“I was offered $20,000 to sell you Ozempic,” the text overlay reads on TikTok influencer Stella Kittrell’s post. “A year ago I got my first Ozempic collab offer and it was pretty nuts,” she explains. “A year ago it was $15,000 for a 15 second ad, now it’s $20,000 for a three-frame Instagram story.”

While Kittrell didn’t take the money, other’s have—and they’re part of a growing network of ambassadors for telehealth companies paid to promote compounded weight-loss medications. Many juggle these promotions as side gigs alongside traditional jobs, with their ongoing weight-loss transformations unfolding in real time on TikTok.

“I’ve been on a journey, a pretty big journey,” says Susan Graham to her 8,000 followers in a video. She goes on to discuss her eight-month weight-loss journey using tirzepatide. “I do compound now with Amble,” she continues, “if you want to change your life, my name is Susan and I work with Amble.” She then instructs viewers to click the link in her bio for semaglutide and tirzepatide at their fingertips. In another paid post with Zappy Health, lifestyle influencer Jasmines Vanity writes, “now that I’m down 25 pounds, I’m feeling amazing! Less bloating, I sleep better, no food noise, and my cardio is actually getting better in the gym,” offering followers $50 off their first month using her code.

Here, telehealth companies like Zappy Health and Amble Health act as intermediaries, connecting influencers and consumers with compounding pharmacies that produce medications like semaglutide and tirzepatide during FDA-declared shortages. In 2022, both drugs appeared on the FDA’s shortage list, opening the door for compounded versions to hit the market at discounted rates, according to The Cut.

Established companies like Hims and Ro have also since expanded into this market. Today, an estimated two million Americans rely on compounded GLP-1 drugs. The savviest telehealth companies now recruit influencers to promote these products, with top-tier promoters earning as much as $30,000 a month, according to The Washington Post.

However, this ecosystem’s time might be running out. The FDA recently announced that the tirzepatide shortage had been “resolved,” threatening access to compounded versions. A new bill is also currently under consideration with Congress proposing penalties for telehealth companies, social media influencers, and healthcare providers who benefit financially from sharing misleading information about prescription drugs on social media.

TikTok this year also introduced stricter rules, limiting weight-loss-related content to users 18 and older and excluding it from the “For You” page. What happens to the Ozempic influencers? That remains to be seen.