamorized meds. As a result, they’ve been grouped as “aesthetic treatments” at medical (or med) spas rather than as what they are: long-term medical care for obesity.

Just how medical are med spas?

Med spas combine the feel of a day spa (think facials and massages) with the more clinical treatments of a dermatologist or plastic surgeon’s office ( think Botox, electromagnetic body sculpting, and now weight-loss injections).

Unlike an in-person or virtual medical clinic — where everyone is a licensed medical provider — the providers at med spas are highly variable. Who’s legally allowed to do what depends on both the state you’re in and the provider’s license. Each role — doctor, nurse practitioner, registered nurse, medical assistant, aesthetician — has a different scope defined by their licensing board. And while a doctor or NP may sign your prescription from the back office (or from hours away in a satellite office), they might not be the one to actually consult with you.

Even who’s allowed to own a med spa changes by state. In California, for example, a medical doctor has to own at least 51% of the business. In other states, non-physicians can run the show, but may face closer scrutiny from regulators. All this to say: The level of medical oversight, and the depth of knowledge when it comes to metabolic health, is a wild card.

The trouble with drive-thru drugs

The demand for medication at these businesses is clear. Research shows about 60% of medical spas in the U.S. now offer GLP-1 medications. For some businesses, GLP-1s now account for 15% of their monthly income — and nearly 40% of patients seeking the medications are brand-new clients.

But beyond questionable care and oversight, med spas writing these scripts pose a larger threat. They undermine what these drugs really are, and are meant to do. “The widespread availability of GLP-1s at med spas may lead some people to view them as a quick fix rather than part of a long-term health strategy,” says Dr. Fatima Cody Stanford, M.D., an obesity medicine physician at Massachusetts General Hospital and associate professor at Harvard Medical School. That mindset, she warns, can overshadow the critical role of diet, exercise, and lifestyle support in achieving sustainable health.

Indeed, a study published in Diabetes, Obesity and Metabolism found that people regained two-thirds of their original weight a year after stopping the drug semaglutide. Prioritizing lifestyle changes, however, can help mitigate the weight rebound. After ceasing weight-loss medications, WeightWatchers members — who follow healthy habits as part of their program — not only maintained their weight loss, they dropped another 1.8% of their body weight after 13 weeks.*

“Med spas reinforce this magic-bullet mindset, especially when they’re not paired with lifestyle support and education,” says Dr. Lydia Alexander, M.D., president of the Obesity Medicine Association. For true, lasting success, it’s essential to address all aspects of health — including metabolic function, muscle preservation, nutrition, and mindset — not just the number on the scale. “Weight loss is only one part of the picture.”

Another growing concern: many med spas aren’t necessarily focused on treating obesity — they often serve clients looking to lose a smaller amount of weight for cosmetic reasons. And because these clients are typically paying out of pocket for drugs like Wegovy, some experts worry this demand could make it harder for those with medical need to access or afford these medications. When GLP-1s are treated more like luxury items or quick-fix tools, it can complicate broader efforts to ensure they’re used responsibly — and covered fairly.

Key differences between a med spa and a medical clinic

Where you get your prescription can shape your experience — and your results. Medical clinics and med spas often take very different approaches to care. Here are some of the key differences to keep in mind:

• Med spas often offer a more transactional experience. They may focus solely on weight loss, skipping a full review of your medical history — including other medications, underlying conditions, or factors contributing to weight gain. Without them, you risk side effects, complications, or less effective treatment.
  
  
• Inadequate follow-up is a major concern. Obesity care is not just about weight loss, but long-term weight maintenance and overall metabolic health. Med spas often lack a clear treatment plan, defined length of treatment, and education around side effects. (And the side effects aren’t minor — nausea, vomiting, dehydration, constipation, and more serious risks like pancreatitis or kidney issues can all occur.) And because they don't closely monitor progress, they also don't initiate a change of plan or medication as the patient changes.
  
  
• Personalization vs. one-size-fits-all. Licensed medical providers tailor GLP-1 treatment to your unique health history, goals, and needs. In contrast, many med spas take a one-size-fits-all approach, offering the same plan to everyone, regardless of what’s going on beneath the surface.
  
  
• Overlooking FDA requirements. Some med spas may prescribe GLP-1s without confirming whether you meet clinical guidelines — like having a BMI of 30 or higher, or a related health condition such as type 2 diabetes. These criteria exist for a reason: They help ensure the medication is safe, appropriate, and effective for your specific needs. Skipping this step can increase the risk of side effects, misuse, or getting a treatment that’s not actually right for you.
  
  
• No medication review or risk assessment. GLP-1s can also interact with other medications, impacting blood pressure, blood sugar, and more, particularly for those already managing conditions like diabetes or hypertension. Without proper medical oversight from an experienced healthcare provider, these medications may not only be less effective, but also pose significant health risks.

What does a safe and sustainable GLP-1 treatment plan look like?

Stanford shares key strategies for maximizing the benefits of GLP-1 medications and ensuring long-term success:

• Adopt a holistic approach: GLP-1 medications should be part of a comprehensive health plan. Pair your treatment with a balanced diet, regular physical activity, and routine medical supervision to optimize results. Weight loss is most effective when integrated into a lifestyle change rather than relying solely on medication.
• Set realistic expectations: GLP-1 medications are valuable tools for weight management, but they are not quick fixes. Understand that sustainable weight loss requires a combination of healthy habits — GLP-1s are only part of the picture.
• Stay consistent with regular monitoring: Regular check-ins with your healthcare provider are essential to track progress and adjust treatment plans as necessary.