Meta’s War on Wellness and the Backlash Hitting Hims

Brought to you by:

This week, we’re stepping back from the noise and focusing on three pressure points where growth ambition collides with operational risk.

Today:

• Macro: Hims vs Novo - The GLP-1 gold rush and the backlash hitting Hims

• Trends: Charting threats to Meta performance (and how to defend against them)

• Tactics: A new wave of Meta ad tools and what’s actually working inside real ad accounts

• Quick Hits: Find a simple hack that will help your email flows print money.

Let’s get into it.

🧭 Macro: Hims vs. Novo — A GLP-1 War of Access, Power, and Perception

This week, a public power struggle broke out between one of the fastest-growing consumer health platforms (Hims) and one of the most valuable pharmaceutical companies in the world (Novo Nordisk).

Novo Nordisk abruptly ended its partnership with Hims just two months after announcing it. The deal was meant to make Wegovy (the blockbuster FDA-approved GLP-1 weight loss drug) available to Hims users at a discount via Novo’s official pharmacy channel.

But behind the scenes, Novo wanted more control. And Hims wouldn’t budge.

What happened:

• Novo accused Hims of continuing to sell compounded semaglutide (personalized, low-cost versions of Wegovy) after the FDA declared shortages resolved.

• They called it an "illegal sham," alleging unsafe ingredients from foreign suppliers and marketing that misled patients (Novo’s press release via ABC News).

• Hims hit back hard. CEO Andrew Dudum accused Novo of trying to pressure Hims into funneling patients exclusively toward branded Wegovy, regardless of clinical appropriateness. He called the move anticompetitive and refused to "be strong-armed by any pharmaceutical company" (@AndrewDudum on Twitter).

This is a war over:

• Access vs. Exclusivity: Hims positioned itself as a platform of choice and affordability. Novo wants channel control to protect margins, consistency, and brand safety.

• Regulatory gray zones: Hims argues its compounding practices are legal under Section 503A of the FD&C Act (patient-specific personalization). Novo says the volume and marketing cross the line into prohibited mass manufacturing.

• Narrative control: Both sides are fighting for consumer trust. But Hims took the bigger hit with its stock plummeting 30–35% in a single day, and lawsuits from investor firms are reportedly being prepared.

🧠 Takeaway:

This isn’t just about GLP-1s. It’s about power consolidation in healthcare. Novo wants brand control. Hims wants clinical flexibility. Consumers want affordable access.

Only one of those has regulatory momentum on its side right now. Expect this to get messier before it gets clearer.

📊 Trends: Meta Is Cracking Down on Health & Wellness Brands (Still)

This section is a follow-up to our earlier dive into this issue, “Is Meta Quietly Choking Your Brand?”, which first surfaced the quiet performance drops hitting health and wellness advertisers.

Since then, more brands have been impacted, and more tactics have emerged to deal with it.

If you're running a health or wellness brand on Meta, you’ve likely felt the shift.

Since early 2024, Meta has been quietly rolling out a categorization system that flags domains and data sets connected to health-related content. But over the past few months, it’s become a full-blown dragnet, throttling performance, removing event tracking, and sending CPAs soaring across supplement, beauty, and longevity brands.

And now, more brands are being hit every week.

Just ask Brett Fish (full video breakdown here), who’s been helping dozens of brands navigate Meta’s new classification and data throttling framework.

🔍 What’s Happening…

Meta is now classifying websites under Health & Wellness based on domain-level scans and content associations. Once flagged, two major restrictions kick in:

1. Core Setup Mode: This blocks custom event parameters and URL data (a method used to pass granular insights to Meta).

2. Event Loss: Many flagged accounts are losing lower-funnel event tracking—no add to cart, initiate checkout, or purchases. You're essentially flying blind beyond view content.

There are three tiers of restriction, but even Tier 1 (Core Setup only) has caused major performance drops for many advertisers. Tier 2 involves total loss of standard events in certain regions. Tier 3 (complete data blackout) hasn’t been widely enforced—yet.

🤖 Why It’s Happening: Privacy Risk Management

As Barry Hott explains in this thread, Meta is trying to avoid tracking behavior that could imply a user has a medical condition, like arthritis, anxiety, or PCOS, without explicit consent.

If someone clicks an ad for a product targeting a known condition, lands on a page naming it, and completes a purchase, Meta’s pixel might inadvertently infer private health info, risking compliance with GDPR, HIPAA, and emerging state laws.

Meta’s solution is to Block the whole funnel.

Even if your brand is “wellness adjacent,” the net is wide. Barry points out this includes:

• Longevity supplements

• Sleep, gut, or joint support

• Women’s hormone and menopause brands

• Libido and hair loss solutions

Even if you're not naming diagnoses in ads, Meta scans your entire domain, including organic traffic behavior.

🛠 What Brands Are Doing

Brands hit by restrictions are scrambling to adapt. So far, there are two leading responses:

1. Custom Events: Renaming events (e.g. calling a purchase something generic like "checkout_complete") and passing them via Shopify’s custom pixel or tools like GTM, Elevar, or Blotout.

• ✅ Pros: Easy to implement

• ❌ Cons: Risky (violates Meta's formal policies), may still be blocked if tied to flagged domains

2. Clean Data Set + Server-Side Only: Advanced brands are building new Meta data sets disconnected from flagged domains, using server-side tracking only, and stripping any identifiers that might flag them again.

• ✅ Pros: Restores standard event optimization

• ❌ Cons: Technical lift required, ongoing monitoring needed

🧱 Proactive Measures

Even if you haven’t been hit yet, you should:

• Scrub your website for references to specific medical conditions. As Barry says in this post, if a lawyer could read your site and conclude you’re targeting someone with a medical condition, Meta’s policy team can too.

• Reframe messaging: “Supports gut health” is okay. “Treats IBS” is not.

• Segment pages: Split your site into wellness-safe and condition-specific sections. Firewall high-risk content.

• Set up Domain Security: As Barry notes here, Meta now lets you pre-approve trusted domains. This prevents black hat hijacks and offers added protection against domain spoofing (see screenshot below).

🧠 Takeaway

If you're in wellness, now is the time to:

• Audit your site

• Diversify ad channels

• Invest in clean data pipelines

• Rethink how you speak to symptoms vs conditions

Tactics: Meta’s New Ad Stack—Early Results

Meta’s ad platform is evolving fast. And like every big shift, the changes come wrapped in shiny new promises and confusing performance swings.

Over the past few months, marketers have been testing Meta’s latest tools: Value-Based Optimization, the new Incrementality setting, and expanded tROAS support inside.

Let’s dig into what’s actually delivering results.

⚖️ The Case for tROAS (If You Use It Right)

On a recent episode of the Andrew Faris Podcast, Andrew made a strong argument in favor of tROAS. But only when it’s used intentionally.

The risk is Meta’s algorithm will always chase the highest AOV, which doesn’t always equal the highest contribution margin, especially if high-priced SKUs have worse shipping economics, discounting, or higher return rates.

If you’re using tROAS, Andrew recommends:

• Cleanly separating prospecting from retention.

• Using tools like Triple Whale or Elevar to filter out noise.

• Reviewing incrementality, not just blended ROAS.

📈 Value-Based Optimization (VBO) Is (Mostly) Working

Meta’s internal reps are making a big push for Value-Based Optimization. And in some cases, it’s working.

Kody Nordquist shared test results showing strong performance gains from the switch. Kody reports that 17 of 22 brands using VBO saw ~30% gains in ROAS and scaled spend, especially when using.

Importantly, most teams are still running VBO alongside Max Value/Lowest Cost campaigns.

Takeaway: VBO is worth testing in parallel, but don’t kill your existing campaigns until you have clear side-by-side results.

🧪 Meta’s New Incrementality Setting: Volume, Yes. Margin? Not Yet.

David Parrottino has been testing Meta’s new Incrementality setting, which promises to optimize for truly new customers. The results are mixed:

Pros:

• 100% of purchases in his test were from net new customers (validated with Triple Whale).

• Full delivery of lifetime budget over a 4-day test window.

Cons:

• 20–30% higher CAC vs. manual bid campaigns.

• Lower nROAS.

• Higher CPMs and CPCs using identical creative and messaging.

This tool may be Meta’s replacement for old-school, lowest-cost prospecting. And like early ASC, it currently lacks bid controls.

Incremental bidding is still new, so expect this functionality to evolve over time.

🎯 Ad Set Bias and Creative “Hot Pockets”

Jacob (@jforjacob) recently shared a cautionary tale: he mistakenly uploaded the same creative variant into a CBO ad set six times.

The strange thing is that the results weren't the same. In fact, they were completely different.

• One variant got strong early signals, won spend, and scaled profitably.

• The others flopped, or didn’t get enough delivery to prove anything.

All six variants were identical. The difference was timing and early feedback loops.

This echoes what many operators have suspected: Meta heavily favors early signal velocity and may sideline potential winning ads simply because they didn’t catch fire fast enough.

Fixes:

• Use minimum spend floors inside CBO to force fair delivery.

• Rotate winners back in deliberately.

• Don’t trust early signals blindly.

🧠 Takeaways

Meta’s ad stack is getting more sophisticated—but also more unpredictable. Here’s the cheat sheet:

• Use tROAS intentionally. Separate prospecting, clean your data, and track margin, not just AOV.

• Test VBO + ASC+ Max Value / tROAS side-by-side. Many are seeing stronger ROAS and scale.

• Use Incrementality mode sparingly. High new customer purity, but pricey.

• Watch out for ad set bias. Enforce floors and test systematically.

Quick Hits

• Shopify affiliate platform Social Snowball gets acquired for $35M by DotDigital.

• Want to up your close rate in email flows? Add a Calendly link at the bottom labeled “free 15-minute customer consultation.”

• Send this simple ad format to your creative strategist.

• Check out Anthropic’s massive new prompt bible.