GLP-1 Drugs and the Obesity Crisis
- Kate Lee
- 12 hours ago
- 4 min read
Authored by: Kate Lee
Art by: Amy Em
In the United States, obesity rates have increased by 37% over the past two decades, now affecting 41.9% of the adult population [1]. This alarming rise, driven by increasingly sedentary lifestyles and nutrient-deficient diets, is projected to continue. Obesity is medically defined as an excessive fat accumulation that presents a risk to health, or a body mass index (BMI) that exceeds 30 [2]. Beyond its impact on well-being, obesity also places a significant economic burden on the nation.
Annually, obesity is estimated to add $5,010 in medical costs per person, more than twice the expenditures for people at a healthy weight [3]. Overall, obesity accounts for $170 billion higher in healthcare costs. Poor health also contributes to increased absenteeism and productivity, costing US up to $26.8 billion per year [4].
In response, pharmaceutical companies have invested heavily in developing weight-loss medications, the most promising being glucagon-like peptide 1 receptor (GLP-1R) agonists, commonly known by commercial names such as Ozempic. Initially developed for type 2 diabetes, these drugs showed significant weight-loss effect, prompting their off-label use, which refers to the use of a drug outside of its intended use. In 2021, the FDA approved GLP-1s specifically for chronic obesity under the name Wegovy. By the end of the year, nearly 2 million people in the US were using GLP-1s—a threefold increase from 2019 [5].
This rapid growth in semaglutide use has sparked intense debates surrounding its efficacy, accessibility, and broader societal implications. GLP-1s appear to offer a revolutionary solution to one of the biggest health crises in the US. Of the total population, 38% of adults are eligible for treatment, and 69.1% of those would show at least 10% weight reduction— potentially cutting national obesity rates in half [6]. Economically, this could be transformative.
However, cost remains a critical barrier. Wegovy costs $1,349 a month, amounting to $17,585 a year [7], when studies calculated that the drugs could be manufactured for less than $5 a month [8]. Meanwhile, other governments directly negotiated the monthly cost of Wegovy: $186 in Denmark, $137 in Germany and $92 in the United Kingdom [9]. The GLP-1 market is dominated by a few large companies like Eli Lilly and Novo Nordisk, which implement patent tactics to maintain high pricing and profitability.
Support from public insurance programs and most employee-sponsored insurances is highly limited. As most insurers consider weight-loss a cosmetic or lifestyle choice, rather than a medical necessity, insurance covered only 0.1% of the overweight/obese population for weight-loss medications in 2022 [8]. Consequently, when patients are forced to pay out-of-pocket, interest in GLP1s drops by more than 30% [9].
What if the government expanded coverage? According to cost estimates, this could be detrimental to the government. If 40% of all Americans took GLP-1 drugs, the total cost to public insurance programs, health exchange subsidies, and US taxpayers is estimated to exceed $1 trillion annually [10]. This would cost the federal government more than it would save from reducing other healthcare spending. What’s more, GLP-1s are chronic medications, raising serious concerns about long-term affordability and sustainability. For how long would governments be able to finance their provision for over half the population?
To be cost-effective, the price of GLP-1s would have to fall by more than 50% [9]. If Novo Nordisk charged Americans what it charged Danes, the US healthcare system could save up to $317 billion annually, saving taxpayers $128 billion [11].
Skepticism also remains as a barrier. With much of the controversial discourse that surrounds GLP-1s, particularly on social media, more than half of the population remains skeptical of their effectiveness and side effects. Many projections also assume long-term, linear efficacy, overlooking real-world issues such as adverse effects, weight regain, and individual variability in responses.
In conclusion, while GLP-1s are undeniably effective in treating obesity, their current costs and accessibility barriers prevent them from producing large-scale economic and public health benefits for the US.
Ultimately, this discussion comes down to the fundamental question of whether to prioritise prevention or treatment. Should the government focus on the root causes, such as reducing food insecurity, encouraging better lifestyle habits, or addressing social stigmas? Or should they invest in promoting the widespread use of medical therapeutics such as GLP-1 drugs?
References
Warren, M., et al. (2022). The state of obesity: Better policies for a healthier America. Special feature: Food and nutrition insecurity among youth and families. Issue Report.
World Health Organization. (2025). Obesity. World Health Organization.
Warren, M., et al. (2022). Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes, Obesity and Metabolism, 24(8), 1553–1564.
Cawley, J., Meyerhoefer, C., Biener, A., Hammer, M., & Wintfeld, N. (2021). Direct medical costs of obesity in the United States and the most populous states. Journal of Managed Care & Specialty Pharmacy, 27(3), 354–366. https://doi.org/10.18553/jmcp.2021.20410
DeSilver, D. (2024, March 21). As obesity rates rise in the U.S. and worldwide, new weight-loss drugs surge in popularity. Pew Research Center.
https://www.pewresearch.org/short-reads/2024/03/21/as-obesity-rates-rise-in-the-us- and-worldwide-new -weight-loss-drugs-surge-in-popularity/
Wong, N. D., Zhao, Y., Ji, J., & et al. (2023). US population eligibility and estimated impact of semaglutide treatment on obesity prevalence and cardiovascular disease events. Cardiovascular Drugs and Therapy. https://doi.org/10.1007/s10557-023-074883
Wilson, A. (2024, May 14). How much does Wegovy cost with & without insurance. Ro. https://ro.co/weight-loss/wegovy-cost/
Barber, M. J., Gotham, D., Fortunak, J., & Hill, A. (2024). Estimated sustainable cost-based prices for diabetes medicines. JAMA Network Open, 7(3), e243474.
Sanders, B. (2024, May 15). How weight loss drugs could bankrupt American health care. United States Senate.
Atlas, S. J., Pearson, S. D., & Institute for Clinical and Economic Review (ICER). (2022, October 20). Medications for obesity management: Effectiveness and value; Final evidence report. https://icer.org/assessment/obesity-management-2022/
Nathan, A., D’Souza, R., & Murry, T. (2024, April 12). Weighing the GLP-1 market. Goldman Sachs Research, Top of Mind, (127), 1–https://www.goldmansachs.com/intelligence/pages/gs-research/weighing-the-glp1-market/report.pdf
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