For years, I have worked with families across New York City who face some of the toughest barriers to healthcare. As someone who grew up in Harlem and has built a career supporting at risk children and families, I have seen how overwhelming, costly, and isolating it can be to get the care you need. That struggle shows up in everything from limited affordable options to the shame people carry when talking about their health, especially when it involves obesity.
I also understand this issue personally. I live with type 2 diabetes and obesity. When I first started GLP-1 medication, my A1C was 13. With consistent care and access to the right treatment, I was able to bring it down to 5.6. That is not a small thing. These medications support my health in a real and measurable way. And like so many others, I rely on safe, FDA-approved options. That is why it hits me hard to see the rise of online posts advertising quick, cheap weight loss using unregulated versions of these drugs. These offers look tempting, but they are dangerous. They take advantage of people who are trying to manage real health conditions and deserve trustworthy options.
Obesity is a serious health concern in our state. According to the New York Department of Health, 30.1 percent of New Yorkers are living with obesity. Structural inequalities like limited access to healthy food, economic stress, and the high cost of care all play a role. Yet despite the need, access to FDA-approved anti obesity medications remains limited and expensive. When people cannot afford or obtain legitimate care, they turn to whatever seems reachable. That is where the risk begins.
Many of these online “treatments” contain active pharmaceutical ingredients shipped from overseas with no FDA supervision. There is no way to verify purity or safety. Between September 2023 and January 2025, more than 200 shipments of illicit ingredients entered the country, and most made it straight through customs. That is not acceptable.
Some sellers go even further, encouraging people to mix the ingredients themselves, essentially telling folks to become their own pharmacists. This is reckless. The FDA has already received nearly 1,500 reports of adverse events tied to compounded GLP 1s.
In my work and in my own health journey, I have seen how disparities put people at risk. When families face high medication costs, limited access to providers, and systems that are hard to navigate, they become easy targets. The same inequities that fuel higher obesity rates in marginalized communities now leave people vulnerable to predatory marketing disguised as care.
Compounded medications absolutely have a role when used properly. They are essential for patients who need custom formulations or during real shortages. But GLP-1s are no longer in a shortage. That means much of the compounding happening right now is not legal, and it is contributing to a crisis that harms the very communities already fighting for equitable care.
There has been some progress. Earlier this year, a bipartisan coalition of 38 state attorneys general, including our own New York State Attorney General Letitia James, urged the FDA to act. The FDA responded with a “green list” aimed at blocking illicit ingredients at the border. And in Pennsylvania, authorities fined a pharmacy one million dollars for illegally producing thirty thousand (30,000) doses of weight loss drugs in uninspected facilities. These are good steps, but we need sustained federal and state action to fully protect our communities.
New Yorkers deserve a healthcare system where safety and affordability support each other. As someone who depends on these medications to stay healthy, and as a leader serving families every day, I will keep advocating for stronger protections and better access. Our communities deserve nothing less.
Written by Stephanie Wilson, LMSW
About Stephanie Wilson, LMSW
Stephanie Wilson, LMSW, is a social worker who works closely with families, particularly those from marginalized and underserved communities, Through her work, she has seen firsthand the complex challenges parents face in raising their children today.
Featured image credit: DepositPhotos.com
