Noom offers compounded GLP-1 drugs, promises patients can quit and keep weight off

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Noom is the latest weight loss startup to start prescribing compounded versions of the obesity medication semaglutide, following similar moves by Hims, Ro, and other telehealth companies capitalizing on shortages of brand-name obesity drugs.

The startup will sell the compounded GLP-1 drug starting at $149 a month, it said Thursday. The company, which historically offered a dieting app, has been prescribing shots like Ozempic and Wegovy since May 2023.

It also promised that its new program, called GLP-1Rx, will help patients taper off medication and sustain that weight loss through coaching to support behavior change. If they regain weight within 18 months of the 12-month program, they’re eligible for a free year of Noom, a value of $209, or an equivalent discount on medications.

The new offerings thrust Noom into the middle of several thorny issues.

Positioning GLP-1 obesity medications as a temporary jumpstart to weight loss, rather than a long-term therapy, is at odds with how many obesity medicine doctors and drugmakers say they should be used.

And while compounded versions of branded medications are allowed to be made while branded drugs are in short supply, they’re not approved by the FDA for efficacy or safety, and the agency has warned that it’s seen reports of unintended overdoses of compounded semaglutide. The academic obesity medicine community has generally criticized the prescription of these versions because they say it’s difficult to know what’s in them.

Pharmaceutical manufacturers Novo Nordisk and Eli Lilly have sued dozens of weight loss clinics, telehealth companies and medspas over how they’ve marketed alternative versions of their drugs.

Adonis Saremi

In an interview with Endpoints News, Noom CEO Geoff Cook said the company decided to offer compounded GLP-1s to provide a “good, cash-pay, accessible, affordable option” for people who have struggled to get their hands on the branded drugs, which can cost upwards of $1,000 a month for people without insurance.

The company said it’s partnered with a 503B compounding pharmacy that’s registered with the FDA and follows good manufacturing practices. It declined to disclose the name of the pharmacy, but Cook said it’s one that produces generics like epinephrine for hospitals. For members who want them, Noom will provide certificates of analysis for the drugs that verify their purity and potency, said Adonis Saremi, the company’s chief medical officer.

“There are some bad actors out there, but we’ve done our due diligence,” Saremi said.

Tapering off drug

The Noom executives said they’re also confident that users can stop the medication and keep the weight from rebounding by sticking with the “healthy habits” learned through the Noom app, things like food tracking and exercise.

“We certainly believe that the majority of folks can find a way off the medication with sustained weight loss outcomes, but certainly not everyone,” Cook said.

But data available from randomized clinical trials show that most people tend to gain a substantial portion of weight back after they stop taking GLP-1 medications. In the Step 1 trial extension for semaglutide, participants regained two-thirds of their prior weight loss a year after quitting the drug. In the Surmount 4 trial for tirzepatide, the drug marketed by Eli Lilly as Zepbound, patients regained more than half of their lost weight after a year off the drug.

Disha Narang

This has also been the experience in clinical practice, said Disha Narang, director of obesity medicine at Illinois-based health system Endeavor Health. When her practice’s patients have gone off their medications because they can’t find a drug due to the shortage, or they’ve lost insurance coverage, their hunger that was suppressed by the drug comes roaring back along with the weight, she said.

“This is a marathon, a chronic therapy,” she said, adding that people “don’t bat an eye” at taking a drug long-term for other diseases, like hypertension or heart disease. “There’s literally zero indication to make this a short-term therapy.”

Noom executives argued that other studies from Epic Research and one from Denmark researchers that were published in the Lancet provide evidence that people can maintain weight loss after discontinuing GLP-1s. However, both of those studies still found that many people regained weight. According to the Epic study, while 56% largely kept the weight off or lost more after semaglutide, about 44% of people regained at least a quarter or all of their weight back.

Noom expects many people in the program will want to taper off the medication, or at least titrate to a lower dose, because plenty of people have discontinued the medication already.

“The more likely state is that folks will come off the medication within 24 months, and so it’s really just putting them in the best state to succeed post-medication,” Cook said.