Why We Never Prescribed Compounded Weight Loss Injections, Even During the Shortage

The Naderi Center · Reston, VA and Chevy Chase, MD

When weight loss injections were in short supply, compounded copies were everywhere: med spas, wellness clinics and telehealth apps. We never prescribed them, not once. Here is why, where compounded GLP-1s stand today, and how to know that what you are injecting is the real medicine.

Why Did a Facial Plastic Surgery Practice Start a Weight Loss Program?

Medical weight loss was never part of our plan. For more than two decades, The Naderi Center has been a facial plastic surgery and cosmetic dermatology practice in Reston, Virginia and Chevy Chase, Maryland. Weight loss came to us because our patients asked.

When GLP-1 medications changed weight loss, our patients wanted them, and they wanted them from us. We referred people to other physicians, and many simply would not go. They trusted the physicians who already cared for their skin and their faces, and they did not want to hand an injectable medication to someone they did not know.

“Our patients trust us with their faces. When they asked us to help with weight loss, we said yes on one condition: we would only ever prescribe the real, FDA-approved medication.”Dr. Shervin Naderi

So we built a program the way we build everything else: physician-led, careful, and with safety ahead of convenience. That decision was tested almost immediately.

What Happened During the GLP-1 Shortage?

Demand for semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound) outran supply. The FDA placed semaglutide on its drug shortage list in 2022, and tirzepatide later that year. While a drug is on that list, the law allows pharmacies to make compounded copies of it.

What followed was a flood. Compounded weight loss injections appeared at med spas, wellness clinics and online platforms, often at a fraction of the brand-name price. Many came from pharmacies patients had never heard of, in vials with handwritten-looking labels and doses measured in units on an insulin syringe.

We had patients ask us for them every week. Our answer was always the same.

Why We Said No to Compounded Versions

The short answer is that we did not know what was in them, and neither did anyone else with certainty. Compounded semaglutide and tirzepatide are not FDA approved. They are not tested in the clinical trials that proved the brand-name medications work, and their strength, purity and sterility depend on the pharmacy that made them.

The FDA itself raised concerns during the shortage, including reports of patients injured by dosing errors with compounded semaglutide and products made with salt forms of the drug that are not the same active ingredient as the approved medicine.

“Safety is number one. We were not going to put a patient on something when we could not be sure what was in the vial. If the real medication was not available, the answer was to wait, not to take a risk.”Dr. Shervin Naderi

Holding that line was not always easy. Some patients went elsewhere for a cheaper or faster option. We understood, and we told them honestly why we would not do it. Many came back once brand-name Zepbound was available again.

Where Do Compounded GLP-1s Stand Now?

The shortages are over. The FDA declared the tirzepatide shortage resolved in December 2024 and the semaglutide shortage resolved in February 2025. The grace periods it gave compounding pharmacies ended in the spring of 2025.

Since then, pharmacies are no longer allowed to make routine copies of these drugs. The only narrow exception is a single patient with a documented medical reason that the approved product will not work for them. The FDA has sent warning letters to compounders, and in April 2026 it proposed keeping semaglutide and tirzepatide off the list of drugs that large outsourcing pharmacies can compound in bulk. Eli Lilly has also sued compounders, med spas and telehealth companies selling copies of its medicines.

In other words, the position we took during the shortage is now, for practical purposes, the rule.

How Can You Tell If Your Weight Loss Injection Is the Real Medicine?

If you are already taking a weight loss injection, a few simple checks will tell you what you have.

• The packaging. Brand-name Zepbound comes from Eli Lilly as a prefilled pen or a sealed single-dose vial in Lilly’s own box. A vial labeled only “tirzepatide” from a pharmacy you do not recognize is compounded.
• Added ingredients. “Tirzepatide with B12,” “semaglutide with glycine” and similar blends are compounded products. The approved medications contain no added vitamins.
• Where it came from. Your prescription should be filled through Lilly or a licensed retail pharmacy, not mailed from a pharmacy chosen by a website.
• Who is prescribing. A physician should review your full medical history before you start, and see you regularly while your dose is raised.

If you took a compounded version elsewhere and want to switch, we can help. Your doctor will review what you were taking and start brand-name Zepbound at the right dose for you.

What Does Physician-Led Weight Loss Look Like Here?

Every patient in our program is seen by a physician. Dr. Alexandra Snodgrass, a board-certified dermatologist, sees most of our weight loss patients, and Dr. Shervin Naderi also prescribes Zepbound. He takes it himself, and he has shared his own weight loss journey openly on Instagram.

Your first visit is a full review of your health, your medications and your goals. If Zepbound is right for you, you start at the lowest dose and step up slowly, with a monthly visit in Reston, in Chevy Chase or by video. Your doctor watches for side effects, adjusts your dose, and helps you plan how to keep the weight off.

And because we are a facial plastic surgery and dermatology practice, we watch your face too. Significant weight loss can leave the cheeks and temples hollow, sometimes called “Ozempic face.” We can plan for that with you, so your face keeps up with your body.

We welcome patients from Reston, Herndon, McLean, Great Falls, Vienna, Arlington, Alexandria, Bethesda, Potomac, Chevy Chase and Washington, DC, with offices in Reston and Chevy Chase and virtual visits for everyone.

Read more about our physician-led Zepbound weight loss program, and how to prevent “Ozempic face”.

Medically reviewed by Dr. Shervin Naderi, MD, FACS, double board-certified facial plastic surgeon. The Naderi Center for Plastic Surgery and Dermatology, Reston, VA and Chevy Chase, MD. Sources: U.S. Food and Drug Administration statements on GLP-1 compounding, 2024 to 2026.