By now, most everyone has heard of the new GLP-1 medications — glucagon-like peptide 1 agonists, known under common brand names like Ozempic and Wegovy. Originally intended to help control diabetes, these drugs have the fortuitous side-effect of inducing often significant amounts of weight loss in patients, leading the FDA to approve Wegovy for chronic weight management in 2021.
Along with an evolving understanding of nutrition science, these drugs have changed the narrative around obesity: Rather than the result of a failure of willpower, many now see the condition as a disease like any other, and a treatable one.
And patients want the meds: According to a 2023 survey by Ro, a leading direct-to-patient healthcare company, and the Obesity Action Coalition (OAC), some 44% of workers would change jobs in order to gain coverage for weight loss medication, while 51% would stay at a job they didn’t like.
As obesity treatments proliferate, costs remain high
According to the Mayo Clinic, GLP-1 medications can lead to about 10 to 15 pounds of weight loss on average — and, in connection with diet and lifestyle changes, even more.
But that effectiveness comes at a cost. Without insurance coverage, a month’s worth of Wegovy, (which must be injected once a week) could cost as much as $1,800 — that’s more than many Americans pay for housing.
Meanwhile, insurers have scaled back their coverage of the drugs, leaving some 69% without coverage for GLP-1 medications to treat obesity — or diabetes, according to obesity care provider Found. (Along with adverse effects and unknown long-term efficacy, some payers may be hesitant to cover a medication that may be required over the long term, or even for a lifetime; one-time procedures, like bariatric surgery, tend to have better coverage rates.)
But for patients struggling with their weight, motivation to seek treatment remains high. There’s a social stigma — 54% of Ro’s survey respondents reported having been teased, treated unfairly or discriminated against due to their weight. Ultimately, though, the people seeking these drugs are concerned for their health: Some 67% say they’re trying to lose weight to live a longer, healthier life.
Navigating the high cost of health care, no matter your weight
Regardless of the number on the scale, many Americans face high costs at the doctor’s office or pharmacy counter. Medical debt remains one of the leading causes of bankruptcy in the United States.
And, of course, being overweight or obese can increase your costs even further. Insurance companies often use BMI — a metric long dismissed by many experts as incomplete and misleading — to determine eligibility and calculate rates.
While many of these factors are out of the individual consumer’s control, the good news is that there are actions you can take to lower your medical costs while still receiving the care you need.
Here are a few of them:
- Take care of yourself. Even without weight loss, a nutritious diet and regular exercise regime can improve your physical and mental health — which may result in your needing less medical attention in the first place. You might also consider quitting smoking or cutting back on your alcohol consumption.
- Save money on medications. Online pharmacies and in-person discount programs can help lower the cost of prescription drugs you need. You can also save money by switching to a generic, if your doctor has prescribed you a brand-name drug that has an equivalent.
- Check out your benefits — and use them. Your health insurance coverage may come with benefits you didn’t know about, like a free wellness check-up or access to fitness programs. These benefits can help you catch lurking health concerns earlier or stay in better shape.
- Choose in-network providers. Even if your health insurance policy covers out-of-network care, chances are it’ll come at a higher price — so choose in-network providers whenever possible.
- If you can, get group health insurance. Group health insurance is the coverage offered, at a discount, by businesses to their workers; because they’re buying so many plans at once, the premiums tend to be lower for policyholders. More than half of Americans already have this kind of health insurance coverage, but if you’re self-employed or your employer doesn’t offer it, you may still be able to access group health insurance through a professional guild, university or other organization.
- If you qualify, consider switching to Medicare. In many cases, Medicare coverage can be cheaper than private health insurance for individual policyholders. However, those who need to add a spouse or child(ren) to their policies may find better rates on the private market.
- Consider an HSA or FSA. Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) can help you save money in a tax-incentivized way to pay for certain qualified medical expenses. FSAs are available to any employee, whether or not they carry health insurance coverage, while HSAs require the account holder to have a High Deductible Health Plan (HDHP).