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As with any business, there can be people who cut corners, which has led to a spate of FDA warnings about compounded semaglutide (among other medications) in recent years
Lilly's dual GLP-1/GIP agonist reached Phase 3 in 2019 and read out body-weight reductions of roughly 22% at the 15 mg dose in SURMOUNT-1, meaningfully above semaglutide's ~15%
10.1507/endocrj.44.163 27 LiechtyE
There is also a concern about long term effects, so people with a history of pancreatitis, for example, would be unlikely to be prescribed a GLP-1
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