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Ashish Rana, MD, discusses Sermo’s recent clinician survey, which highlighted patients’ use of unapproved and compounded GLP-1 medications.
The 45th Sermo Barometer survey has revealed the full extent to which unregulated peptide use has infiltrated US clinics and exam rooms.1
Conducted from May 8-12, 2026, the survey included 507 US-based healthcare providers. These physicians were from a variety of specialties including cardiology, dermatology, endocrinology, neurology, internal medicine, and orthopedic surgery.1
“The concern is over prescribing medications that potentially may be helpful, but may not be necessary for the particular patient,” Ashish Rana, MD, internal medicine program director and associate chair of academic medicine at Crozer Health, as well as a member of Sermo’s advisory board, told HCPLive in an exclusive interview. “So, physicians are put in awkward positions where patients want something, but we don’t necessarily think it’s necessary for them at that moment, which creates a conflict immediately.”
The Sermo survey focused on gathering information regarding emerging peptide therapies in patient conversations. Among those surveyed, 48% reported that patients have disclosed using peptides that have not received approval from the US Food and Drug Administration (FDA) in the past 12 months. These drugs are typically accessed via medspas, compounding pharmacies, and online “research” products.1
According to the survey, 69% of patients report seeking out peptides for weight loss, while 57% report taking the drugs as an anti-aging treatment, 55% report using them for muscle gain, and 41% for longevity. Additionally, these patients are not learning about these peptides from their clinicians – 84% of survey responders said that patients typically cite social media, influencers, podcasts, or online forums as their source of peptide information.1
The survey also indicated physicians’ increasing discomfort with patients’ access to and self-prescription of peptides. Approximately 66% responded to the survey expressing moderate or extreme concern regarding patients accessing and taking investigational peptides outside of supervised clinical pathways. 81% of responders said a clear approval or review pathway from the FDA is crucial or extremely important to how they counsel patients on the safety of emerging therapies.1
Patients having so much exposure to GLP-1s without any clinical guidance also results in a significant amount of misinformation regarding results. 33% of surveyed clinicians reported unrealistic patient expectations in the clinic, citing them as the biggest challenge of peptide conversations. 21% reported feeling pressure to recommend unapproved treatments – clinicians are more often spending visit time recalibrating expectations instead of discussing evidence-based therapy options.1
As further GLP-1-based therapies advance towards regulatory approval, including triple agonists like retatrutide, physicians have also expressed concern that these drugs will enter a market overly influenced by social channels. Among relevant specialists surveyed, 69% said they anticipate strong patient interest following these therapies’ potential approval, with 24% reporting patients already questioning them about triple agonists.1
The FDA has scheduled an advisory committee meeting for July 2026, during which it will discuss regulatory considerations for compounding certain peptide-based therapies. Speculation has suggested that the organization may potentially loosen existing restrictions.2
“If a patient is manifesting symptoms of a GI problem, don’t necessarily attribute it only to gastroenteritis or colitis or something – explore deeper,” Rana said. “Is there a non-prescribed medication involved? Ask that question directly, because when you do, patients are more obliged to then answer correctly and truthfully.”
Editors’ Note: Rana reports no relevant disclosures.