Dysfunctional Healthcare Driving Robust Growth for Med Spas

Seemingly limitless demand for obesity meds, botox, and lip fillers is driving robust growth for med spas in the U.S. The medical spa industry reports expansion from 1,600 locations in 2010 to more than 10,000 in 2023. The revenue for an average spa more than doubled to $1.4 million per spa. In 2023, that added up to a $15 billion industry.

Yes, med spas are enjoying a time of booming growth.

Meeting a Need

We confess. It is quite easy to sneer at this burgeoning business. There is an element of it that seems like exploitation of vulnerable people who can’t find help for their needs in more traditional healthcare settings. Writing for Bloomberg, Amanda Mull puts it this way:

“Think of med spas as the vape shops of the health-care world. Regulatory changes, technological advancements and the normalization of previously taboo personal habits have combined to create demand for products that existing businesses were poorly equipped to meet.”

Weight Management with No Apologies

There are plenty of problems with getting GLP-1 injections from many of these med spas. These are potent medicines and getting prescriptions for them without a real medical evaluation is not wise. On top of that, many of them are selling counterfeit or downright scammy versions of these medicines. Litigation and other legal action related to this is easy to find.

But people have their reasons for ignoring the warnings flashing all around about weight loss in the med spa setting. Implicit bias in a medical setting is one of those reasons. “Sometimes patients need a spanking,” said one physician whose career is in surgical obesity care. Their remark came up in a discussion of how to expand the reach of comprehensive obesity care. The irony was overwhelming but not acknowledged.

It can be tough to reach people after they figure out they might get a rebuke from a healthcare provider. Med spas are more interested in getting money from their customers than giving them a scolding. Validation, not humiliation, is at the heart of their business model.

A Cash Business

The other dominant feature of the med spa business is cash payment. This does not mean they don’t take credit cards. Rather, it means they don’t mess with health insurance. The cost is fully transparent and payment is due when the spa delivers products and services.

We are in an odd place with obesity – the most prevalent chronic disease in the world and the gateway to a host of other chronic conditions. Health insurance is now more of a barrier to obesity care than it is a facilitator of access. This is a key part of what is driving both patients and providers to the medical spa setting. The transactions are simple and straightforward.

But, no, we don’t believe getting weight loss meds from a med spa is a good idea. We do understand, though, how bias, stigma, and the failure of health insurance to help with obesity is driving some people in that direction.

Click here to read and hear more about this trend from Marketplace and here to read more of Mull’s reporting on it.

Botox Injection at the FIBO Wellness Convention, photograph by dronepicr, licensed under CC BY 2.0

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March 10, 2025