The shortage-based legal exemption that underpinned widespread compounded semaglutide availability is no longer active for either 503A pharmacies or 503B outsourcing facilities Compounded GLP-1 programs operating today must navigate a legal framework that includes restrictions on compounding drugs that are commercially available drugs - meaning the compounding pharmacy's specific formulation, documentation, and prescriber individualization process matters for legal compliance The FDA still permits compounding under 503A for individual patient-specific prescriptions that involve a prescriber-documented "significant difference" from the commercially available product - but that requires specific clinical justification, not just a standard intake form Availability of specific compounded GLP-1 formulations may be affected by FDA enforcement actions, pharmacy-specific compliance status, and ongoing regulatory developments in this space None of this means compounded GLP-1 programs are operating illegally
Other licensed pharmacological options : For patients unsuitable for or unable to tolerate Wegovy, alternatives include: Orlistat (lipase inhibitor that reduces fat absorption) Liraglutide 3mg (another GLP-1 receptor agonist, recommended by NICE TA664 for specific patient groups, though local NHS availability may vary) Consideration of bariatric surgery referral for eligible patients with severe obesity Medically supervised diets : If rapid weight loss is clinically indicated (e.g., pre-bariatric surgery), options include: Very low-calorie diets (800 kcal/day) under specialist supervision for up to 12 weeks Low-calorie diets (8001200 kcal/day) with appropriate nutritional support These differ fundamentally from HCG protocols as they provide adequate protein, vitamins, and minerals and are used within NHS-approved frameworks
We are still likely discover new downsides of these drugs along the way (not to mention the more practical side of access and cost)
Endoscopic Sleeve Gastroplasty (ESG): A Minimally Invasive Revolution ESG is a non-surgical, incision-free procedure that uses an endoscope (a thin tube with a camera and suturing tool) inserted through the mouth to reduce stomach volume
