People with eating disorders are using telehealth to access weight-loss drugs. What we don’t know is how large the problem is.
An alliance of peak eating disorder associations has called out single-issue telehealth providers for potentially inappropriately prescribing GLP1-RA weight loss drugs to vulnerable patients, as Canberra eyes a crackdown on the industry.
RACGP obesity specific interest group chair Dr Terri-Lynne South said telehealth was a “fantastic adjunct” to regular primary care, but that single-issue scripting services did not appear to be doing quality assessment and ongoing management.
She has treated one patient that she knows of who has accessed a GLP1-RA despite having a BMI outside of the prescribing guidelines.
“Obesity management is complex, and I think it’s very hard to do without having stable and regular health practitioner involvement, and often multimodal [treatment],” Dr South told The Medical Republic.
“I do think that it is the general practitioner who knows that individual best.”
Butterfly Foundation CEO Jim Hungerford told TMR that the current regulations – or lack thereof – make it difficult to see the scope of the problem.
“We are getting anecdotal reports from individual people speaking about people that they’re caring for, their loved ones, inappropriately trying to access and … [sometimes] successfully accessing these prescription weight loss drugs.
“But sadly, because there is no particular regulation that really brings in the accountability for these, these businesses and they are prescribing these [drugs] in such huge quantities we actually don’t know [the extent].”
Related
Unlike regular general practice, telehealth-only clinics operate outside of the Medicare Benefits Schedule and the Pharmaceutical Benefits Schedule.
The upshot of the government having its finger in vast majority of consults in general practice is that it keeps count.
We know how many Level B consults were done via telehealth with a regular GP in 2024 – approximately 21 million – because the government is keeping count.
We know the average out-of-pocket cost of a face-to-face Level C consult is $59.63 because the government is keeping count.
We know that 9.8 million Australians received a subsidised prescription for rosuvastatin because the government is keeping count.
Telehealth-only clinics are, comparatively, a black box.
“One of the key things that we’re really, really concerned about is ensuring that there is an appropriate medical assessment before somebody receives a prescription, particularly for the GLP1-RAs,” Mr Hungerford said.
“We know that, at the moment, you can access these products simply by filling out an online questionnaire.
“[If] nobody checks to see whether or not accurate information is provided there and then, you will receive the prescription.”
Federal health minister Mark Butler’s office told the Australian Financial Review last month that the government was “concerned about reports of unscrupulous and possibly unsafe behaviour by some telehealth providers”, and that the TGA had been asked to come up with options to improve telehealth standards.
Dr Matt Vickers, clinical director at telehealth giant Eucalyptus, told TMR that its clinics actively screen patients seeking access to GLP1-RAs for eating disorders.
One of the online-only clinics in the Eucalyptus stable, Juniper, is solely focused on weight loss.
“We agree that eating disorders are a complex and sensitive medical and psychological issue … and we check in with patients regularly while on treatment,” he said.
“Eucalyptus has also been advocating for better telehealth regulation for some time.”
The Butterfly Foundation national helpline is available on 1800 334 673.
