In Pennsylvania, too many families know the devastating toll obesity and related chronic diseases can take. Access to safe, effective medications can change lives, and when you need medication, you want to trust that it’s real — and that it’s safe.

But right now, shady companies are putting that trust — and the health of Pennsylvanians — at risk. Across the country, unregulated compounding pharmacies are selling knockoff versions of GLP-1 medications with zero FDA approval. They often use untested or contaminated ingredients and bypass the strict safety and quality controls that real, FDA-approved drugs must meet. These copycat products are flooding the market under the guise of affordability, luring in patients with aggressive online ads and false promises. And they are targeting the very communities already hit hardest by obesity and chronic disease: low-income families and communities of color.

In fact, the Shapiro administration recently held a Chester County pharmacy accountable for compounding and packaging 30,000 doses of injectable weight-loss drugs in uninspected facilities.

Let’s be clear: compounded GLP-1s are not the same as the legitimate medications that doctors prescribe for weight loss and chronic disease management. Those legitimate medications undergo rigorous testing for FDA approval and are prescribed by doctors with safeguards for dosage accuracy and purity. The FDA has already issued warnings about overdoses, contamination and hospitalizations linked to compounded versions of semaglutide and tirzepatide. Patients have ended up in the ER because these products were mislabeled or improperly dosed. When it comes to injectable medications, there is no margin for error, yet these companies are operating with none of the oversight that protects patients from harm.

What makes this even more troubling is who they are targeting. Black Pennsylvanians make up 13 percent of our state’s population but 25 percent of Medical Assistance recipients. Nationally, 43 percent of Black adults live with obesity, compared to 33 percent of white adults. Those numbers reflect decades of structural inequities that have left some communities with less access to healthy food, safe places to exercise and preventive care. Now, predatory companies are exploiting those same inequities, pushing unproven drugs on people who are simply trying to manage their health and improve their lives.

The motivation here could not be clearer. These companies are putting profit over people. They see rising demand for GLP-1 medications, know that cost and access barriers exist and swoop in to sell dangerous products to those with the fewest options. It is cynical, it is exploitative — and it cannot be allowed to continue.

As someone who grew up in Dauphin County, served my neighbors in local government and now serves as co-chairman of the PA Diabetes Caucus, I believe Pennsylvania must act. We need stronger enforcement to shut down illegal compounders and stop these sketchy products from reaching our communities. We need to work closely with federal partners to ensure unsafe ingredients aren’t making their way into our state. And we need to protect access to real, FDA-approved GLP-1 medications through Medical Assistance so that people aren’t forced to choose between no treatment at all or a dangerous, unregulated copycat.

I’m working on legislation to protect patients. However, the federal government can take steps right now. I implore the FDA to verify the validity of these fake GLP-1s or prohibit their sale entirely.

Pennsylvanians deserve better than counterfeit medicine cooked up in back rooms and peddled through predatory online ads. Safe, effective, regulated treatments must be the standard, not a privilege. We have a responsibility to protect our communities from harm, close the door on these bad actors and make sure that every family can trust the medicine they rely on. Because no parent should ever have to wonder if the medicine they are giving their child — or themselves — is real or a dangerous fake.

State Rep. Justin Fleming represents the 105th Legislative District in Dauphin County. He writes from Harrisburg.