Anonymous wrote:I was told my UHC policy excludes any treatment related to weight loss. Seems so stupid because they will cover diabetes - just won't treat issues that will cause diabetes. That could be specific to our plan because my husband's company is pretty small and only a handful use the health benefits. Most have better plans through a spouse.

I'm doing compounded Zepbound instead. I'm not thrilled using compounded drugs but my dr seemed to think this pharmacy was legit. I'm working with an endocrinologist instead of a weight loss clinic because I found some of them to be a little sketchy

Anonymous wrote:Insurance won't cover unless there's a certain BMI or preexisting conditions, so not sure why so much anger around this. It's also already having a positive effect: fewer knee replacements, less type 2 diabetes. Why would this be bad? It's going to lower health costs, even with the high price of the drugs (and that's now, they will get cheaper) As for people who are not obese, semaglutide is available for a cost that is really not that high considering benefits. right now.

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Anonymous wrote:We didn’t have this obesity problem 30 years ago. Cook your food. Stop buying processed food. Stop wanting to use medication as a crutch. Pay $1K/month to get it. You want insurance to pay, right. That’s what you really meant. Stop stuffing your face. Really exercise. Really.

Yes! I see so many older women out with their daughters and the moms are all slim and the daughter's all overweight or obese!!! Americans got lazy.

Yep. My mom sent a photo of --her, my brother and sister when we were 12, 15, and 17 and she was around 40-42 at the beach. My god we were so thin--though I never was thought of as 'thin'. Even my mom was thin by today's standards and she wasn't one of the 'small' moms. It was pretty crazy to see. That was the late 70s/early-mid 80s. I can't remember a single fat person in my high school and the kids we thought were fat---were nowhere even considered chubby today.

My teen sons have always been very fit ---16 year old is too skinny. 18 year old all muscle.

My husband and I workout together all the time. Today the 16 year old had off so he came to our crossfit-type gym class with us.

We always work out. I was a college soccer player and ran marathons for years after. Then every kind of fitness fad there was. My diet ok--not a complete health nut. Same weight since I was 25.

Husband is also an athlete.

Working out is like brushing your teeth in our family. It's something to be done daily. And, if you don't you still get out and get fresh air. We also buy groceries at Whole Foods and don't have soda or too much crap around the house. Chips for the boys some, etc.

And by the logic of this thread we should be obligated to subsidize an active lifestyle with a $1k/month stipend. Maybe buy a new carbon bike every five months. Makes total sense.

I keep asking people like the two of you: WHY ARE YOU ON THIS THREAD? you don’t need the meds. This does not concern you.

It does because you are demanding somebody cover your own expenses. Pay out of pocket and we don't care. Demand extensive and subsidized access to these expensive medications and people are going to have an interest in that debate.

Interesting. If we are looking at this from a purely economic angle, then it follows that you should be in favor of coverage.
In the aggregate, obesity costs the American healthcare industry 260 billion dollars. Interventions through medication prior to the onset of the obesity-related conditions should reduce that overall cost, particularly if demand increases and costs come down, as they should be expected to.

https://www.jmcp.org/doi/full/10.18553/jmcp.2021.20410

NP here.

First, this must be a new economic principle - demand increases and costs go *down.* Fascinating.

Regardless, you're probably right that drug intervention could bring the costs of obesity down, and it would be a net gain for the system. But insurance companies don't deal in the overall, aggregate health costs - they deal with the health costs of their own insureds. And people change health insurance often - they change jobs, get a different plan in the Exchange, etc. Moreover, virtually everyone is off private coverage, and on Medicare, when they turn 65. So if an insurance company pays for a weight loss drug simply so people can lose weight - which is what many are suggesting here - it may pay dividends down the road. But it won't pay dividends to that insurer if the insured has changed plans. And companies know they won't get any returns if formerly obese people's health improves when they are elderly.

Insurance companies pay actuaries a lot of money, and I'm pretty sure if they could establish that they'd save on claims if they covered all weight loss drugs for everyone, they'd do it. Or are you suggesting that they know they could save money but are choosing not to?

I am astonished, and disheartened, that this has to be explained.

I am not sure what you think you explained. Someone made the argument that insurance should not cover weight loss medication because the costs of that medication eventually "trickle down" to the person paying the insurance premiums. That is true in an abstract long term sense. It is ALSO true that the cost of claims made as a result of obesity eventually trickle down to the individual paying the insurance premiums. Medication to treat obesity reduces claims from resulting conditions so is at best a wash. So no need for anyone paying insurance premiums to worry about cost to them.

What I explained, and that you apparently still didn't get, is that the "abstract long term sense" and "Medication to treat obesity reduces claims from resulting conditions so is at best a wash" are completely irrelevant. Even if everything you are saying is correct (and it's all just speculation on your part), insurance companies don't make decisions based on the overall population, they make it based on their pool of insureds, and how *they* will benefit. Covering an expensive drug for a 62 yo likely won't result in much savings to them, because that person will be on medicare when the benefits are realized. Helping an otherwise healthy obese person lode weight with an expensive drug may or may not help their bottom line, because of job changes, etc.

Short version - it doesn't matter if widespread coverage of these drugs will help the overall health of the population and reduce nationwide health costs, because that's not what the coverage decision will be based on.