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Clinic file

SkinnyRx

The bottom line

No verdict has been issued yet.

This is a neutral factual record. SkinnyRx (skinnyrx.com) is a direct-to-consumer telehealth platform whose Terms and Conditions, Privacy Policy, and a February 2026 FDA warning letter all identify the operating company as Lean Rx, Inc. (d/b/a SkinnyRx and LeanRx), based at 2108 N St, Suite N, Sacramento, CA 95816. It offers compounded semaglutide and compounded tirzepatide in injectable, oral-tablet, and sublingual-tablet forms, plus a separate $49-then-$149/month membership pathway that facilitates (but does not itself fulfill) access to branded medications including Wegovy, Zepbound, Mounjaro, and the investigational once-daily pill Foundayo through third-party manufacturer programs (NovoCare Pharmacy, LillyDirect). Intake is a roughly five-minute online quiz reviewed by a U.S.-licensed, board-certified provider; patients are not charged unless the intake is completed and are refunded in 24-48 hours if a provider determines they don't qualify. SkinnyRx names no compounding or dispensing pharmacy anywhere in its own public materials. Compounded-medication offerings are explicitly not available in Alabama, Louisiana, or Mississippi per its own Terms, so all-50-state coverage is not confirmed for its core compounded product line; branded offerings are stated to "may be available in all U.S. states" without an enumerated list. SkinnyRx offers a 90-Day Money-Back Guarantee with narrow eligibility conditions (continuous 90-day paid membership, weekly self-logged weight in its app, ending weight not below starting weight, claim filed within 14 days of the guarantee period's end) and states plainly it does not accept returns or refunds on medication once other conditions aren't met; the branded-path membership fee is non-refundable once charged. Governing law is California, with mandatory individual AAA arbitration, a class-action waiver, and a one-year limitations period for disputes; non-arbitrable disputes are venued in Sacramento County, California courts. On February 20, 2026, the FDA issued a warning letter to Lean Rx, Inc. (MARCS-CMS 717989) for misbranding under FDCA sections 502(a) and 502(bb), citing website labeling that falsely implied SkinnyRx itself is the compounder and marketing claims implying FDA approval/equivalence. Separately, a federal putative class action (Freeland v. Foothills Pharmacy, Ltd. et al., No. 4:26-cv-00263, M.D. Pa., filed February 3, 2026) targets the marketing of oral tirzepatide tablets sold under several telehealth brands; SkinnyRx is not a named defendant but is described throughout as the consumer-facing storefront the named plaintiff purchased from, and the complaint separately alleges that no entity named "LeanRx" or "Lean Rx" could be located in California Secretary of State records despite the Sacramento address on SkinnyRx's own Terms, while a same-named Delaware entity is tied to an unpaid New York City tax lien filed against a residential address. SkinnyRx's BBB profile shows a B rating (not BBB-accredited) and 151 complaints over three years, concentrated in product and billing/subscription disputes. A Trustpilot profile for skinnyrx.com exists based on search-result snippets, but Trustpilot blocks direct fetch access, so its rating and review count could not be independently verified as of the access date and are not reported here.

The supply chain

You buy fromSkinnyRxThe brand: marketing, checkout, and the subscription.
Your clinician works forSkinnyRxNo contract medical group found on the clinic's own pages.
Your prescription is filled byNo pharmacy on our recordNothing we can verify — the receipt the rest of the chain depends on.
Licensed where you live?Check your stateEvery fill depends on the pharmacy holding a license in your state — verified below, state board by state board.

What checks out

No gate criteria passed yet.

What to watch

On February 20, 2026, the FDA issued a warning letter (MARCS-CMS 717989) to Lean Rx, Inc. dba SkinnyRx for misbranding under FDCA sections 502(a) and 502(bb). After reviewing skinnyrx.com in December 2025, the FDA found that the compounded semaglutide and tirzepatide products pictured on the site display the name "SkinnyRx" on the label, which "suggest[s] SkinnyRx is the compounder of those drugs when in fact it is not." The letter separately cited specific marketing claims on the site — "from the same family as GLP-1 treatments like Mounjaro® and Zepbound®," "Get access to the same active ingredient as name-brand GLP-1 medications," and "It contains the same active ingredient as FDA-approved medications" — as implying FDA approval or evaluation that compounded drugs have not received. SkinnyRx was given 15 working days to respond describing corrective steps. This is a concern signal about labeling/marketing practices, not a shutdown order or a finding about drug safety or manufacturing quality.
A federal putative class action, Freeland v. Foothills Pharmacy, Ltd. et al., No. 4:26-cv-00263 (M.D. Pa., filed February 3, 2026), concerns the marketing and sale of oral/sublingual compounded tirzepatide tablets — which the complaint alleges have no demonstrated mechanism of absorption or clinical efficacy when delivered as a pill — sold through several consumer-facing telehealth brands. SkinnyRx is not a named defendant (the named defendants are Foothills Professional Pharmacy, Ltd.; Avocado Health Technology, Inc.; Sajad Zalzala, M.D.; and TeleRx Providers, P.C.), but the named plaintiff purchased her product from SkinnyRx, and the complaint describes SkinnyRx throughout as one of the storefronts allegedly operating within a common enterprise centered on Foothills Pharmacy and Avocado Health. The complaint notes SkinnyRx's own site names Dr. Zalzala (a named defendant) as its "Medical Director," and separately alleges — based on its counsel's review of California Secretary of State records — that no entity named "SkinnyRx," "LeanRx, Inc.," or "Lean Rx" is registered in California despite the Sacramento address SkinnyRx lists in its own Terms, and that a same-named Delaware entity (LeanRx, Inc., DE File No. 2590640) is instead tied to a November 2025 New York City tax lien filed against a residential address. These are allegations in a complaint against other parties, not adjudicated findings or claims against SkinnyRx itself, and are reported here as such.
SkinnyRx's BBB profile shows a B rating (not BBB-accredited) with 151 complaints filed over the last three years (117 closed in the last 12 months), the largest categories being Product Issues (52) and Service/Repair Issues (50), followed by Sales & Advertising (20), Delivery (14), Billing (6), Order (5), and Customer Service (4). Representative complaints on file describe: a customer billed for a 12-month tirzepatide supply who received only 4 months of medication with late/incorrect shipments; a customer billed roughly seven weeks before their stated renewal date whose cancellation request was refused on the grounds the order had already been "transmitted," a claim the customer disputed; and a customer denied a refund for medication reported as ineffective, with the company citing a no-refund policy on shipped medication. This is a volume/pattern signal from a public complaint registry, not a verdict on any individual dispute's merits.
Trustpilot review integrity
Review integrity concern
69% of this company's reviews are organic (unprompted) — above our 40% threshold, the pattern most consistent with review gaming.
Score
4.7 / 5 across 2,308 reviews (trailing 12 months)
Review source
69% organic (unprompted) · 30% verified or invited (company-sent, post-transaction)
OrganicVerified / invited
Source: Trustpilot's own "Transparent Inviting" disclosure, company profile (accessed 2026-07-12).
Review integrity concern

69% of this company's Trustpilot reviews are organic (unprompted), above our 40% threshold. Verified and invited reviews both require a real completed transaction and the company choosing to send the invite, which makes them hard to fabricate at scale. A heavy skew toward organic, unprompted reviews is a known review-manipulation vector — it does not by itself disqualify a clinic, but it weighs against the verdict. See how we weigh this.

Corporate address transparency
Agent or mailbox address — no operating location listed
Registered-agent address, found on its BBB profile. The company does not publish this address on its own public pages.
Legal entity
Lean Rx, Inc. dba SkinnyRx
Listed address
2108 N St, Ste N, Sacramento, CA 95816
Notes
2108 N Street is a national registered-agent service's California office — the same service that operates the Sheridan and Casper, Wyoming addresses in this audit.

Who fills your prescription

SkinnyRx does not name a compounding or dispensing pharmacy anywhere on its own website or in its Terms and Conditions. Its FAQ states only, generically, that "503A pharmacies are licensed by state boards of pharmacy and are FDA-compliant." Notably, the FDA's February 2026 warning letter to SkinnyRx's operating company found that the compounded semaglutide/tirzepatide product labels pictured on skinnyrx.com display the name "SkinnyRx" itself, which the FDA determined falsely suggests SkinnyRx is the compounder of the drugs when in fact it is not — the actual compounder is left undisclosed to consumers. A federal class-action complaint filed against unrelated defendants (Foothills Professional Pharmacy, Ltd.; Avocado Health Technology, Inc.; Sajad Zalzala, M.D.; TeleRx Providers, P.C.) separately identifies SkinnyRx as one of several consumer-facing telehealth storefronts selling oral tirzepatide tablets, alleging (without SkinnyRx itself being a named defendant) that SkinnyRx's site "does not disclose any corporate leadership, ownership structure, clinical staff, prescribing entity, or pharmacy operations responsible for the issuance of prescriptions or fulfillment of medications sold through the platform." For branded medications (Wegovy, Zepbound, Mounjaro, and the investigational oral GLP-1 Foundayo), SkinnyRx's Terms state the medication purchase, dispensing, fulfillment, shipping, and billing are handled by a separate third-party pharmacy or manufacturer-affiliated program (its FAQ names NovoCare Pharmacy and LillyDirect as the manufacturer programs for this pathway), not by SkinnyRx.

Partner pharmacies have not yet been profiled. Each named partner must clear the pharmacy gate independently before this clinic stays on the index.

What it's actually like

Legal entity and address (per SkinnyRx's own Terms and Conditions, and independently confirmed by the FDA's warning letter and BBB profile): Lean Rx, Inc. ("SkinnyRx", "LeanRx"), 2108 N St, Suite N, Sacramento, CA 95816; support@skinnyrx.com; 1-888-979-9580. Products and pricing (per skinnyrx.com's product pages, current at the access date): Compounded Injectable Semaglutide, as low as $149.25/month (list $349); Oral Semaglutide (swallowed tablet), as low as $199/month (list $349); Sublingual Semaglutide Tablets, as low as $249/month (list $349); Compounded Tirzepatide Tablets (a sublingual/buccal formulation — instructions direct patients to place the tablet between gum and cheek, let it dissolve, and wait at least 30 minutes before eating, drinking, or taking other oral medication), as low as $224.25/month (list $349); Compounded Injectable Tirzepatide, as low as $224.25/month (list $399). Separately, a SkinnyRx Membership ($49 for the first month, then $149/month, recurring, cancel-anytime-prospectively) is required only for the branded-medication pathway and grants access/coordination support (not fulfillment) for Wegovy, Zepbound, Mounjaro, and the once-daily investigational pill Foundayo (orforglipron) — the site's own catalog lists both the Wegovy Pill and Foundayo Pill as currently "Unavailable." No 3- or 6-month bundle pricing was found; all plans are billed monthly (a *disclaimer on the site notes prices shown apply to the monthly plan paid upfront or via buy-now-pay-later, and actual price depends on the product/plan prescribed). Intake (per the site's own "how it works" copy): (1) "Take the quiz" — a roughly five-minute online questionnaire; (2) "Get prescribed" — SkinnyRx's team of licensed, U.S.-based, board-certified providers reviews the answers to determine candidacy for GLP-1 treatment; (3) "Get your meds" — medication ships free. Per its FAQ, payment is processed only after the intake is completed, and a full refund is issued within 24-48 hours if a provider determines the patient doesn't qualify (including for paid video appointments). Pharmacy disclosure: no compounding or dispensing pharmacy is named anywhere in SkinnyRx's Terms, Privacy Policy, or product pages; its FAQ states only that "503A pharmacies are licensed by state boards of pharmacy and are FDA-compliant," without identifying which pharmacy fills SkinnyRx's own orders. States served: per the Terms, "certain compounded medication and related offerings are currently not available in Alabama, Louisiana, and Mississippi," and SkinnyRx does not permit residents of those three states to purchase compounded offerings; branded-medication offerings are stated to "may be available in all U.S. states," though no enumerated state list is published for either pathway. Refill: per the FAQ, near the end of a supply, patients receive an email to check in with their provider, who determines continued eligibility; if eligible, medication ships automatically, and patients can also book an appointment through the portal to address side effects. Refund/cancellation/guarantee: subscriptions auto-renew and may be charged/shipped up to five days early "to ensure uninterrupted treatment"; cancellation is available anytime via the Customer Help Center or the online account, effective prospectively from the next billing period. A 90-Day Money-Back Guarantee is offered for compounded-medication programs and for SkinnyRx's own membership/subscription fees (not for separately billed branded-medication or third-party pharmacy charges), but eligibility requires: a continuously paid membership for the full 90-day Guarantee Period; weekly self-logged body weight in the SkinnyRx mobile app; an active, maintained prescription throughout the period; no prior refund/chargeback previously received; and a refund claim submitted within 14 calendar days after the Guarantee Period ends (claims after that window "will not be honored under any circumstances"). Eligibility is determined solely from self-reported, unverified weight-log data, and SkinnyRx reserves audit/denial rights and states its eligibility determination is "final and binding," subject only to the Terms' arbitration clause. The Guarantee can be redeemed once per account and is non-transferable. Governing law/arbitration: California law governs; the Terms contain a mandatory, individual-basis AAA arbitration provision (Section 11) with a class-action and jury-trial waiver, a one-year limitations period to bring any arbitrable dispute, a liability cap of $100 for SkinnyRx's total aggregate liability, and venue in the state/federal courts of Sacramento, California for any non-arbitrable disputes. No insurance is accepted; the Terms state SkinnyRx and its affiliated practices/providers operate on a cash-pay basis outside Medicare, Medicaid, and commercial insurance. Founding date: not clearly established from the public record. SkinnyRx's own site does not publish a founding date. Its BBB profile lists a business-start date of January 19, 2019 while the BBB file itself was only opened June 27, 2024; third-party review-aggregator sites offer conflicting, unverified claims of 2022 or 2024 founding. Given the conflict and the unreliability of the aggregator sources (several of which read as paid or SEO-driven "review" placements), no founding date is reported as confirmed. Parent company: not disclosed by SkinnyRx itself beyond "Lean Rx, Inc." A federal class-action complaint (Freeland v. Foothills Pharmacy, Ltd. et al., filed February 3, 2026) alleges, based on its counsel's investigation of California Secretary of State records, that no entity named "SkinnyRx," "Skinny Rx," "LeanRx, Inc.," or "Lean Rx" could be located registered in California, and that a company named "LeanRx, Inc." is instead registered in Delaware (DE File No. 2590640) with no publicly identified officers, directors, or beneficial owners, and that this Delaware entity is the subject of a New York City tax lien (filed November 19, 2025) tied to a residential address in Hancock, New York. This is an allegation in a filed complaint against other parties, not an adjudicated finding, and is reported here as such.

SkinnyRx in your state

Ship-to coverage per our record, and the state-by-state read: whether SkinnyRx's partner pharmacies hold a license where you live, checked against each state board's own portal. Click any state for its file.

Alaska — Ship-to coverage in reviewAlabama — Ship-to coverage in reviewArkansas — Ship-to coverage in reviewArizona — Ship-to coverage in reviewCalifornia — Ship-to coverage in reviewColorado — Ship-to coverage in reviewConnecticut — Ship-to coverage in reviewDelaware — Ship-to coverage in reviewFlorida — Ship-to coverage in reviewGeorgia — Ship-to coverage in reviewHawaii — Ship-to coverage in reviewIowa — Ship-to coverage in reviewIdaho — Ship-to coverage in reviewIllinois — Ship-to coverage in reviewIndiana — Ship-to coverage in reviewKansas — Ship-to coverage in reviewKentucky — Ship-to coverage in reviewLouisiana — Ship-to coverage in reviewMassachusetts — Ship-to coverage in reviewMaryland — Ship-to coverage in reviewMaine — Ship-to coverage in reviewMichigan — Ship-to coverage in reviewMinnesota — Ship-to coverage in reviewMissouri — Ship-to coverage in reviewMississippi — Ship-to coverage in reviewMontana — Ship-to coverage in reviewNorth Carolina — Ship-to coverage in reviewNorth Dakota — Ship-to coverage in reviewNebraska — Ship-to coverage in reviewNew Hampshire — Ship-to coverage in reviewNew Jersey — Ship-to coverage in reviewNew Mexico — Ship-to coverage in reviewNevada — Ship-to coverage in reviewNew York — Ship-to coverage in reviewOhio — Ship-to coverage in reviewOklahoma — Ship-to coverage in reviewOregon — Ship-to coverage in reviewPennsylvania — Ship-to coverage in reviewRhode Island — Ship-to coverage in reviewSouth Carolina — Ship-to coverage in reviewSouth Dakota — Ship-to coverage in reviewTennessee — Ship-to coverage in reviewTexas — Ship-to coverage in reviewUtah — Ship-to coverage in reviewVirginia — Ship-to coverage in reviewVermont — Ship-to coverage in reviewWashington — Ship-to coverage in reviewWisconsin — Ship-to coverage in reviewWest Virginia — Ship-to coverage in reviewWyoming — Ship-to coverage in review
Coverage in review

How we review. Every clinic must clear two gates: a credible compounding pharmacy, licensed in every state it ships to, and a clinic that supports long-term patient success. We pay for our own access and accept no payment, referral fees, or coupon arrangements from anyone we cover. See the methodology.