Obesity rates have continued to rise over the last few decades, with 42% of Americans currently having a BMI over 30 kg/m2. A new class of weight-loss "super drugs," such as Ozempic, Wegovy, or Mounjaro, have shown remarkable benefits — with Mounjaro showing an average of 23% weight loss in clinical trials. At these levels of weight loss, there are great improvements in blood pressure, blood sugar, and overall heart disease and diabetes risk. The new weight loss medications represent an opportunity to prevent and reverse certain chronic conditions including diabetes and heart disease at a population level.
As we're in the early stages of widespread use of these medications, employers offering health plans that cover weight-loss medications are quickly learning that leveraging these medications to manage obesity-related costs isn't easy. That's not only because of their high costs and
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Maximizing the benefits of these medications
From an employee/payor perspective, there are three things that need to be focused on to ensure maximal clinical benefits:
A personally tailored approach to prescribing. A tailored approach optimizes effectiveness, minimizes side effects, addresses comorbidities, considers lifestyle factors, and prioritizes safety. Obesity is a multifaceted condition with diverse underlying causes, and what works for one person may not be as effective for another. Every individual has different physiological characteristics, medical histories, genetic factors, and lifestyle considerations. By considering factors such as an individual's medical history, body composition, metabolism, and lifestyle, health-care providers can select the most suitable medication for optimal weight loss and long-term weight management.
A customized approach to prescribing weight-loss medications critically helps ensure safety by considering contraindications, drug interactions, allergies, and potential risks associated with specific medications. Lifestyle factors, such as dietary habits, exercise routines, work schedules, and personal preferences, can significantly impact the success of weight-loss medication treatment, and a personally tailored approach considers these factors to select medications that are convenient, feasible, and compatible with the individual's lifestyle, increasing adherence and long-term sustainability. Simply put, the new GLP1 medications are a remarkable advancement but may not always be the best medication for every patient. Using the whole formulary of available weight loss medication not only drives better outcomes but also promotes cost containment.
Behavioral change support. Behavioral health programs provide a comprehensive approach to weight loss that goes beyond physical aspects, promoting overall well-being and sustainable lifestyle changes. A strong behavioral health program plays a vital role in weight-loss efforts by helping individuals develop new habits, providing peer support, offering important nutritional instruction, and providing increased insight into mental stress and mindfulness to help address personal psychological factors and prevent weight cycling.
These programs help individuals develop a healthier relationship with food and their bodies by addressing emotional eating, body image concerns, and stress management. It provides cognitive training techniques to foster a positive mindset and introduces stress reduction strategies to help better understand the body's signals. It will also emphasize support, peer engagement, and community involvement. Ongoing education on nutrition and portion control, along with individualized exercise plans, encourages healthy habits and long-term maintenance.
Ongoing data measurement, reporting, and integration. Implementing regular check-ins, progress tracking, and goal setting is important for motivation and accountability. Equally important is the ability to provide integration with the individual's PCP and care team, so there's seamless care coordination, including data to the payer to give them optics into the value of their spend. Weight-loss journeys can be challenging, and individuals may face obstacles, setbacks, or lack of motivation along the way. Monitoring changes in weight, sleep, and eating habits as well as periodically checking glucose, cholesterol, and triglyceride levels with your provider helps provide motivation and accountability.
Integrating a tailored approach, behavioral health support, and ongoing measurement into weight-loss programs provides individuals the necessary support, tools, and strategies to address the psychological aspects of weight loss, which in turn leads to better outcomes, improved overall well-being, and long-term success in achieving and maintaining a healthy weight.
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The exciting promise of weight-loss medications
With more powerful medications in the pipeline, weight-loss medications are the new inescapable reality. Similar to hypertension and cholesterol medications in the past, it will soon be the norm to include weight-loss medications in an employer health plan: Organizations today spend
Organizations that cover weight-loss medications will find that pairing that coverage with the highest quality behavior change support will put them ahead of the curve in achieving positive, long-term clinical outcomes and cost savings.
