The treatment landscape for obesity is evolving rapidly. While lifestyle modifications and surgery have long been the primary options, a new class of medications called GLP-1 drugs has emerged as a promising tool for weight management. Initially developed to treat and control type 2 diabetes, these therapies have since gained widespread attention for their success in promoting weight loss.

Between 2019 and 2024, prescriptions for GLP-1 medications among overweight and obese adults have increased dramatically, reflecting a growing acceptance of pharmaceutical options in obesity care. However, this surge also raises important questions about access, cost, and long-term patient support.

Understanding GLP-1 Drugs and Their Mechanism

GLP-1 agonists mimic a natural hormone involved in regulating blood sugar and appetite. By activating GLP-1 receptors, these agonists help reduce hunger and slow gastric emptying, leading to decreased food intake and weight loss. While initially approved to manage blood glucose levels in diabetes, GLP-1 agonists have demonstrated substantial benefits for weight reduction, leading to FDA approvals specifically for obesity treatment.

Currently, three GLP-1 drugs are approved for weight management in the United States:

• Saxenda (Novo Nordisk), approved in 2014, was the first GLP-1 drug for obesity.
  
• Wegovy (Novo Nordisk), approved in 2021, offers improved efficacy over Saxenda.
  
• Zepbound (Eli Lilly), recently approved, adds to the expanding options available.
  

These approvals have driven a surge in prescriptions and interest among patients and healthcare providers alike.

Dramatic Growth in Prescriptions

From 2019 to 2024, the proportion of GLP-1 prescriptions among overweight and obese adults increased from 0.19% to 1.33%, representing a 587.8% growth. During the same period, prescriptions for patients without type 2 diabetes rose from 3.7% to 16.5%.

Despite this growth, a large majority of individuals with obesity remain untreated with GLP-1 medications, bariatric surgery, or behavioral health interventions. Over 80% of adults with overweight or obesity did not receive any such treatment in 2024, underscoring significant unmet needs and a substantial market opportunity for drug manufacturers.

Cost and Coverage Challenges

One of the biggest challenges to the broader use of GLP-1 weight loss treatments is their high cost. With monthly prices often exceeding $1,000, these therapies pose a financial burden. In 2024, only 18% of large employer health plans covered GLP-1 therapies, often with added requirements like counseling or lifestyle programs.

In response, pharmaceutical companies have pursued partnerships with insurers and pharmacy benefit managers to reduce patient out-of-pocket expenses and improve access. Recently, Novo Nordisk and Eli Lilly have collaborated with major insurers to offer discounts and copay caps, making these drugs more affordable for eligible patients.

Supply Constraints and Market Competition

Rapid demand growth led to supply shortages in 2023 and early 2024, prompting some telehealth providers to source compounded alternatives from pharmacies. These alternatives, while addressing immediate needs, raised regulatory and safety concerns due to less oversight.

Currently, supply issues have eased, and pharmaceutical companies have regained exclusive market control. Nevertheless, the earlier shortages and competition affected manufacturers’ profits and triggered leadership changes, particularly at Novo Nordisk.

Impact on Other Obesity Treatments and Mental Health

The rise in GLP-1 prescriptions coincides with a decline in bariatric surgeries, suggesting that many patients are choosing medication over invasive procedures. However, there is concern about a simultaneous decrease in behavioral health services among these patients. Studies indicate that individuals on GLP-1 drugs may face increased risks of depression, anxiety, and suicidal ideation, emphasizing the need for integrated mental health support during treatment.

Looking Ahead: Balancing Access, Cost, and Care

GLP-1 medications have opened a new frontier in obesity treatment, bringing hope to many who struggle with weight management. Yet, high costs, limited coverage by insurers, and the importance of comprehensive care, such as mental health resources, pose continuing challenges.

The path ahead for obesity treatment will likely involve a combination of pharmacological solutions, lifestyle, and behavioral interventions to maximize effectiveness. As obesity prevalence grows, broadening access to GLP-1 options alongside holistic care approaches will be key to effectively addressing this public health issue.

If you’re considering GLP-1 drugs for weight loss, speak with your healthcare provider concerning your options and insurance coverage. You can also visit our Weight Loss Medications Page to explore available treatments.

Frequently Asked Questions (FAQs)

What are GLP-1 medications, and how do they help with weight loss? 

GLP-1s mimic a hormone involved in regulating appetite and blood sugar. They help reduce hunger and slow digestion, leading to lower calorie intake and weight loss. Originally developed for type 2 diabetes, some GLP-1 therapies are now FDA-approved specifically for obesity treatment.

Does insurance cover GLP-1 treatments?

Coverage varies widely. Many employer-sponsored insurance plans do not cover GLP-1 therapies for weight loss due to their high cost. However, some insurers have begun offering discounts or copay caps through partnerships with manufacturers. It’s best to check with your insurance provider to understand your coverage options.

Are there any side effects or risks associated with GLP-1 treatments?

Common side effects are nausea, vomiting, and digestive discomfort. Some patients may experience mood changes, including anxiety and depression. Because of these risks, it is important to have regular medical supervision and mental health support while using these medications.