Direct-to-Consumer GLP-1: At the Center of the Storm

The world of GLP-1 medications—Ozempic, Wegovy, and their counterparts—has exploded into a global phenomenon. Initially developed as a critical tool for managing diabetes, these medications have transformed into a weight-loss craze, used by people with diverse needs, from those looking to lose 200 pounds to those aiming to shed just 20.

The demand is undeniable, but the journey of GLP-1 medications from clinical settings to consumer-driven markets has been anything but smooth. As fitness professionals, understanding the complexities surrounding these medications is vital—not just for our clients' success but for the future of our industry.

A Rapidly Growing Market

Over the last year, the use of GLP-1 medications has been reshaped by decreasing costs and expanding availability. Third-party administrators are working to make these drugs more accessible, opening up new markets of patients.

Two Texas companies, Next Gen Wellness and KORB Health Group , are leading the charge in connecting people on GLP-1 medications with fitness and wellness services. Their work has sparked a new dynamic in our industry: a push to integrate GLP-1 clients into health clubs, nutrition programs, and lifestyle coaching.

But rapid growth often comes with challenges—and this market is no exception.

The Microdose Controversy

In late 2023, compounding pharmacies introduced a new twist: microdose versions of GLP-1 medications. Instead of the traditional once-weekly injections, these pharmacies created flavored, sublingual (under-the-tongue) doses to be taken twice daily.

This innovation offers several advantages:

• Improved Tolerance: Patients can eat regular meals and exercise at higher intensities without the nausea or weakness often caused by injectable forms.
• Better Gym Outcomes: With smaller doses in their system, clients are better equipped to train effectively, preserve muscle mass, and stay consistent with their fitness routines.
• Personalized Care: Compounding pharmacies can tailor doses to individual needs, potentially reducing side effects.

However, this development has ruffled feathers in the pharmaceutical industry. Large drug manufacturers see compounding pharmacies as a threat to their market share and have launched legal actions against some vendors.

This controversy was highlighted in a recent study by DiStefano et al. (2025), which examined compounding pharmacies advertising microdose GLP-1 medications in Colorado. The study underscores the growing tension between pharmaceutical companies and compounding pharmacies over market share and patient accessibility.

What This Means for Fitness Professionals

Trainers and coaches don’t need to pick sides in this pharmaceutical debate—but we do need to stay informed. Here’s why:

• Safety Comes First: Understanding how microdose GLP-1 medications affect exercise tolerance, energy levels, and muscle preservation is critical for designing effective and safe training programs.
• Individualized Plans: Clients on microdose versions may require different exercise intensities and durations based on the medication's impact on their metabolism.
• Long-Term Outcomes: While we don’t yet have extensive clinical trials on compounded medications, early reports suggest these options may support clients' ability to integrate exercise into their weight-loss journeys more effectively.

Our role as fitness professionals is clear: become the trusted guide clients need to navigate this evolving landscape.

Knowledge Is Power: The Path Forward

The rise of compounded GLP-1 medications is just the beginning of a larger shift in how fitness, medicine, and wellness intersect. Trainers who stay informed and proactive will not only help their clients achieve better results but also position themselves as leaders in this new era of integrated care.

The relationship between exercise intensity, medication dosage, and long-term safety is a complex one. By mastering these dynamics, we can create transformative fitness programs that go beyond weight loss to deliver lasting health improvements.

Let’s Lead the Change Together

I’ll be diving deeper into these topics at SCW Fitness Education DC MANIA 2025 during the GLP-1 Exercise Specialist Certificate Workshop. This isn’t just about certification—it’s about giving you the tools to thrive in the fastest-growing niche in fitness and healthcare.

?? Date: February 27, 2025

? Time: 4:30–8:30 PM

?? Earn 4 CECs through NESTA - National Exercise & Sports Trainers Association, Inc.

?? Learn More and Register Here: https://www.medhealthfit.com/mania

This workshop will cover:

• How to design effective programs for clients on GLP-1 medications.
• Strategies for preserving muscle mass and enhancing metabolic health.
• Practical tools for collaborating with physicians and leveraging referrals.

Don’t just adapt to the future of fitness—lead it.

?? Register now for the GLP-1 Exercise Specialist Certification

Let’s take the confusion out of GLP-1 medications and build a brighter, healthier future for our clients and our industry.

Reference DiStefano, MJ, Dardouri, M, Moore, GD, Saseen, JJ, Nair, KV. Compounded glucagon-like peptide-1 receptor agonists for weight loss: The direct-to-consumer market in Colorado. Journal of Pharmaceutical Policy and Practice. 2025. 18(1):2441220. DOI: 10.1080/20523211.2024.2241220