Employee Weight Loss Strategies & GLP-1 Medications: Navigating the New Era

By Jessica Somar, CHES, Director of Wellbeing Strategy, Benefit Commerce Group

As a corporate wellness professional with over 15 years of experience, I’ve witnessed firsthand the growing emphasis on weight loss within both individual and corporate settings. Despite best efforts, the obesity rate in the U.S. continues to climb. Currently, 42% of Americans have a BMI of 30 or higher, and the economic impact of obesity exceeds $1.4 trillion annually, according to a recent Milken Institute report.

The advent of GLP-1 medications has ushered in a new era in weight loss strategies. These drugs, approved by the FDA for weight management, have sparked considerable debate among individuals trying to lose weight and employers aiming to balance support for employees with rising healthcare costs.

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I recently attended an enlightening webinar hosted by Garner Health, titled “Navigating the GLP-1 Surge,” presented by CEO Nick Reber and his team. Their insights shed light on the complex landscape of GLP-1 usage, cost implications, and management strategies. Here are some key takeaways:

1. Rising GLP-1 Usage: Nearly 2% of the U.S. population is currently using GLP-1 medications, a figure that could rise to 10% by 2030. These medications are costly, with annual expenses exceeding $10,000 per person.
2. Cost Implications for Employers: The high cost of GLP-1 drugs significantly impacts employer medical expenses. Effective management of these costs while ensuring access to necessary treatments is essential.
3. Efficacy of GLP-1 Drugs: GLP-1 medications are highly effective for individuals with diabetes and cardiovascular conditions. However, their benefits for weight loss in patients without these chronic conditions are limited, leading to high costs for relatively low-risk patients.
4. Wasteful Prescriptions: A small group of physicians contribute to a disproportionate number of “wasteful” prescriptions, resulting in inflated costs. Many patients discontinue treatment prematurely, leading to unnecessary expenses and lost benefits.
5. Management Strategies: Employers should guide patients to high-performing physicians who can effectively prescribe GLP-1 medications, reducing waste and costs. Implementing programs that direct members to these providers can be highly beneficial.
6. Call to Action: Employers should integrate metrics on GLP-1 usage and steer members towards high-performing providers to balance cost management with employee support.

For employers, the decision to cover GLP-1 medications for weight loss presents a complex challenge. While these medications can be highly effective in managing weight and related conditions, their high cost requires careful consideration and strategic planning.

At Benefit Commerce Group, our employee benefits team is dedicated to helping clients navigate these challenges. We believe that supporting employees in achieving a healthy BMI can yield both positive ROI and VOI. Here are some strategic recommendations for employers considering GLP-1 coverage:

• Pre-Authorization Processes: Implement criteria such as a BMI of 30 or higher, or a BMI of 27 with one or more co-morbidities. Consider additional requirements, such as participation in a weight management coaching program.
• Re-Authorization: Require re-authorization every six months for ongoing GLP-1 treatment to ensure continued medical necessity.
• Lifestyle Coaching Programs: Use lifestyle coaching as a gatekeeper to manage costs and ensure that these medications are a suitable option for employees.
• Regular Evaluation: Continuously review and assess the approach to covering weight loss drugs to ensure it remains effective and sustainable.

Beyond covering GLP-1 medications, employers should consider incorporating additional wellness components into their benefits program:

• Education and Awareness
• Access to Wellness Programs
• Flexible Work Arrangements
• Healthy Food Options
• Supportive Environment
• Incentives and Rewards
• Employee Assistance Programs (EAP)
• Leading by Example

As a Certified Health Education Specialist, I emphasize the importance of a holistic and multi-faceted approach to employee wellbeing. Supporting weight loss and overall health should be an integral part of a comprehensive wellness program focused on long-term positive behavior change.

Let’s work together to create healthier, more supportive workplaces.