| One day in late March, I stepped out of a subway car and into a station full of ads. They blanketed even the turnstile where commuters enter, bar and all. The images featured a slim white device. In some, models were using the device to inject themselves in the belly. "A weekly shot to lose weight," the ads read, "with coaching, care, and healthy lifestyle changes to make it last."
The startup Ro is one of the dozens of companies providing prescriptions for meds like Novo Nordisk's buzzy new obesity drug Wegovy and the diabetes drug Ozempic. And it is investing heavily in making sure everyone knows it. There were more than 1,000 ads total, across over 100 New York City subway stations, all for Ro's weight-loss telemedicine offering. The company is also running digital, TV and audio ads, and working with influencers.  Ro's Wegovy ads in a Times Square subway station. Source: Ro A weight loss program membership costs about $135 a month, which covers medical consults and health coaching, but not the price of medication. These medications can cost around $1,000 or more a month, depending on insurance coverage. Another player selling Wegovy and Ozempic is Sequence, which WW International, also known as WeightWatchers, recently purchased.
Ro's advertising may help set it apart in a crowded market, but it has also sparked backlash. One of the concerns? Ro and other companies are telling prospective customers they can use diabetes drugs like Ozempic to lose weight. But Ozempic hasn't been formally approved by US health regulators for that purpose, and that's considered an "off label" use of the drug. Legally, drug manufacturers have to promote their products in a way that's consistent with the label. For Ozempic, that would be type 2 diabetes, because that's what the US Food and Drug Administration approved it for in 2017. But that law generally applies only to drugmakers marketing their own drugs, not telemedicine companies. "Companies are operating in this gray area," says Nathan Cortez, a law professor at Southern Methodist University. And as telemedicine companies proliferate and get more popular, their advertising is "just becoming more and more aggressive." Low-risk drugs like birth control pills or hair-loss medications are a good fit for a remote prescribing model. But "with something like Ozempic or these other drugs that are newer, I don't think you can treat all drugs the same," he says. "They're not all completely harmless."
People seeing these ads might get the impression that taking weight loss drugs is a quick fix. In reality, patients may need to take these drugs long term to keep the weight off. The drugs can carry serious risks, and they also have some pretty common, unpleasant side effects, like diarrhea, nausea and vomiting. In an interview, Ro Chief Executive Officer Zachariah Reitano noted that the subway ads featured Wegovy, a drug that was approved in 2021 specifically for weight loss, not the less-expensive Ozempic—though the images do direct onlookers to a link that features both medications. He also said that the drug prescribed is up to the medical provider. "We wanted to start a conversation around obesity being a disease that warrants ongoing, high-quality health care," he said. "There's no part of our campaign whatsoever that says everyone should be on these medications." (More of the company's response here and here.) It's not just Ro. Google Ozempic or Wegovy and you'll find no shortage of sponsored posts from various telemedicine companies. Novo held off on promoting Wegovy until a shortage resolved late last year, but it's now running ads. The marketing bonanza for weight-loss drugs is only beginning. — Emma Court | 
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