For the most part,what they are doing is legal. Whether they abide by the intention of Australia’s stringent regulations is the question.

Look at how promotions skirt around advertising rules. Using online quizzes as a substitute for real-time doctor consults is another example. One company is now avoiding the Therapeutic Goods Administration altogether,by sellingunapproved copycat medicine in the face of worldwide Ozempic shortages,also known as compounding.

The TGA,which regulates medicine,has regularly expressed its displeasure. For one,it has made numerous pleas for doctors to restrict their prescribing of Ozempic to the people who really need it – diabetics – to little avail.

It hascalled out telehealth companies making medications that mimic Ozempic:“Compounding medicines on a commercial-like scale has the potential to adversely affect many patients,as the quality,safety and efficacy of the compounded product has not been subject to the rigorous testing required for the safe supply of registered medicines in Australia.”

It has also taken atough line on advertising:“We are concerned about business models that employ marketing strategies to influence health care choices made by Australians without first having consulted with a health professional in real time.”

Last year,the TGA said it received about 1000 requests to remove digital ads for weight loss products,and almost 2000 for ads specifically related to drugs like Ozempic. In November,it fined telehealth provider InstantScripts $742,500 over alleged unlawful advertising.

‘With global shortages of weight loss drugs expected to continue this year,there is scant time to get the settings right.’

But it hasn’t moved the dial. Barbara Mintzes,a professor of pharmaceutical policy at the University of Sydney,says our rules exist for a reason.

“Medicines can cause serious side effects which can be life-threatening. Prescription medicines cannot be legally sold or advertised to the public in Australia for this reason,” she says.

“Advertising of services for people to get a prescription for a specific medicine is just online shopping. It’s not a health consultation. This completely contradicts the intention of the regulations. There are also reasons to be especially worried about Ozempic[and similar] prescriptions without a proper health check.”

Both European and US medicines regulators are investigating links between weight loss drugs and suicidal ideation. There are also particularly acute risks for people with eating disorders such as anorexia and bulimia.

For most people,ads are annoying. But they can also prey on those most likely to be searching weight loss online,who need protection.

Natalie Spicer,the head of clinical and support services at the Butterfly Foundation,says ads for weight loss drugs can be dangerous when they are misleadingly promoted as providing quick,easy or desirable results. The language in these ads can internalise unrealistic beauty ideals about size and diet,driving people to unsafe practices.

“It is essential that there is more regulation around advertising these products ... Similarly,it’s vital that doctors do a thorough consultation and look out for signs of an eating disorder before prescribing such potentially harmful medications,” she says.

Eucalyptus,one of the major telehealth players,defends its own practices around quality and safety. But this company has also called for more guidance,given there are no government-endorsed national standards specific to the telehealth sector.

“We think more could be done to strengthen the regulatory framework,” a spokesperson said.

“Eucalyptus has long been of the view that there is a need for national quality and safety standards for the entire telehealth sector. This would ensure telehealth providers are regulated appropriately,and consistently.”

Telehealth has clear benefits,particularly in an environment where GPs have become more expensive. It’s been a boon for people in regional areas who find healthcare harder to access. The government has more to do this year to improve our primary care system and its affordability. But it must also keep an eye on how other services are filling the gaps.

Butterfly Foundation National Helpline:1800 ED HOPE (1800 33 4673) or emailsupport@butterfly.org.au

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