Your favorite local restaurant or hair salon is subject to more inspections and oversight than the medspa down the street selling peptide injections.
As wellness clinics increasingly capitalize on the exploding interest in the chains of amino acids that promise everything from longevity to weight loss, a Washington Post investigation has found gaping holes in the nation’s regulatory system. Many popular peptides have not been studied in clinical trials. But they are proliferating in gray and black markets as the Food and Drug Administration struggles to keep up, leaving American consumers vulnerable to potentially tainted, dangerous or untested products.
After contacting pharmacy, medical and nursing boards in all 50 states and D.C., The Post found that an overwhelming majority lack the authority and resources to oversee the booming peptide industry that Health Secretary Robert F. Kennedy Jr. is working to expand. Most have rarely disciplined peptide distributors.
Several local authorities said in interviews that they feel powerless to fully protect consumers. They report schemes consumers may not be aware of — peptides being made within people’s homes, peptide labels claiming to come from manufacturing facilities that turn out to be empty office spaces, and medspas selling peptides that were never approved for human use.
“They’re perfect areas for scams,” as many people want to look younger or lose weight, said Susan Alverson, the director of regulatory affairs for the Alabama Board of Pharmacy. “You just can’t talk people out of it.”
Former acting FDA commissioner Janet Woodcock said the failures to properly monitor America’s obsession with peptides revealed the “crazy jigsaw of oversight.”
The average person who would never dream of injecting themselves with something they bought over the internet, Woodcock said, might “happily go into a medspa thinking [its products] had been rigorously checked.”
The FDA, charged with keeping Americans’ drugs safe, has struggled in recent years to recruit and retain staff — especially drug inspectors — leading to fewer drug inspections, according to a 2024 report from the U.S. Government Accountability Office. Additionally, Kennedy is pushing to expand peptide access.
Public health experts say the peptide market has expanded beyond the agency’s capacity to oversee it.
In a statement, Department of Health and Human Services spokesperson Emily Hilliard disagreed with that assessment.
“The FDA continues to take action to protect the public from illegally marketed peptide products by using its full range of enforcement authorities, including warning letters, inspections, import actions, seizures, injunctions, and collaboration with federal and state partners,” she said. “Claims that the FDA is unable to carry out its mission are false. The agency continues to execute its statutory responsibilities, including advancing science-based regulatory decision-making, protecting the nation’s drug supply, and taking enforcement action against products that violate the law.”
But several officials noted the FDA does not have unlimited resources.
“The FDA is really in a position where they have to take the most dangerous drugs and focus on those,” Alverson said, leaving states to step into the gaps.
But in the vast majority of them, including Alabama, no regulatory authority exists to inspect medspas. And critics say the state medical, pharmacy and nursing boards that typically oversee the nation’s health practitioners are historically flawed. They’re long understaffed, with practitioners policing their own colleagues and relying on patients to report injuries they might not realize are related to peptides or might be too embarrassed to share.
Of the 41 boards of pharmacy who responded to The Post’s inquiry, eight — Ohio, Connecticut, Louisiana, Nebraska, Nevada, Oregon, Pennsylvania and Utah — reported publicly disciplining practitioners or pharmacies in cases regarding peptides. While some states noted investigations might be ongoing, most said they could not quantify or identify any peptide-related actions, either because there hadn’t been any or because state law doesn’t require them to catalogue actions in this way.
Of the 33 medical boards that replied, only Minnesota and Utah pointed to public reprimands or fines of physicians who had misprescribed peptides.
Of the 35 states whose nursing boards responded, most stressed that they lacked regulatory oversight and had not sent warnings to their nurses about peptides and their potential for misuse. Many reported they had not taken any disciplinary action when it came to peptides.
“We are a complaint-driven agency, and if we don’t get a complaint, we don’t get involved,” said Vincent A. Culotta Jr., the executive director of the Louisiana State Board of Medical Examiners.
Penalties, which are rare, can also be light. In Mississippi, board of nursing investigators found that a nurse was mixing and distributing weight-loss peptides marked solely for research use (considered the gray market) to customers who paid in cash. She was fined $500 and had her license suspended for six months, according to records from the state.
The public health system is falling short when it comes to peptides, said Peter Lurie, president of the nonprofit Center for Science in the Public Interest, a food and health watchdog, and a former FDA official.
“It’s a toxic mix of limited federal resources, limited federal authority, and … similar limitations at the state level. So everybody is in effect saying there’s only so much we can do, and every one of them may be right,” he said. “But the end result of it is that the products are sold in an almost unregulated fashion.”
A ‘big fan’ of peptides
Kennedy, a self-professed “big fan” of peptides, has made a priority of attempting to expand Americans’ access to them. He has likened peptides to supplements, saying they both don’t have clinical trials, and said before becoming HHS secretary that he would fight their “aggressive suppression.”
The FDA had previously sidelined some peptide products, banning their production for safety reasons. Agency scientists have said there isn’t enough evidence to allow certain peptides to be produced by compounding pharmacies, as Kennedy has pushed for. FDA officials have raised conflict-of-interest concerns over an advisory panel on that topic that includes people with ties to peptide-related businesses and clinics. The panel started meeting Thursday with deliberations continuing Friday.
Hilliard said all committee members underwent an ethics review. “FDA is committed to robust, transparent discussions about the products it regulates to help ensure Americans can make informed decisions about their health,” she said.
The products, touted by celebrities and influencers for healing and antiaging powers, have come under fire from medical experts. These researchers say many claims have not yet been tested because popular peptides haven’t gone through the rigorous clinical trials typical of FDA-approved drugs for safety and efficacy. But people continue to buy them online through chatrooms or in person at medspas or even bodegas.
Joshua Sharfstein, who served as principal deputy FDA commissioner during the Obama administration, said that if peptides are regulated similarly to supplements and not required to undergo clinical trials for effectiveness, it’s probably impossible to “distinguish between snake oil and legitimate medicine.”
“The further we stray from that, the more confusing the market is going to be, and the harder time people will have in knowing what really will help them,” he said.
HHS did not respond to questions about Kennedy’s views on peptides.
Without stronger oversight, consumers could be at risk, said Scott Brunner, CEO of the Alliance for Pharmacy Compounding, which advocates for compounding pharmacies.
“We’re not talking heroin here,” Brunner said. “We don’t have bodies in the street, and yet one sketchy manufacturer … and you end up with a multi-patient adverse event, patients dying, patients having to be hospitalized, patients experiencing loss of function, and it’s going to be extraordinarily bad for everybody, from RFK on down to the compounding pharmacies that are my members.”
Jeff Cohen, a health care business and regulatory lawyer who helped found the recently constituted American Peptide Association, said in an interview that he hoped the organization could help protect consumers. While he applauded Kennedy’s efforts to expand access to peptides, he said the secretary is constrained by government bureaucracy.
“There’s an inherent friction between wellness and science-based health care,” said Cohen, who also founded the American IV Association as IVs became more popular. “Science-based health care is double-blind studies for years. … You can’t monetize something that’s being studied like that. Quite frankly, the wellness space has always been driven by human curiosity and people wanting, choosing to experiment on themselves.”
YouTube is full of self-starter videos on how to monetize these substances, while TikTok and Instagram are full of transformation videos. YourPeptideBrand.com promises a fast way to start a peptide business, with images of vials with the phrase “YOUR LABEL HERE.”
YourPeptideBrand.com CEO Benjamin Morgan told The Post he’s thrilled Kennedy has waded into the peptide fray as he believes the secretary understands the value of health and wellness.
“We’re just trying to set the stage for what’s to come,” said Morgan, who also runs a supplement branding company and is working on a bloodwork analysis business.
Private equity is joining the fray as medspas cash in on the wellness movement. Considering the amount of black and gray market sales, it’s unclear how large the overall market is, but estimates are often lucrative.
Kimie Buley, director of education for the Alabama Board of Medical Examiners, said in a statement to The Post that the state is trying to educate businesses and the public about peptide dangers while “trying to get our arms around the mental gymnastics some practitioners are doing to justify injecting people with non-FDA approved substances they are purchasing through gray channels.”
Kennedy and peptide advocates say they are seeking to protect the American consumer from buying items off the black market or experimental products designed specifically for studies.
Paul Knoepfler, a professor at the University of California at Davis School of Medicine, has been tracking unproven peptide use in parallel to the marketing of stem cells by clinics. Kennedy’s push to reduce barriers to access to something that has so few clinical human studies seems hypocritical, given his attacks on common vaccines, Knoepfler told The Post.
“It really seems like a double standard, because when it comes to these peptides … you don’t really need a lot of evidence,” Knoepfler said. “But then on the vaccines, they’re saying don’t take proven vaccines, even though they’re proven to be safe.”
Leaving it to the states
With the FDA’s role in flux, the states are left to fill the vacuum. Many regulators The Post spoke with said that despite limited success cracking down, they fear they’re lagging behind the massive growth in the peptide market.
In Alabama, the state attorney general enacted an emergency freeze on the operations of Aurora Mobile IV and Wellness, which was advertising pharmaceutical-grade weight-loss drugs but instead offering research-grade versions not intended for humans, according to the attorney general’s office. One of the owners of the medspa, Amanda Medders, told investigators that “probably not all of [the customers] know it isn’t FDA approved,” according to the state’s complaint. In a settlement with the state this year, she surrendered her nursing license, and she and her co-owner husband agreed to close the clinic, pay more than $24,000 in fines and not work in the health care industry directly treating patients.
Jeremy Knowles, one of the lead attorneys representing more than three dozen plaintiffs in a civil action against Aurora Mobile IV and Wellness, alleged that users of the products involved in the lawsuit suffered nausea, headaches, swelling, irritation of the injection sites and even hospitalization.
“Their victims, vulnerable Alabamians who trusted the Defendants with their bodies, were injected with unapproved tirzepatide and semaglutide peptides without their knowledge or consent,” the lawsuit said.
Knowles added that he suspects there are many more cases like this bubbling up across the country.
“It doesn’t take a mathematician to figure out there was an awful lot of profit in this,” he said.
Medders declined to comment, citing the ongoing litigation.
An osteopathic doctor in Utah was banned from treating patients with peptides after investigators found that he had offered non-FDA-approved versions, along with ketamine, at his medspa, according to documents the state sent to The Post. Utah put his medical license on probation for three years and revoked his controlled-substances license. In April, the doctor was indicted by a federal grand jury, with the prosecutors alleging that he obtained misbranded peptides from China, knowing “they were not backed by proper, reliable testing and clinical trials.” The doctor has pleaded not guilty.
The Texas Board of Nursing, which has received 46 specific complaints regarding peptides or injectable weight-loss medications since 2021, has disciplined five practitioners — most receiving warnings with an order for remedial education.
Providers also are fighting back. A physician in California has contested an attempt by Nevada’s pharmacy board to fine him, following the hospitalization of two women injected with peptides at his booth at a Las Vegas longevity festival.
‘Very scary place’
There is one state aggressively targeting peptide distributors: Ohio.
Since the start of 2025, Ohio has suspended the licenses of roughly 50 medspas, many for selling unregulated peptides and other unapproved drugs.
Unlike the vast majority of states whose legislatures have not granted their pharmacy boards the regulatory authority to inspect medspas, Ohio’s has the power to police the fast-growing peptide market.
As the chief pharmacist for the Ohio Board of Pharmacy, Jenni Wai has seen enough to make one recommendation: Buyer, beware.
“If you don’t know the source of the drug, it can be a very scary place,” Wai said. “It’s really lawless at this point.”
The Ohio Board of Pharmacy caught one medspa selling what it claimed in a text to be “raw/pure peptides.” The medspa said the peptide vials, some of which it was selling for more than $600, included the active ingredient in the weight-loss drugs Mounjaro and Zepbound. A grand jury later indicted the owner, and the business was fined $90,000 and had its drug-distribution license revoked.
In another case, Ohio investigators found a medspa selling an array of peptides advertised for “inflammation,” “tissue repair” and “neuroprotection.” The medspa had an extensive liability disclaimer, requiring patients to “accept responsibility for any risks or complications that may arise.” The board also suspended the medspa’s drug-distribution license.
While Indiana acquired similar regulatory powers this legislative session, Kam Gandhi, executive director of the Arizona State Board of Pharmacy, said that he wishes his state and others could copy Ohio.
“I envy Ohio and what they’re able to do,” Gandhi said. “A lot of states don’t have that authority, and that is a big blind spot.”
The National Association of Boards of Pharmacy is working on guidance to develop medspa regulations for states, said its head, Lemrey “Al” Carter.
When it comes to entities selling peptides not regulated by boards of pharmacy, Carter said, “it’s just going to get worse.”
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