We need to talk about the Hims & Hers Super Bowl ad

the pharmaceutical ad that didn't include side effects ;;;

I don’t know about you, but I tuned in the Super Bowl primarily for Kendrick Lamar’s halftime show. (I was not disappointed.) On this annual day famed for its display of capitalism, one commercial caught my eye. Initially, it broke into my consciousness with its combination of Childish Gambino’s “This is America,” a message of systemic injustice in medicine, and a confident offer to solve these injustices. While the critiques are true, I immediately became skeptical of the solution given that it was still rooted in capitalism.

The ad was from the (highly gendered¹) telehealth platform Hims & Hers which allows folx to chat online with doctors and receive prescriptions for certain drugs. The ad itself marketed GLP-1 drugs for weight loss. Brand name versions of these weight-loss drugs are known as Wegovy and Zepbound.²

To be clear, there are patients who can (and already are) seeing major health benefits from these drugs. There is no shame in taking them. However, there are light risks associated with GLP-1 drugs, particularly when purchased from companies like Hims & Hers (more on that below). If you are considering these drugs, please talk to a trusted doctor.

With that, there are specific problems with the Hims & Hers ad (including ignorance of risks). If you haven’t seen it, take a look below:

Even before it aired during Super Bowl, this ad drew the ire from health and policy experts. The Obesity Society called out the ad for its negative portrayal of obesity. The Partnership for Safe Medicines noted the tiny legalese containing required disclosures. In a letter to the US Food and Drug Administration (FDA) two senators — Dick Durban (D-IL) and Roger Marshall³ (R-KS) — said the ad “risks misleading” patients.

so what’s actually missing from the ad?

First, the ad notably omits any side effects associated with GLP-1 drugs. According to the Cleveland Clinic, these drugs have a range of possible side effects. The most common are appetite suppression (which is behaviorally how they cause weight loss), nausea, vomiting, and diarrhea. Less common side effects include dizziness, increased heart rate, headaches, and upset stomach. Some rare but serious side effects include functional changes to the kidneys, thyroid, pancreas, or retina.

Gender may be an important determinant in side effects as well. Cis women terminate GLP-1 treatment more often than cis men citing gastrointestinal side effects such as nausea. However, it is hard for scientists to draw confident conclusions regarding gender and GLP-1 drugs because the vast majority of our knowledge comes from studies on cis men and male rats. The lopsided information environment is so poor that two scientists had a dire warning for researchers:

What also clearly emerges is the paucity of data in female animal models or women in very basic aspects of the science of GLP-1—gaps that should be urgently mended, given the growing popularity of these medications, especially in women.

The Hims & Hers ad has also drawn criticism for the lack of clear language around the FDA approval status of their compounded GLP-1 drugs. In truth, these drugs are not FDA approved and are not subject to safety testing by the FDA. The commercial versions of GLP-1 drugs (like Wegovy and Zepbound) are FDA approved, but the compounded versions offered by Hims & Hers are not.

wait. what’s drug compounding?

Drug compounding is a very specific process of generating a pharmaceutical. Broadly, compounding is when a licensed pharmacist, physician, or company (like Hims & Hers) generates a medication tailored to the needs of a specific patient. Typically, compounded drugs are not produced in bulk. In contrast, generic drugs are produced in bulk and reviewed by the FDA before hitting the market.

Further, not just any drug can be compounded. The FDA has created a number of regulations around drug compounding, including to protect the intellectual property of a patent holding company. However, one allowed reason for compounding is in the event of a drug shortage, as determined by the FDA.

GLP-1 drugs (with its active agent semaglutide) have been listed as in shortage since August 2022, allowing compounding pharmacies like Hims & Hers to produce versions with no direct FDA oversight. As a result, compounders can offer GLP-1 weight loss drugs at much lower prices than the brand name versions and reap the rewards.

Of course, the GLP-1 commercial producers (Eli Lilly and Novo Nordisk) have been enraged at compounding versions eating into their exorbitant profits. Both companies have filed lawsuits to stop the proliferation of cheaper GLP-1 drugs. Novo Nordisk even took out ads in USA Today and the New York Times warning consumers about compounded drugs.

But, compounded versions will continue to be produced as long as semaglutide is on the FDA’s drug shortage list. Hims & Hers is taking advantage because it is fundamentally a pharmaceutical company (despite what its Super Bowl ad would lead you to believe).

will hims & hers be held accountable?

Senators Durbin and Marshall asked the FDA to take enforcement action against Hims & Hers for their misleading ad. The agency has yet to respond, but the company is pretty cozy with the power centers of the second Trump administration.

Hims & Hers was founded in San Francisco (originally just as Hims) and has long been a Silicon Valley darling. The company’s Series C venture capital funding included support from the Founders Fund cofounded by Peter Thiel. With Thiel’s cronies (like Elon Musk and JD Vance) at the levers of power, Hims & Hers can draw on its past for future support.

Indeed, Hims & Hers joined the flow of corporate money into Trump’s second inauguration fund. The company donated $1 million to the fund, the same amount as Silicon Valley powers Meta and OpenAI. That level of corporate handouts reportedly came with an “intimate” dinner with Trump and Vance.

For Hims & Hers, the gamble on compounded GLP-1 drugs ultimately depends whether the FDA keeps semaglutide on its list of drug shortages and (to a lesser extent) whether it chooses to take enforcement action based on their Super Bowl ad. Trump’s nominee to lead the FDA, Martin Makary, has a long history of attacking the agency. Upsetting the deep pockets of Hims & Hers is likely not high on his to-do list.

With such a permissive regulatory environment and direct connections to the administration, Hims & Hers is likely to keep growing its share of the semaglutide market with misleading ads. And, they certainly won’t be changing their name to Hims, Hers, & Theirs any time soon.

1. I once had to buy sildenafil from Hims even though I am not a him.

2. Ozempic and Mounjaro are the same class of drugs but marketed for treatment of type 2 diabetes.

3. Sen. Marshall is a trained physician, but that did not stop him from supporting anti-vaxxer Robert F. Kennedy, Jr. as Secretary of Health and Human Services.