Obesity is not just about physical appearance and clothing sizes. It’s a chronic, life-changing health condition that’s been linked with heart disease, type 2 diabetes, and certain types of cancer—not to mention a lower quality of life. Obesity is widespread, too, affecting 38.9% of Americans age 60 and older.¹ 

Despite what the diet and fitness industries would like you to believe, losing weight is not always a matter of willpower. Rather, there are often physiological reasons that make it harder for some people to reach and maintain a healthy weight.

"It's a brain disease," said Dr. Fatima Cody Stanford, an obesity medicine physician at Mass General Hospital and associate professor at Harvard Medical School, on an episode of 60 Minutes. "And the brain tells us how much to eat and how much to store."

If you’re living with obesity and have tried diet and exercise with limited success, weight loss medications could give you an added boost. Several drugs have been approved by the Food and Drug Administration (FDA) to treat obesity over the long term. These medications are shown to be highly safe and effective, working in different ways to make weight loss more achievable. 

Who qualifies for weight loss medication?

Weight loss medications should not be taken solely for the sake of vanity. They’re meant for people who struggle with health problems due to being overweight or having obesity. Your provider may prescribe medication if you have a body mass index (BMI) of 30 or greater. They may also prescribe it if you’ve been diagnosed with a condition related to your weight—such as type 2 diabetes, high blood pressure, heart disease, or sleep apnea.

Not all people with a high BMI should take weight loss medications. Many adults are able to lose weight successfully by improving their diet and adding more physical activity to their routine.

What are the newest drugs to fight obesity?

There is a new generation of safe, effective weight loss drugs shown to help people shed significantly more weight than previous medications.

Approved by the FDA in 2021, semaglutide (Wegovy) is a GLP-1 receptor agonist delivered via subcutaneous (just under the skin) injection. This class of drugs was originally created to treat type 2 diabetes. Semaglutide works on appetite centers in the brain, helping a person eat less food and still feel satisfied. This weight loss medication also reduces feelings of hunger. In a clinical trial, subjects who received a weekly injection of semaglutide lost an average of 15% of their total starting body weight.²

Another FDA-approved GLP-1 receptor agonist is liraglutide (Saxenda). Like semaglutide, liraglutide works by decreasing appetite and helping you feel fuller for longer. A trial of liraglutide with more than 3,700 participants showed an average weight loss of 8%.³

Tirzepatide (Zepbound) is also an injectable GLP-1 agonist shown to be highly effective for losing weight. It was approved by the FDA in 2023. In a study, the average weight loss of participants taking Zepbound ranged from 15% to 20.9%.

Orforglipron, a nonpeptide oral glucagon-like peptide-1 (GLP-1) receptor agonist made by Eli Lilly, is currently wrapping up phase 3 clinical trials. In earlier trials, patients taking orforglipron achieved an average 14.7% weight loss. Orforglipron could be available as early as 2026.

Is medication to treat obesity a good idea?

There is no "magic pill" or injection to cure obesity. Understanding the pros and cons of weight loss medications can help you make an informed decision about taking them.

Pros of weight loss medications

Weight loss medications should not replace smart eating habits and exercise. However, when combined with healthy lifestyle changes, these drugs could help you treat your condition, improve your health, and lose more weight in the long run. One study showed that some people taking prescription weight loss medications were able to achieve and maintain a loss of 10% or more of their starting body weight.⁴

Why is this good news? Shedding even 5% of your weight can help lower blood pressure and blood sugar, reduce triglyceride levels, ease joint pain, and improve sleep. That means weight loss medications have real potential to provide relief and improve overall health for millions of older Americans.

Cons of weight loss medications

All weight loss medications—both newer and older versions—come with the risk of unpleasant side effects. Side effects may include:

• Dry mouth
• Dizziness
• Insomnia
• Oily stools
• Abdominal pain
• Headache
• Nausea
• Vomiting
• Diarrhea
• Constipation

While side effects of anti-obesity medications are usually mild and temporary, some people may experience more severe complications that impact their ability to function. That’s why it’s important to discuss the risks vs. benefits with your health care provider before starting any drug regimen.

How do I talk to my doctor about weight loss medication?

Learning to be your own advocate can help you get the high-quality obesity care you need. Start by asking questions at your next checkup:

• What is my ideal weight and/or BMI?
• Could a health problem or current medication be causing me to gain weight?
• How will weight loss improve my health?
• Do I qualify for weight loss medications?
• Are weight loss medications safe for me to take?

As a person with obesity, you should know and understand all the treatment options available to you. If you feel your doctor is not listening to your concerns, or that they don’t take obesity seriously as a chronic disease, it may be time to find a new provider. You deserve to feel seen and heard.

Are obesity drugs covered by insurance?

Some insurance plans cover anti-obesity drugs while others, such as Medicare, outright exclude them (see what Medicare covers for obesity treatment here). Lack of insurance coverage can prevent many people from accessing the full continuum of care for obesity.

The newer injectable drugs have a high out-of-pocket cost. Novo Nordisk and Eli Lilly, makers of the GLP-1 agonist drugs Wegovy and Zepbound, recently cut prices for people without insurance. However, these medications still have high starting price tags of $499 and $349 per month, respectively. If you’re considering weight loss medication, it’s a good idea to contact your insurance carrier to see what your plan covers, if anything.

Lawmakers and advocates are working to broaden access to affordable anti-obesity treaments. The Treat and Reduce Obesity Act (TROA) is a bipartisan bill designed to enable CMS to clarify that FDA-approved anti-obesity medications may be covered under Part D.

But recently, the Centers for Medicare & Medicaid Services (CMS) proposed a new rule that would no longer exclude AOMs under Medicare Part D and would "require Medicaid programs to cover these medications when used to treat obesity." This new rule has the potential to improve health outcomes and save lives by expanding coverage for anti-obesity medications to 7.4 million American adults.

What if insurance won’t cover my weight loss medication?

Your doctor prescribed a weight loss medication, and you're feeling hopeful—until you get a denial from the insurance company. While this can be frustrating, here are some tips on how to move forward.

• Ask your provider to advocate for you to your insurance company. They can often make a more compelling case for coverage than you could on your own.
• Appeal the insurer’s decision. You generally have 180 days to file an appeal. Have your insurance card handy and call the customer service line to get the process started. Keep a log of all conversations.
• Explore other ways to manage the cost. If you are unable to get your insurer to cover the cost of weight loss medication, there may be alternative ways to ease your out-of-pocket expenses:
  • Check with the drug manufacturer to see if they offer any savings coupons.
  • Request a discount card from GoodRx or SingleCare, which both offer prescription drug savings of up to 80% at most U.S. pharmacies.
  • Ask your provider if they offer low- or no-interest payment plans.

NCOA worked alongside other organizations to create the Obesity Bill of Rights. This is a set of eight patient-centered principles to ensure all Americans with obesity have access to the high-quality treatment options they need and deserve. Find out more at right2obesitycare.org.

Sources

1. Centers for Disease Control and Prevention. Obesity and Severe Obesity Prevalence in Adults: United States, August 2021–August 2023. September 2024. Found on the internet at https://www.cdc.gov/nchs/products/databriefs/db508.htm

2. Once-Weekly Semaglutide in Adults with Overweight or Obesity, The New England Journal of Medicine. Found on the internet at https://www.nejm.org/doi/full/10.1056/NEJMoa2032183

3. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management, The New England Journal of Medicine. Found on the internet at https://www.nejm.org/doi/full/10.1056/nejmoa1411892

4. Anti-obesity drug discovery: advances and challenges, Nature. Found on the internet at https://www.nature.com/articles/s41573-021-00337-8