Today, more than 40% of adults over 60 are considered obese, fueling chronic disease and straining Medicare’s budget. With the price tag for obesity-related care rising, some experts suggest covering GLP-1 medications for weight loss through Medicare could save billions, citing data that estimates Medicare spending could drop by $1,262 to $5,442 annually per beneficiary for a weight loss of 5% percent or 25%, respectively.  

Despite the hype, there’s no single magic pill for our national obesity crisis — or bending the obesity cost curve. So far, the benefits associated with consistent GLP-1 use in curbing medical spending lack sufficient data-backed evidence. The majority of studies about the effect of weight loss on health care spending come not from GLP-1 literature, but rather bariatric surgery research. These studies are largely observational and show mixed or modest results. Other research via a microsimulation found GLP-1s were more effective than lifestyle modifications in achieving weight loss, but did not find sufficient evidence to confirm them to be cost-effective.

For GLP-1 users, weight loss would need to lower their medical costs upwards of $10,000 annually for a payer to break even on drug spending. Drug price aside, the weight loss benefits of GLP-1s may not be realized due to documented adherence issues. The hefty price tag and inconsistent medication adherence may explain why the Centers for Medicare & Medicaid Services (CMS) opted not to cover GLP-1s for weight loss in prescription drug plans in its final rule.