OPINION: Coloradans Need Protection from Counterfeit Weight Loss Drugs

This op-ed by Angelina Romasanta appeared on Colorado Newsline on December 19, 2025

I have spent my career as a physician assistant caring for patients of all ages — listening to their concerns, diagnosing their needs, and helping them navigate treatment plans in ways that are medically sound and humane. That’s why I am alarmed by the rapid spread of a dangerous gray market of counterfeit and illegally compounded GLP-1 medications and active pharmaceutical ingredients.

Colorado families deserve better — and state leaders must act to protect them.

Advances in GLP-1 therapies have transformed our medical approach to obesity — a condition that impacts heart health, metabolic risk, and overall well-being. Here in Colorado, our own Gov. Jared Polis signed legislation this summer to expand access to weight loss treatments, including allowing employers to opt into covering GLP-1s. When used under proper medical supervision these drugs can help patients manage their weight with dignity and support. With obesity impacting more than 24% of adults in the state, increasing access to FDA-approved weight loss drugs keeps Coloradans safe and healthy.

But the dark side of growing demand is that unscrupulous actors are exploiting patients’ real needs: selling unapproved, clandestine, and potentially unsafe “alternatives” that bypass the safeguards of regulated care.

The crisis began when legitimate GLP-1 supplies became scarce: Regulatory shortages prompted compounding pharmacies to step in, as allowed. These compounding efforts were meant as a short-term, carefully regulated bridge. Once shortages ended earlier in 2025, mass compounding should have stopped too.

Instead, some med-spas, telehealth companies, and compounding entities have continued compounding or supplying GLP-1s — frequently sourcing active pharmaceutical ingredients, or APIs, from abroad, sometimes via unregulated importers. These compounds are not FDA-approved, so their manufacturing lacks the rigorous safety, labeling and oversight that patients deserve and expect.

Even more troubling: Some companies are selling raw APIs directly to consumers to be reconstituted at home — turning a medication to be taken under medical supervision into a do-it-yourself experiment. As a clinician, I find this unconscionable. We are talking about medications meant to affect metabolism, hormones and overall health — not benign over-the-counter vitamins. When patients don’t know the purity of a powder or the exact dose, they are risking far more than money.

As of July 2025, federal data show hundreds of adverse events tied to compounded or illicit GLP-1s — hospitalizations, overdoses and even deaths. These are not abstract statistics; these are real people whose lives and trust in the health system have been harmed.

We cannot stand by and let this continue. The federal government should strengthen enforcement to stop illicit APIs from entering U.S. supply chains, like Attorney General Phil Weiser and members of the Colorado congressional delegation have strongly called for. At the same time, Colorado’s regulators, licensing boards and legislators must take action to shut down illegal compounders, hold accountable those who mislead patients, and protect access only to safe, FDA-regulated medications.

I chose to become a PA because I believe in equitable access to safe, effective and compassionate health care. As a clinician, I have looked patients in the eye and walked with them through difficult decisions about their health. As a Coloradan, I believe everyone deserves transparency, dignity and protection — especially when it comes to their health.

If our leaders heed this call, we can help ensure that obesity treatments remain tools of healing, not shortcuts to danger.