Where GLP-1 Use Is Highest and Where It Is Growing, State by State
The states with the most GLP-1 prescriptions per person are not the states where use is growing fastest. Appalachia and the Deep South lead on volume, the Northeast leads on growth, and no public dataset covers cash-pay or compounded use. Here are the numbers, and what they can and cannot tell you.
Key Highlights
- Prescriptions per 100 residents are highest in West Virginia, Kentucky and Louisiana, and lowest in Hawaii, Nevada and Rhode Island.
- Between 2023 and 2024, prescriptions grew fastest in Rhode Island, Massachusetts and New Jersey, and fell in Louisiana, South Dakota and Idaho.
- Every state-level dataset available is built on insurance claims, so it excludes cash-pay and compounded prescriptions, which are where many med spas operate.
- Nationally, Gallup found 11% of adults using a GLP-1 for weight loss in mid-2026, up from 3% in 2024.
Why There Is No Single Answer
We looked for a single authoritative state-by-state dataset on GLP-1 use and did not find one. The big public trackers are national only. The state figures that exist come from commercial claims analyses, they use different metrics, and their rankings disagree. So this post presents two clearly labeled views, volume and growth, and treats neither as the boom-state ranking.
Highest Use per 100 Residents
Measured as GLP-1 prescriptions per 100 residents in commercial claims data, the highest-use states cluster in Appalachia and the Deep South. The lowest are in the West and Northeast.
Fastest Growth, 2023 to 2024
Growth tells a different story. The Northeast moved fastest between 2023 and 2024, while several states with high volume were flat or falling. Louisiana (-11.6%), South Dakota (-11.1%) and Idaho (-11%) declined.
What These Numbers Cannot Tell You
All of the state-level data is built on insurance claims. A med spa's GLP-1 patients, who are mostly cash-pay and often treated with compounded products, do not show up in it, so these rankings describe the insured, prescription-channel market, not your local demand. We found no credible state-level data on compounded or cash-pay GLP-1 use, and we would not publish a ranking of it. Nationally, a Gallup survey in mid-2026 found 11% of US adults currently using a GLP-1 for weight loss, up from 3% in 2024, and among current users 18% reported using a compounded or custom-mixed drug.
What to Do With It
Use the numbers as context, not a plan. If you are choosing where to open, look at licensing and regulatory posture alongside demand, because compounding enforcement and state corporate-practice rules shape what a clinic can actually offer. If you already operate, your own booking data is a better signal than any state ranking. Our Regulations Research page keeps a Data Trends section with the sources behind these figures.
MedGrid MSO provides management services to independently owned practices; it does not practise medicine and does not direct clinical decisions. Requirements vary by state and by service, and change over time — nothing on this page is legal or medical advice. Talk to us or your own counsel before making a structural decision for your clinic.