More than two in five American adults are obese. Annually, 300,000 people die from the illness and hundreds of thousands more from related conditions. Given this huge burden, why do insurers continue to dismiss the seriousness of obesity?
Reluctance to Cover Medications
In the past, reluctance to allow the use of weight loss medications may have stemmed from concerns about potentially serious side effects. There were also few FDA approved medications. But with safe and effective options like semaglutide now available, and more medications in the pipeline, there’s no reason people who need help losing excess pounds should continue to suffer. Yet that is what’s happening to many patients.
Despite acknowledgement of obesity as a serious chronic disease, most insurers remain unwilling to cover new weight loss medications. This is the case even for patients who are morbidly obese. Without coverage, patients’ only option is to pay out of pocket for the medication. It’s an untenable financial barrier that most people can’t overcome.
It’s easy to tell people with obesity to “eat better” or “get more exercise.” But depending on where one lives, following that advice can be challenging. Fresh produce, for example, can be hard to get in a food desert. And a busy neighborhood without sidewalks or safe parks to recreate can deter people from being physically active.
Even for people who live in an ideal environment, lifestyle changes may not be enough to achieve significant weight loss and keep obesity-related conditions at bay. The disease is linked with increased risk of heart disease, stroke, type 2 diabetes, sleep apnea and high blood pressure. People with obesity also face tremendous stigma.
The High Price of Obesity
The cost of obesity is staggering. Medical expenses for obese patients are twice as much as those for people in lower weight categories.
Addressing the obesity epidemic will require more than a “diet and exercise” mentality. FDA approved medications can play an important role. Insurers shouldn’t withhold those tools from patients who are trying to achieve a healthier weight. Rather, it would be wise of them to cover the medication – just like those for other serious conditions – when a doctor deems it’s necessary.