With instances of obesity and type 2 diabetes climbing significantly in the last decade, it's no wonder clinicians are turning to Glucagon-like peptide-1(GLP-1) receptor agonists more often as part of a viable solution to this growing epidemic.
Data from a 2022 study by the CDC (Centers for Disease Control) indicates that there are 22 U.S. states with adult obesity prevalence equal to or greater than 35%, up from 19 states in 2021 and up from 0 states just ten years ago when there were no U.S. states reporting a prevalence in adult obesity over 35%.1 Additionally, the CDC's National Diabetes Statistics Report for 2022 found that approximately 37.3 million people in the U.S. have diabetes,2 with approximately 90-95% of them having type 2 diabetes.3
As demand for GLP-1s continues to grow quickly, the cost of obtaining these and related medications is rising at a concerning rate. Employers find themselves wrestling with the question of whether it's feasible to cover these medications for employees in a cost-effective manner that's good for their bottom line and their employees' health.
When making such a crucial decision for your organization, it's essential to understand the facts about these medications vs. the many myths circulating online and through word of mouth. Let's separate some common misconceptions about GLP-1s from the truth. We'll get real about how they're being used to treat obesity, what's really driving demand and causing shortages, and their safety and effectiveness for people at various stages of their weight health journey.
Myths vs Facts About GLP-1s
Here are some common myths you may have read or heard regarding GLP-1s. It's time to set the record straight.
Myth #1:
GLP-1s are a new class of drugs.
The Facts: GLP-1s have been FDA-approved for treating type 2 diabetes for more than 15 years. Why are they being talked about by so many as if they were a new class of drugs? The initial formula required twice daily injections, which was a tough sell to patients. Today, GLP-1 medications are available as a daily pill, daily injection, or a once-a-week injection, making adherence more manageable.
Myth #2:
Ozempic is prescribed (and FDA-approved) for weight loss.
The Facts: Ozempic is FDA-approved for treating type 2 diabetes. The maximum weekly dose is 2mg subcutaneously. Patients may get a prescription for Ozempic as an "off-label" use for obesity.
Wegovy, on the other hand, is FDA-approved for obesity, with a maximum dose of 2.4mg per week. It takes four months to titrate Wegovy to this dose.
Both brands contain the same drug, semaglutide, in different doses, leading to confusion between the medications.
Myth #3:
Due to shortages, people living with type 2 diabetes may not have access to semaglutide because providers are prescribing it for weight loss.
The Facts: Although there are shortages of semaglutide, the most common ones are in the more potent strengths, which are more commonly used to treat obesity. Shortages in the 0.25mg, 0.5mg, or 1mg pens which are typically prescribed for diabetes are less common than those in higher doses.
Myth #4:
People are going to use a GLP-1 to lose 5-15 pounds and "get into their skinny jeans."
The Facts: GLP-1s are not "vanity drugs." According to the FDA labeling, patients must either have a BMI > 27 with medical comorbidities like type 2 diabetes or a BMI >30 to use GLP-1s for the treatment of obesity.
Myth #5:
"Natural semaglutide" offered by some medical spas is a safe and cost-effective way to treat obesity.
The Facts: These "homeopathic" drugs or compounded medications are not subject to FDA regulation; therefore, the safety and efficacy of these methods cannot be determined.
Myth #6:
Pharmacy trends of 2-3x GLP-1 utilization are being driven by people trying to lose weight who "just don't want to" improve their diet and exercise habits.
The Facts: The largest driver of GLP-1 utilization is treating those with type 2 diabetes. The increase in cases of type 2 diabetes, closely associated with obesity, has drastically increased since the pandemic. The guidelines informing the treatment algorithm for type 2 diabetes have also changed: you no longer need a behavior change program plus metformin before starting a GLP-1 medication. Now, GLP-1s can be started at diagnosis to improve glycemic control and outcomes. Therefore, increased utilization can be primarily attributed to a rise in the need for the drug vs. the assumption that people are choosing the drug instead of making long-term lifestyle changes.
Plus, the drug itself doesn't melt away fat; it works by targeting appetite centers in the brain and slowing gastric emptying, decreasing the sense of hunger and helping you feel fuller for longer. This is why pairing the drug with a behavior change program is essential to long-term success. As both classes of medications currently used to treat type 2 diabetes – GLP-1s and sodium-glucose cotransporter-2 inhibitors (SGLT-2s) – gain more primary indications and continue to have the current safety profile, utilization will continue to be on a "hockey stick" trajectory, matching the increase in diagnosed cases of type 2 diabetes.
Myth #7:
If you have bariatric surgery, you will not need to take medications to maintain weight loss.
The Facts: Maintaining optimal weight health after bariatric surgery requires the same multidisciplinary approach built on a foundation of behavioral change. To achieve long-term success, some patients who have had bariatric surgery will not need medications but others may need anti-obesity medications (AOMs) to treat weight regain.
Myth #8:
AOMs might cause problems similar to the severe cardiac problems associated with people who took Redux or Fen-Phen.
The Facts: The newer classes of AOMs have been prescribed for a long time and have an attractive safety profile. In fact, the GLP-1's have been shown to be cardioprotective.4
Achieving Long-Term Success with GLP-1s
When considering weight health management as part of your employee benefits package, it's important to note that, although GLP-1s are costly, so are catastrophic claims caused by poorly controlled chronic conditions. Additionally, people living with obesity often have more unplanned absences from work, which can, over time, lead to decreased productivity within your organization.
Achieving success with GLP-1s starts with promoting an overall culture of health in the workplace. While you may not see an instant ROI from covering these medications, you can achieve immediate VOI (value on investment) from covering GLP-1s as part of a fully subsidized weight health program, leading to increased leverage for attracting and retaining the best talent.
GLP-1s are Here to Stay
At WeightWatchers, we believe that using GLP-1s safely and appropriately, in combination with long-term lifestyle changes and sufficient guidance, support, and coaching, can lead to a future where optimal weight health is achievable and accessible. We have a best-in-class medical group that serves as a steward of these treatments. We make sure to connect the right patients with the right treatment plan, which may include GLP-1 medications, other anti-obesity medications, or no medications at all. Regardless of your stance on using GLP-1s to treat individuals who have overweight or living with pre-obesity, obesity, and diabetes, these medications are here to stay.
With obesity known to be one of the most common chronic conditions that adversely affect bone and joint health, it is necessary to track the prevalence and progression of obesity and weight-related chronic conditions and to treat them effectively to reduce musculoskeletal claims. Obesity is connected to more than 200 chronic conditions such as type 2 diabetes, heart disease, inflammatory arthritis and even some cancers.5
As demand and prescriptions increase in response to rising cases of diabetes and obesity (and related conditions), today's employers must find an effective and health-focused way to incorporate these medications into their health plans. Knowing the facts about GLP-1s ensures you can make an educated decision about where these medications fit into the future of your organization.
Find out how our full-spectrum weight health platform designed for employers and health plans delivers individualized member pathways based on true clinical need. Learn more today.
