Beneath the hype, weight loss drugs may drive big changes in public health

With Oprah's recent primetime special about weight loss, you could say that obesity drugs like Ozempic, Wegovy and Mounjaro have reached the pinnacle of pop culture. But an important story about public health is developing as well: eliminate obesity, and you potentially eliminate diabetes, heart disease, stroke and cancer.

A USC white paper estimates that Medicare coverage for new obesity treatments could generate $175 billion in cost offsets in the first 10 years alone. A Goldman Sachs forecast predicts widespread use of the drugs in the U.S. could boost gross domestic product by 1% as lower obesity-related complications increase workplace efficiency.

Obesity medication coverage could benefit Medicare and enhance health equity

"Obesity is a leading risk factor for mortality in the U.S.," says Darius Lakdawalla, director of research at the USC Schaeffer Center for Health Policy and Economics. "Our modeling shows that new treatments generate substantial benefits to Medicare and its beneficiaries. Developing strategies for unlocking that value should be a priority for policymakers.

"Improving access to obesity medications could also enhance health equity, since obesity disproportionately impacts lower-income communities of color. More than half the Black Medicare population has obesity and three-fourths have high blood pressure."

A 'completely new era' in managing obesity complications

"These medications not only benefit patients in terms of the weight loss itself but also clearly improve metabolic function and either ameliorate or even eliminate diabetes," says Pinchas Cohen, dean of the USC Leonard Davis School of Gerontology.

"They have recently shown, in placebo controlled randomized trials, not just to improve numbers of kilograms and blood sugar levels, but also to actually prevent the frequency of heart disease, stroke, and related complications of obesity and diabetes. We are now in a completely new era in the management of this conditions."

Cohen is also a distinguished professor of gerontology, medicine and biological sciences who studies processes related to aging.

Investment needed to improve food environments

"New medications, like Ozempic and Wegovy, show immense promise in helping people living with diabetes and obesity make major health improvements. But these drugs are expensive, and most people will transition off of them at some point. So, we also need to ramp up our investment in big picture solutions that make it easier for people to start and sustain healthy eating habits," says Kayla de la Haye, director of the Institute for Food System Equity at the USC Dornsife Center for Economic and Social Research.

"For people living in unhealthy food environments–where unhealthy foods are cheap, convenient and accessible, while healthy options are not—their food environment is really stacked against them. We need strong investment to make our food environments healthier, especially for communities that are low income, and communities of color, where historic disinvestment has really compromised the quality of food they can access."

De la Haye, who recently published research in Nature Communications, studies the impact of low-quality food environments on overall health.

Coverage will likely increase with mounting evidence of metabolic benefits

"It has been easier for plans and programs like Medicare Part D to say they don't cover 'lifestyle' drugs, which weight loss drugs typically fall under," says Geoffrey Joyce, an associate professor and chair of the Department of Pharmaceutical and Health Economics at the USC Mann School of Pharmacy & Pharmaceutical Sciences.

"But as the evidence grows on the cardiovascular/metabolic benefits of these drugs, there will be increasing pressure to cover them," says Joyce, who also is director of health policy at the USC Schaeffer Center for Health Policy & Economics.