SANTA CRUZ, CALIF. — Telehealth companies have required patients to try alternative medications or discontinued weight loss drugs, leading to patient weight regain and disagreements over medical practice. David Davis, a 57-year-old power plant worker living near Santa Cruz, California, was prescribed Zepbound for obstructive sleep apnea, with his insurance company requiring him to use Vida Health for prescription approval.

A Vida Health nurse determined Davis was a candidate for Zepbound but mandated that he try naltrexone and bupropion first. Naltrexone is used to curb alcohol and opioid use, and bupropion is an antidepressant. Neither medication is approved for treating obstructive sleep apnea. A patient advocate for Davis's insurer, Blue Cross and Blue Shield of Texas, stated that requiring the two generic drugs was not part of the plan's rules. Davis began paying out-of-pocket for a compounded version of the medication through an online pharmacy. Vida Health stated its providers follow clinical eligibility criteria and plan sponsors' coverage policies when prescribing medication.

Separately, Penny Byer started taking Wegovy in April 2025 and achieved a healthy body mass index. Virta Health discontinued prescribing the medication for her in December of that year. Byer's weight and cholesterol levels returned to pre-treatment measurements after she stopped the drug. Virta Health stated its internal research indicates patients can maintain weight loss after discontinuing obesity medications.

Dr. Catherine Varney, obesity medicine director for UVA Health in Charlottesville, Virginia, stated that some telehealth providers are giving medical advice outside their scope of practice. She also noted that these providers encourage patients to stop medications despite clinical trial evidence showing that patients typically regain two-thirds of their weight after discontinuing. "They're offering medical advice outside the scope of their practice, and they're pushing the patients to come off the medications when the evidence is clear in the research clinical trials that showed that when patients came off these medications, they regained two-thirds of their weight back, just the same as if you would come off blood pressure pills." Varney said.

"The endgame is to eventually get the patient healthy, get them on an exercise program and get them off the GLP-1s." said Jayne Hornung, chief clinical officer at MMIT. "Omada is neither a gatekeeper of GLP-1s nor are we a vending machine." said Wei-Li Shao, President of Omada Health. The company reported a 51 percent membership increase over the past year, reaching more than 1 million members, and supported over 150,000 members on GLP-1 medications at the end of 2025. A systematic review published in The BMJ, which analyzed 37 studies involving 9,341 patients, concluded that stopping obesity medications leads to rapid weight regain.