The FDA has vowed to fix a pharma ad loophole—but they’re targeting the wrong one.
When Serena Williams revealed her use of GLP-1s in an advertisement for telehealth provider Ro, she was defiant: “I’m not afraid to say it and say it loud.”
But what she didn’t say loudly, or even quietly, was the list of side effects and challenges that come with the use of GLP-1s. A pharma company could never do what Williams and Ro have done, despite advertising for the same medications.
Williams’ ad features her alone speaking, with the only text appearing on the screen a web address for Ro. Meanwhile, a 2025 ad by Novo Nordisk for its semaglutide weight loss medication Wegovy is a word soup of clinical trial data, risks and potential outcomes.
In one screengrab, two women talk about Wegovy, and a large headline says “lose weight and keep it off. But below, in small text, reads “people who stopped taking Wegovy generally regained weight.”
Williams doesn’t warn of that potential downside to treatment, but rather details her experience losing weight after the birth of her first child.
“It’s awesome and I know it will help a lot of people,” Williams proclaims. But Novo can’t say the same thing in its ads.
Instead, a voice rattles off a list of potential side effects as happy people hammer together boards or play dominoes in a park. The commercial culminates in a group of plus-size individuals joining together to walk down a street.
But Williams’ ad isn’t by a pharma. It’s a telehealth provider that is not subject to the same regulation when advertising medicines. This telehealth provider benefits greatly from selling these medications through its platform without the same restrictions drug companies face.
Ro tries to avoid direct promotion of GLP-1s by removing the label from the packaging. But any pharma nerd—or maybe it’s just me—knows that she is using Eli Lilly’s tirzepatide product based on the injector.
When I told one of the experts I spoke to for this series of stories that Williams actually injects—or at least pretends to inject—one of these medicines into the back of her arm in the commercial, he dramatically threw up his hands and face-palmed. This kind of visual in an ad by a pharma would be subject to rigorous discussion. Will consumers take that as an instructional video for injecting?
Another told me that the FDA has always been firm that you do not have to explicitly mention a drug name to be considered to be promoting it. It’s just that the scope of the FDA’s regulatory power only includes manufacturers—the drugmakers that have filed a new drug application, tested the product, brought it to market and sell it.
The FDA last week vowed to step up its enforcement of pharmaceutical ads, with 100 letters sent out to companies targeting specific violations. While those have not been made public, I have learned that Hims & Hers—a telehealth provider that offers compounded versions of GLP-1s—was a target for an ad that aired during last year’s Super Bowl.
In it, the company alarmingly advertises compounded versions of GLP-1 medicines without mentioning that these are not FDA-approved. Instead, viewers see tiny vials of medicine or pills being offered as weight loss solutions tailored to their bodies.
The FDA touted this new crackdown on pharma ads as closing a loophole that has allowed pharmas to promote their medicines without disclosing the risks. The experts I have spoken to say there is no loophole to close—the regulation was written to include disclosures about drug risks in a truncated way, striking a balance between the inevitable ads and informing the public.
But there’s a clear loophole that the FDA could seek to close: the one that allows Ro, Hims & Hers and many others to promote drugs without disclosing the risks. These entities are typically regulated by the states rather than the FDA, since they have historically dealt with the application of medicine rather than manufacturing medicines for the masses. That has of course changed with the rise in GLP-1s as compounders and telehealth providers seek a slice of the lucrative market.
FDA Commissioner Marty Makary directly addressed social media influencers and telehealth companies in a JAMA article announcing the new ad policy changes, decrying the uptick in drug ads “presented as entertainment.” This represents a big change in how the FDA has viewed the regulation of drug compounders, which have typically been the purview of the states. More on that here.
I urge Congress to capitalize on this moment and close the right loophole—the one that allows companies like Ro or Hims & Hers to skirt oversight and make money off of consumers unaware of a drug’s risks.
Oh, and no disrespect to Williams here. She’s clearly the GOAT. But maybe just not the GOAT at choosing her corporate partners.
