In this multi-part series, we will explore how to build scalable telehealth infrastructure for GLP-1 and weight loss programs within the weight management and obesity care vertical end market.
The Rise in Interest Nationwide Provider Networks and the Telehealth Waves: Telehealth 1.0 and Telehealth 2.0
Since the COVID pandemic, there has been a significant rise of interest and demand from patients seeking virtual care as a modality of access to physicians and clinicians.
This arose from what was a necessity during the pandemic to a permanent reality, and expanded across different acute and chronic disease states and conditions.
According to research from Roche Diagnostics and Epic Research, the rise of telehealth consultations rose from approximately 1% of all patient visits in the pre-pandemic month of February 2020 to a peak of over 50% during COVID pandemic lockdowns, eventually stabilizing at a "new normal" of 6% – 17% depending on the region and specialty.
At the same time, scaled, well-respected provider networks like Amwell and Teladoc drove this initial telehealth wave (what we at MD Integrations call “Telehealth 1.0”) and many DTC business models and brands like HIMS, Keeps, and Ro, commensurately rode this Telehealth 1.0 wave to grow their business models and subscriber bases during this same time.
For example, HIMS in the pre-pandemic year of 2019 had ~202K subscribers to their chronic, lifestyle subscription services. In just two years, HIMS saw their subscriber base increase to ~391K users, a 39% two-year compounded annual growth rate (CAGR).
This catalyst of the pandemic for telehealth provided a lot of interest in virtual care and provider networks being forged, including the founding and initial of MD Integrations as a nationwide doctor-only network.
The next wave (what we call “Telehealth 2.0”) was driven through the expansion of interest in metabolic health management and weight loss care from the FDA-approvals of GLP-1 therapies, leading to the current U.S. addressable market of over $100 billion as we covered in Part One of this series.
In this next telehealth wave, scaled and successful nationwide provider networks like Teladoc and Amwell became viewed as legacy primary virtual care solutions with a heavily synchronous model (and their stock performance and market capitalization precipitously dropped as well), and failed to take advantage of the rise in interest in metabolic health and anti-obesity care because they were not set up to address the rising demand.
On the other hand, direct-to-consumer brands like HIMS saw yet another rise in their subscribers with the GLP-driven catalysts, seeing their additional care modalities helping to increase their subscriber base to 1.5 million as of end of 2023 and more recently in 2026 reported results, see a total subscriber base of over 2.5 million users.
Patient access to metabolic health care modalities like GLP-1 therapies, driven significantly off of virtual care delivery, also became evident through direct-to-patient channels opening up from the two big pharmaceutical companies - Eli Lilly (through LillyDirect) and Novo Nordisk (through NovoCare) during this Telehealth 2.0 wave.
Despite the differences in approach for user and patient access between HIMS (and the many offshoots of direct-to-consumer brands) and Eli Lilly, there was one common thread: a nationwide, scalable, and compliant network of physicians and clinicians.
Let’s unpack what we call the Medical Engine further.
Behind Every Successful Telehealth Company is The Medical Engine
One of the three key pillars of telehealth and virtual care delivery is a doctor network and doctor technology (like an electronic health or electronic medical records platform that doctors and clinicians work out of daily to provide compliant care).
No matter which wave or care modality patients seek in the virtual care sphere, they cannot receive the care they desire and deserve without physicians and clinicians being available to review their medical information, history, and cases with precision, compliance, and pace.
The nationwide clinical networks are the most integral part of every successful telehealth infrastructure, linking patients and users to access to care and treatment.
Despite its obvious criticality to any successful telehealth operations, many businesses, operators, and interested parties seeking to add telehealth as a vector of delivery to its captive base and patient/user population fail to prioritize and overlook working with or building a compliant network of doctors and clinicians.
Specifically for weight management and anti-obesity care in the metabolic health space, having board-certified physicians, like those that MD Integrations employs that are certified from the American Board of Obesity Medicine (ABOM), having a nationwide clinical engine becomes even more critical across four key vectors:
Let’s dig in further on each of these.
Beyond the GLP-1 Prescription: How The Clinical Engine Ensures Compliance, Care Quality, and Success
1. Managing and mitigating the GLP-1 care delivery, including adverse event and patient reporting
A compliant doctor network provides real-time triage. When a patient experiences severe gastrointestinal distress or injection site reactions (redness/swelling), they need immediate access to a clinician who can adjust the dose or titration schedule, preventing a minor side effect from becoming lasting issues (and drop-off on adherence rates and retention rates) for direct-to-consumer brands.
The ROI: Real-time side-effect triage prevents treatment discontinuation, which 2026 data shows hits 50% in the first year without active management, and protects the brand from regulatory injunctions.
2. Providing physician-led, compliant oversight of injections and titration
Patients on anti-obesity medications like GLP-1s are not "set-and-forget" medications, they require a rigorous, longitudinal care model.
The FDA recently warned that dosing errors often result from patients self-administering incorrect amounts or providers miscalculating doses.
With successful direct-to-consumer brands, successful metabolic health administration requires precision titration, and a nationwide network ensures that doctors are following evidence-based protocols to escalate doses slowly, which is the primary factor in maintaining patient adherence and reducing treatment abandonment.
In addition to that, the Clinical Engine part of the telehealth infrastructure also includes a "nursing or clinician layer" to virtually supervise the first subcutaneous injection, significantly increasing patient confidence and reducing "first-dose drop-off."
The ROI: Expert oversight reduces "first-dose" anxiety and ensures patients lose fat, not lean muscle mass, which is critical for long-term metabolic rate protection.
3. Ensuring longitudinal care and ROI to both the patients and the telehealth brands
Clinical data confirms that weight regain is near-inevitable (averaging 60%–75% of lost weight) once medication stops. Transitioning patients into a longitudinal care model that weaves in lifestyle interventions is important beyond what the telehealth nationwide doctor network can provide, including nutrition and resistance training.
The ROI: Shifts the business model from a 3-month flash in the pan, transactional oriented business to a multi-year Lifetime Value (LTV) by positioning the brand as a chronic disease management partner. In 2026, the best brands are shifting from Transactional Telehealth to Chronic Care Models, where physicians monitor markers like blood pressure and blood sugar (A1c) over 12–24 months.
4. Supporting a robust legal and compliance structure, including 50-state licensure management
Legal infrastructure is the strongest defensive moat
The Goal: Supporting a robust legal structure, including 50-state licensure management and "Equivalency Standard" compliance.
The ROI: Ensuring the brand can legally operate in high-value, strict-requirement states where audio-visual and bona-fide patient and physician relationship standards are most rigorous is important, and the right clinical engine partner can make you a viable and sustainable long-term business.
Follow along for Part Three of the series, where we will unpack the importance and critical component of The Digital Patient Experience in telehealth infrastructure.
Please reach out to our team at MD Integrations to learn how you can launch and scale your telehealth brand compliantly.