Future of weight loss

More than 40% of Americans are now classified as obese while 75% of adults are either overweight or obese. A new group of drugs called GLP-1 receptor agonists have come on the scene to help in the battle to lose weight. Are they as good as we think?

You may have heard about them or some of their brand names like Zepbound, Wegovy, and Ozempic. The use of these drugs has exploded in popularity to the point where companies like Lilly and Novo Nordisk have had problems keeping up with demand. There is nothing magical about the science behind these drugs. GLP-1 mimics a protein naturally produced by our small intestines. The receptors for these medicines are located across the body. They help us lose weight because receptors in the gastrointestinal tract slow down and send signals to the brain that give us a sense of feeling full.

There are some side effects but nothing too serious for most patients. We are still learning how these medications impact the body. They are currently approved for treating diabetes, obesity, and those with a history of cardiovascular disease in people who are overweight. There are a few drawbacks to these drugs at present.

Typically, GLP-1 agonists are administered as injections in the abdomen, upper arms, outer thighs, or upper buttocks via a syringe and needle or a pre-filled dosing pen. The shots are generally taken once a day or once a week.

For many, this is a big turn-off. Fortunately, you will be able to take tablets soon. The typical weight loss is from 5-15% of body weight over at least 12 months. But GLP-1 is no quick fix. Like exercise, you must stick with it. If you stop taking it, most people regain the weight they lost. And you can’t expect to magically lose weight while you continue to eat all that junk food you get.

The second drawback is the expense. These medications’ list price is around $1,000 a month to $1,400 a month. Without insurance, we are talking $12,000 plus per year for these drugs. Many insurance plans cover some portion of GLP-1 costs, but the extent of coverage can vary significantly. You probably are wondering whether Medicare covers GLP-1 medications. They do for certain medically accepted indications such as heart attack or cardiovascular disease but not for weight management. To qualify, you must have a BMI of 30 or higher, or 27 or higher with comorbidities like high blood pressure, high cholesterol, or type 2 diabetes. They are currently covered through Part D plans.

An entirely new team of individuals, including a retired congressman, a surgeon, and a talk-show host could play pivotal roles in how the government goes about safeguarding America’s health.

Coinsurance amounts are pegged to the list price of drugs. As such, Medicare beneficiaries who qualify could still face monthly costs of $250 to $430 before they reach the annual out-of-pocket drug spending established by the Inflation Reduction Act (IRA). The IRA cap for out-of-pocket expenses were around $3,300 in 2024 and will be $2,000 in 2025. Most retirees living on modest incomes would still find the cost of GLP-1 prohibitive.

In November 2024, the Biden Administration proposed that Medicare and Medicaid cover obesity medications. In doing so, they sidestepped a twenty-year-old piece of legislation that prevented Medicare from covering drugs for ‘weight loss.’ The new proposal specifies that the drugs would be covered to treat the disease of obesity and prevent related conditions. Those conditions are serious and include diabetes, high blood pressure, cardiovascular disease, sleep apnea, fatty liver disease, and arthritis.

The classification would also mean that every state Medicaid program would be required to cover the drugs starting in 2026. Between the two programs, an additional 7.4 million Americans would gain coverage. The price tag would be high, at least $36 billion over a decade. However, there are more obesity drugs in the pipeline and prices should fall as competition heats up. Starting in 2025, Medicare will also be able to negotiate a lower price for Wegovy as well as many other popular drugs.

As for the future, the costs and usage of GLP-1 medications could change significantly under the second Trump Administration. An entirely new team of individuals, including a retired congressman, a surgeon, and a talk-show host could play pivotal roles in how the government goes about safeguarding America’s health.

Under Robert F. Kennedy, an environmental lawyer, politician, and anti-vaccine organizer, we can expect radically different views and actions in health care, medicine, food safety, and science research. Early indications are that Kennedy, who would run the Department of Health and Human Services, is not a big fan of Ozempic. He does not believe that using popular GLP-1 drugs is ever going to make America healthy again. His remedy would be to provide good food to Americans. He believes that providing three nutritious meals a day to all Americans would solve obesity and diabetes overnight. The problem is that for many Americans the admonition to change your diet, eat less, and exercise more has failed to dent the problem. Why not give the country an avenue that shows a much better chance of success over the long term?



Bill Schmick is a founding partner of Onota Partners, Inc., in the Berkshires.

The views expressed here are not necessarily those of The Lakeville Journal and The Journal does not support or oppose candidates for public office.

Latest News

Jacob assumes leadership role at William Pitt Sotheby’s Litchfield Hills offices

Eddie Jacob was recently promoted to Assistant Brokerage Manager for four Litchfield Hills offices of William Pitt Sotheby’s International Realty.

Photo provided

William Pitt Sotheby’s International Realty has appointed Eddie Jacob as Assistant Brokerage Manager for its four Litchfield Hills offices, the company announced on Nov. 19.

In his new role, Jacob will support agents and help oversee operations in the firm’s Kent, Litchfield, Salisbury and Washington Depot brokerages.

Keep ReadingShow less
Winter sports season approaches at HVRHS

Mohawk Mountain was making snow the first week of December. The slopes host practices and meets for the HVRHS ski team.

By Riley Klein

FALLS VILLAGE — After concluding a successful autumn of athletics, Housatonic Valley Regional High School is set to field teams in five sports this winter.

Basketball

Keep ReadingShow less
Bears headline DEEP forum in Sharon; attendees call for coexistence, not hunting

A mother bear and her cubs move through a backyard in northwest Connecticut, where residents told DEEP that bear litters are now appearing more frequently.

By James H. Clark

SHARON — About 40 people filled the Sharon Audubon Center on Wednesday, Dec. 3, to discuss black bears — and most attendees made clear that they welcome the animals’ presence. Even as they traded practical advice on how to keep bears out of garages, porches and trash cans, residents repeatedly emphasized that they want the bears to stay and that the real problem lies with people, not wildlife.

The Connecticut Department of Energy and Environmental Protection (DEEP) convened the meeting as the first in a series of regional Bear Management Listening Sessions, held at a time when Connecticut is increasingly divided over whether the state should authorize a limited bear hunt. Anticipating the potential for heated exchanges, DEEP opened the evening with strict ground rules designed to prevent confrontations: speakers were limited to three minutes, directed to address only the panel of DEEP officials, and warned that interruptions or personal attacks would not be tolerated.

Keep ReadingShow less
Kent unveils two new 'smart bins' to boost composting efforts

Rick Osborne, manager of the Kent Transfer Station, deposits the first bag of food scraps into a new organics “smart bin.” HRRA Executive Director Jennifer Heaton-Jones stands at right, with Transfer Station staff member Rob Hayes at left.

By Ruth Epstein

KENT — Residents now have access to around-the-clock food-scrap composting thanks to two newly installed organics “smart bins,” unveiled during a ribbon-cutting ceremony Monday morning, Dec. 1.

Rick Osborne, manager of the Kent Transfer Station, placed the first bag of food scraps into the smart bin located at 3 Railroad St. A second bin has been installed outside the Transfer Station gate, allowing 24/7 public access even when the facility is closed.

Keep ReadingShow less