{
  "generated": "2026-08-25",
  "states": [
    {
      "name": "Alabama",
      "abbr": "AL",
      "region": "South",
      "obesity_prevalence_2023": 39,
      "historically_excluded": true,
      "note": "Alabama's Board of Pharmacy requires nonresident pharmacies to hold an Alabama permit, and several compounded-GLP-1 telehealth companies have historically listed Alabama as a state they do not ship to."
    },
    {
      "name": "Alaska",
      "abbr": "AK",
      "region": "West",
      "obesity_prevalence_2023": 33,
      "historically_excluded": false,
      "note": "Cold-chain shipping of temperature-sensitive injectables to Alaska can take longer than to the contiguous states; confirm the provider's shipping method and transit time."
    },
    {
      "name": "Arizona",
      "abbr": "AZ",
      "region": "West",
      "obesity_prevalence_2023": 33,
      "historically_excluded": false,
      "note": "Arizona permits asynchronous telehealth prescribing of non-controlled medications when a valid clinician-patient relationship is established."
    },
    {
      "name": "Arkansas",
      "abbr": "AR",
      "region": "South",
      "obesity_prevalence_2023": 40,
      "historically_excluded": true,
      "note": "Arkansas has among the highest adult obesity rates in the country, yet several compounded-GLP-1 providers have historically excluded it from shipping because of state telehealth and pharmacy requirements."
    },
    {
      "name": "California",
      "abbr": "CA",
      "region": "West",
      "obesity_prevalence_2023": 28,
      "historically_excluded": false,
      "note": "California requires nonresident pharmacies to be licensed by the California State Board of Pharmacy and has its own rules for sterile compounding shipped into the state."
    },
    {
      "name": "Colorado",
      "abbr": "CO",
      "region": "West",
      "obesity_prevalence_2023": 25,
      "historically_excluded": false,
      "note": "Colorado has the lowest adult obesity prevalence of any state in recent CDC estimates."
    },
    {
      "name": "Connecticut",
      "abbr": "CT",
      "region": "Northeast",
      "obesity_prevalence_2023": 30,
      "historically_excluded": false,
      "note": "Connecticut telehealth law permits audio-video and, for established relationships, asynchronous care for non-controlled prescriptions."
    },
    {
      "name": "Delaware",
      "abbr": "DE",
      "region": "South",
      "obesity_prevalence_2023": 35,
      "historically_excluded": false,
      "note": "Delaware requires out-of-state pharmacies to register with the Delaware Board of Pharmacy before shipping to residents."
    },
    {
      "name": "District of Columbia",
      "abbr": "DC",
      "region": "South",
      "obesity_prevalence_2023": 24,
      "historically_excluded": false,
      "note": "The District has one of the lowest adult obesity rates in CDC estimates and broad telehealth access."
    },
    {
      "name": "Florida",
      "abbr": "FL",
      "region": "South",
      "obesity_prevalence_2023": 31,
      "historically_excluded": false,
      "note": "Florida allows out-of-state clinicians to treat Florida patients by telehealth through a state telehealth-provider registration, which is why many national telehealth companies serve Florida."
    },
    {
      "name": "Georgia",
      "abbr": "GA",
      "region": "South",
      "obesity_prevalence_2023": 35,
      "historically_excluded": false,
      "note": "Georgia requires nonresident pharmacies to be registered with the Georgia Board of Pharmacy."
    },
    {
      "name": "Hawaii",
      "abbr": "HI",
      "region": "West",
      "obesity_prevalence_2023": 26,
      "historically_excluded": false,
      "note": "Hawaii has one of the lowest adult obesity rates in the country; shipping temperature-sensitive medication requires overnight cold-chain service."
    },
    {
      "name": "Idaho",
      "abbr": "ID",
      "region": "West",
      "obesity_prevalence_2023": 33,
      "historically_excluded": false,
      "note": "Idaho has some of the most permissive telehealth and pharmacy rules in the country."
    },
    {
      "name": "Illinois",
      "abbr": "IL",
      "region": "Midwest",
      "obesity_prevalence_2023": 35,
      "historically_excluded": false,
      "note": "Illinois requires nonresident pharmacies to be licensed by the Illinois Department of Financial and Professional Regulation."
    },
    {
      "name": "Indiana",
      "abbr": "IN",
      "region": "Midwest",
      "obesity_prevalence_2023": 37,
      "historically_excluded": false,
      "note": "Indiana permits telehealth prescribing of non-controlled medications after a telehealth evaluation."
    },
    {
      "name": "Iowa",
      "abbr": "IA",
      "region": "Midwest",
      "obesity_prevalence_2023": 37,
      "historically_excluded": false,
      "note": "Iowa requires nonresident pharmacies to hold an Iowa nonresident pharmacy license."
    },
    {
      "name": "Kansas",
      "abbr": "KS",
      "region": "Midwest",
      "obesity_prevalence_2023": 36,
      "historically_excluded": false,
      "note": "Kansas permits telehealth prescribing of non-controlled medications when the standard of care is met."
    },
    {
      "name": "Kentucky",
      "abbr": "KY",
      "region": "South",
      "obesity_prevalence_2023": 38,
      "historically_excluded": false,
      "note": "Kentucky requires nonresident pharmacies to obtain a Kentucky permit."
    },
    {
      "name": "Louisiana",
      "abbr": "LA",
      "region": "South",
      "obesity_prevalence_2023": 40,
      "historically_excluded": true,
      "note": "Louisiana has among the highest adult obesity rates in the country and stricter nonresident-pharmacy rules; some compounded-GLP-1 providers have historically excluded it."
    },
    {
      "name": "Maine",
      "abbr": "ME",
      "region": "Northeast",
      "obesity_prevalence_2023": 33,
      "historically_excluded": false,
      "note": "Maine requires mail-order pharmacies to be licensed with the Maine Board of Pharmacy."
    },
    {
      "name": "Maryland",
      "abbr": "MD",
      "region": "South",
      "obesity_prevalence_2023": 33,
      "historically_excluded": false,
      "note": "Maryland requires nonresident pharmacies to hold a Maryland permit."
    },
    {
      "name": "Massachusetts",
      "abbr": "MA",
      "region": "Northeast",
      "obesity_prevalence_2023": 27,
      "historically_excluded": false,
      "note": "Massachusetts has one of the lowest adult obesity rates in the country."
    },
    {
      "name": "Michigan",
      "abbr": "MI",
      "region": "Midwest",
      "obesity_prevalence_2023": 35,
      "historically_excluded": false,
      "note": "Michigan requires nonresident pharmacies to be licensed with the state."
    },
    {
      "name": "Minnesota",
      "abbr": "MN",
      "region": "Midwest",
      "obesity_prevalence_2023": 33,
      "historically_excluded": false,
      "note": "Minnesota requires nonresident pharmacies to register with the Minnesota Board of Pharmacy."
    },
    {
      "name": "Mississippi",
      "abbr": "MS",
      "region": "South",
      "obesity_prevalence_2023": 40,
      "historically_excluded": true,
      "note": "Mississippi has among the highest adult obesity rates in the country, and several compounded-GLP-1 telehealth companies have historically listed it as a state they do not serve."
    },
    {
      "name": "Missouri",
      "abbr": "MO",
      "region": "Midwest",
      "obesity_prevalence_2023": 36,
      "historically_excluded": false,
      "note": "Missouri permits telehealth prescribing of non-controlled medications when a clinician-patient relationship is established."
    },
    {
      "name": "Montana",
      "abbr": "MT",
      "region": "West",
      "obesity_prevalence_2023": 31,
      "historically_excluded": false,
      "note": "Montana requires out-of-state mail-service pharmacies to be licensed."
    },
    {
      "name": "Nebraska",
      "abbr": "NE",
      "region": "Midwest",
      "obesity_prevalence_2023": 36,
      "historically_excluded": false,
      "note": "Nebraska requires nonresident pharmacies to obtain a Nebraska license."
    },
    {
      "name": "Nevada",
      "abbr": "NV",
      "region": "West",
      "obesity_prevalence_2023": 32,
      "historically_excluded": false,
      "note": "Nevada requires nonresident pharmacies to be licensed with the Nevada State Board of Pharmacy."
    },
    {
      "name": "New Hampshire",
      "abbr": "NH",
      "region": "Northeast",
      "obesity_prevalence_2023": 31,
      "historically_excluded": false,
      "note": "New Hampshire permits telehealth prescribing of non-controlled medications."
    },
    {
      "name": "New Jersey",
      "abbr": "NJ",
      "region": "Northeast",
      "obesity_prevalence_2023": 29,
      "historically_excluded": false,
      "note": "New Jersey requires nonresident pharmacies to register with the state Board of Pharmacy."
    },
    {
      "name": "New Mexico",
      "abbr": "NM",
      "region": "West",
      "obesity_prevalence_2023": 33,
      "historically_excluded": false,
      "note": "New Mexico requires nonresident pharmacies to be licensed."
    },
    {
      "name": "New York",
      "abbr": "NY",
      "region": "Northeast",
      "obesity_prevalence_2023": 30,
      "historically_excluded": false,
      "note": "New York requires nonresident pharmacies to register with the state and has specific rules for compounded sterile products shipped into the state."
    },
    {
      "name": "North Carolina",
      "abbr": "NC",
      "region": "South",
      "obesity_prevalence_2023": 35,
      "historically_excluded": true,
      "note": "Several compounded-GLP-1 providers have historically excluded North Carolina, in part because of the state's rules on out-of-state compounding pharmacies."
    },
    {
      "name": "North Dakota",
      "abbr": "ND",
      "region": "Midwest",
      "obesity_prevalence_2023": 36,
      "historically_excluded": false,
      "note": "North Dakota requires nonresident pharmacies to hold a state license."
    },
    {
      "name": "Ohio",
      "abbr": "OH",
      "region": "Midwest",
      "obesity_prevalence_2023": 38,
      "historically_excluded": false,
      "note": "Ohio's telehealth statute permits prescribing of non-controlled medications through telehealth, including asynchronous evaluation when appropriate."
    },
    {
      "name": "Oklahoma",
      "abbr": "OK",
      "region": "South",
      "obesity_prevalence_2023": 40,
      "historically_excluded": false,
      "note": "Oklahoma has among the highest adult obesity rates in the country."
    },
    {
      "name": "Oregon",
      "abbr": "OR",
      "region": "West",
      "obesity_prevalence_2023": 33,
      "historically_excluded": false,
      "note": "Oregon requires nonresident pharmacies to register with the Oregon Board of Pharmacy."
    },
    {
      "name": "Pennsylvania",
      "abbr": "PA",
      "region": "Northeast",
      "obesity_prevalence_2023": 34,
      "historically_excluded": false,
      "note": "Pennsylvania requires nonresident pharmacies to register with the state board."
    },
    {
      "name": "Rhode Island",
      "abbr": "RI",
      "region": "Northeast",
      "obesity_prevalence_2023": 32,
      "historically_excluded": false,
      "note": "Rhode Island requires nonresident pharmacies to be licensed."
    },
    {
      "name": "South Carolina",
      "abbr": "SC",
      "region": "South",
      "obesity_prevalence_2023": 35,
      "historically_excluded": true,
      "note": "Several compounded-GLP-1 providers have historically excluded South Carolina from shipping because of state pharmacy requirements."
    },
    {
      "name": "South Dakota",
      "abbr": "SD",
      "region": "Midwest",
      "obesity_prevalence_2023": 37,
      "historically_excluded": false,
      "note": "South Dakota requires nonresident pharmacies to hold a state license."
    },
    {
      "name": "Tennessee",
      "abbr": "TN",
      "region": "South",
      "obesity_prevalence_2023": 38,
      "historically_excluded": false,
      "note": "Tennessee requires nonresident pharmacies to register with the Tennessee Board of Pharmacy."
    },
    {
      "name": "Texas",
      "abbr": "TX",
      "region": "South",
      "obesity_prevalence_2023": 35,
      "historically_excluded": false,
      "note": "Texas requires nonresident pharmacies to be licensed by the Texas State Board of Pharmacy, and the Texas Medical Board sets telemedicine standards for establishing a clinician-patient relationship."
    },
    {
      "name": "Utah",
      "abbr": "UT",
      "region": "West",
      "obesity_prevalence_2023": 32,
      "historically_excluded": false,
      "note": "Utah has permissive telehealth rules and requires nonresident pharmacies to be licensed."
    },
    {
      "name": "Vermont",
      "abbr": "VT",
      "region": "Northeast",
      "obesity_prevalence_2023": 29,
      "historically_excluded": false,
      "note": "Vermont has one of the lower adult obesity rates in the country."
    },
    {
      "name": "Virginia",
      "abbr": "VA",
      "region": "South",
      "obesity_prevalence_2023": 35,
      "historically_excluded": false,
      "note": "Virginia requires nonresident pharmacies to register with the Virginia Board of Pharmacy."
    },
    {
      "name": "Washington",
      "abbr": "WA",
      "region": "West",
      "obesity_prevalence_2023": 30,
      "historically_excluded": false,
      "note": "Washington requires nonresident pharmacies to be licensed by the Pharmacy Quality Assurance Commission."
    },
    {
      "name": "West Virginia",
      "abbr": "WV",
      "region": "South",
      "obesity_prevalence_2023": 41,
      "historically_excluded": false,
      "note": "West Virginia has the highest adult obesity prevalence of any state in recent CDC estimates."
    },
    {
      "name": "Wisconsin",
      "abbr": "WI",
      "region": "Midwest",
      "obesity_prevalence_2023": 36,
      "historically_excluded": false,
      "note": "Wisconsin requires out-of-state pharmacies to be licensed with the Pharmacy Examining Board."
    },
    {
      "name": "Wyoming",
      "abbr": "WY",
      "region": "West",
      "obesity_prevalence_2023": 34,
      "historically_excluded": false,
      "note": "Wyoming requires nonresident pharmacies to be licensed and has limited in-state obesity-medicine capacity, which increases reliance on telehealth."
    }
  ]
}