Should you microdose GLP-1 drugs? Here’s what experts say

Microdosing GLP-1 drugs for weight loss is growing in popularity among Americans looking to save a little money or reduce gastrointestinal side effects.

Some 12 percent of American adults are using GLP-1s, which started out as diabetes drugs before the weight-loss market took off in 2021. One in seven people using GLP-1s are microdosing the medications, a 2025 survey from health tracking app Evidant found.

Microdosing has been promoted by some telehealth companies like Noom, with actress Rebel Wilson acting as spokesperson for the brand. “I felt amazing, I looked amazing,” Wilson told USA Today last September about Noom’s microdose GLP-1.

Other famous faces jumping on the microdosing trend include Bravo host Andy Cohen and reality TV star Brooks Nader, both who have spoken publicly about it. “It was enough for me. It kickstarted something,” Cohen told “TODAY with Jenna & Friends” last year. He did not say what GLP-1 he had taken.

But a recent warning from Novant Health, a hospital group that serves 6 million patients, warned that smaller GLP-1 doses carry risks for users. Novant also says that microdosing isn’t even that effective.

‘A random unknown drug’

Doctors typically prescribe U.S. Food and Drug Administration-approved GLP-1 drugs for patients to use once a week. Patients often start with small doses of a quarter of a milligram but doctors can prescribe a range of doses, depending on weight loss needs.

Drugmakers are currently testing doses of up to 20 milligrams of semaglutide, the active ingredient in Ozempic and Wegovy, to take weekly.

But several telehealth companies, including Noom, say microdosing can help patients who want to spend less money than paying out of pocket for larger doses and still lose weight.

Microdoses of GLP-1s – created by taking FDA-approved drugs and splitting them into smaller doses – are dubbed “compounded drugs.” These are custom-made by licensed pharmacists who sell them over the counter and for telehealth companies online.

The FDA is taking action to limit the use of compounded GLP-1s. Companies marketing the microdoses are only allowed to make the compounded versions when there is a shortage of FDA-approved GLP-1s, the agency said Wednesday. There is no shortage right now.

Noom, arguably the most prominent telehealth company selling microdoses of GLP-1, uses semaglutide as its active ingredient. The Independent has contacted Noom for comment.

What’s more, compounded versions aren’t approved by the FDA, meaning there may not be a process of verifying safety, effectiveness or quality before medications are marketed to consumers. Noom says it partners with an FDA-regulated facility to produce its drugs and that the facility is sterile.

Drugs not produced in a sterile environment can lead to bacterial infections. Measurement errors are possible when splitting doses, and may lead to an accidental overdose. Brown Health says there was a nearly 1,500 percent increase in calls related to accidentally overdosing on injected weight loss drugs in 2023.

“I don’t recommend using compounded versions of these medications because they’re untested – both in their effectiveness and their safety,” Dr. W. Scott Butsch, the Director of Obesity Medicine in the Bariatric and Metabolic Institute at the Cleveland Clinic, said.

The drugs may also come with undisclosed or even dangerous additives that can interact with other medications or health conditions, obesity medicine doctor Dr. John Cleek, of Novant Health General Surgery & Bariatrics – Mount Pleasant, said last month. GLP-1s at any dosage can change how some blood thinners and hormonal birth control affect the body.

“Most people usually aren’t okay with injecting themselves with a random unknown drug,” Cleek said. “But that’s essentially what you’re doing if you use a compounded GLP-1 drug.”

‘Lifestyle first’

The wider problem with microdosing is that weight-loss benefits don’t outweigh the risks, doctors say.

That’s especially true for people trying to lose less than 5 percent of their body weight, Dr. Katy Williams, a bariatric medicine specialist at University of Missouri Health Care, said in a statement.

“Work on your lifestyle first,” she said. “Your doctor or a weight loss specialist will absolutely be able to find places where you can make meaningful lifestyle changes that can result in five to 10 pounds of weight loss.”

Microdosing to reduce side effects, like nausea and vomiting, is also ineffective, said Butsch. These symptoms typically improve over time but doctors can recommend changes in diet or anti-nausea medication.

“If you take a reduced dose, you run the risk of the drug disappearing from your system faster than intended,” he said. “And when you take it again, you’re going to have that side effect again because there hasn’t been a steady amount of the medication in your system.”