The company purchased more than 457,000 meals—at a total price of more than $9 million—to educate prescribers about Wegovy and other similar drugs it sells, known as GLP-1 agonists, according to a July 5 STAT report. 

Popular weight loss and diabetes injectables Wegovy and Ozempic—both Novo Nordisk products—mimic a hormone produced in the intestines after meals, called glucagon-like peptide-1, or GLP-1. The hormone helps regulate appetite and food intake, sending a signal to the brain that allows one to be more satisfied with fewer calories. Some GLP-1 agonists like Wegovy are approved for the treatment of obesity in those who have weight-related health conditions like high blood pressure or cholesterol. Others like Ozempic are only approved for those with type 2 diabetes.

STAT’s report cited data from the Centers for Medicare and Medicaid Services, which is federally mandated to track gifts valued at $10 or more given by drug and medical device companies to doctors, nurse practitioners, and other prescribers.

In a statement, Novo Nordisk told Fortune it “follows the highest ethical standards, as well as all legal and regulatory requirements, in our interactions with the medical community and our customers.” 

“Novo Nordisk believes that responsible interaction and collaboration between industry and the medical community is good for patients and advances care and science,” the company said.

A “meal” may be as small as a cup of coffee or snack. Thus, multiple “meals” may be associated with one interaction, if it includes a drink and food. Meals are typically “modest,” and are usually provided to prescribers at the office, during the workday “as part of an informational presentation or discussion,” the company said. Last year, 94% of meals provided to health care professionals were under $25 in value, it added.

Spurred by use of the drug among celebrities like Elon Musk, demand for Wegovy—which can help overweight patients lose about 15% of their body weight—and similar drugs is surging. Novo Nordisk expects operating profits to rise by nearly 20% this year, propelled in part by sales of the drug, Bloomberg recently reported.

And with nearly three-quarters of American adults obese or overweight, according to the U.S. Food and Drug Administration, the potential market is enormous.

‘It’s really upsetting’

It’s not uncommon for drug reps and prescribers to meet over meals, and marketing to doctors isn’t illegal in and of itself. STAT’s analysis, however, found that nearly 12,000 prescribers received free food from Novo Nordisk more than a dozen times last year. More than 200 prescribers received more than 50 free meals and snacks from the company, and one doctor received 193 free meals—numbers that are equal parts excessive and concerning, some experts contend.

The figures are “outrageous,” Ceci Connolly, the president and CEO of the Alliance of Community Health Plans, tells Fortune. 

“And it’s disheartening that few people seem to be outraged,” she adds. “We’ve become accustomed to big pharma spending absurd amounts of money on marketing and promotions and influence peddling, whether it’s with clinicians or policy-makers.”

The millions Novo Nordisk spent marketing its drugs to prescribers would be better used furthering research about their potential side effects and long-term effectiveness, Connolly says. Research published this spring suggested that GLP-1s could put patients at an elevated risk of a potentially fatal gastrointestinal condition that requires surgery.

“It’s always nice to do business over a lovely meal,” Connolly says. “But the number of dinners and the amount of money spent wining and dining physicians, who tell us they are so terribly busy and burned out, and then you look at the price of this medication— it’s really upsetting.”

Dr. Nisha Patel, an obesity medicine doctor in San Francisco, Calif., who cares for transplant patients, tells Fortune she doesn’t see an issue with prescribers accepting “a meal here and there” from drug companies.

“But if it’s a meal every day or regularly—that’s something you have to think about,” says Patel, who said she’s made it her mission to never accept gifts from pharmaceutical companies. “Is it worth the optics of what it might look like to the outside?”

It’s an especially important question post-COVID, with trust in the health care system seemingly at an all-time low, she adds. “We as physicians and health care providers need to do what we can to restore that trust in science.” Prescribers accepting gifts—even if those gifts don’t influence their clinical decision-making—makes that tough.

How to look up your doctor

Patel encourages patients to look up their providers on the Center for Medicare & Medicaid Services open payment website to see the value, type, and number of gifts they’ve accepted from pharma companies—and which ones.

But not all patients have the skills or internet access to research their providers. In fact, many of the most vulnerable do not, Connolly points out.

People have always considered doctors a “trusted source,” she added. “But if you now find out that your trusted source is spending more time with drug manufacturer reps than with you, that really calls into question the trust factor and the relationship we’ve historically had with clinicians.”