Obesity in America remains a significant and growing health concern, with far-reaching implications for individuals, employers, providers, and the healthcare system overall. For health plan sponsors, supporting effective weight management is not only about improving employee well-being, it is also a critical strategy for addressing the rising clinical and economic burden associated with obesity and related chronic conditions.1
As interest in weight loss solutions continues to grow, including increased attention to obesity drugs such as GLP-1s, employers and benefits leaders are navigating a complex landscape. Questions around long-term outcomes, member engagement, safety, affordability, and appropriate use are top of mind. These realities underscore the importance of moving beyond isolated interventions and toward a more connected, whole health approach to weight management.
In this article, we explore the value of a whole health strategy for weight loss —one that recognizes obesity as a multifaceted condition influenced by physical, behavioral, and social factors. Effective weight management requires coordinated support across lifestyle change, behavioral health, management of co-morbidities such as diabetes, and evidence-based clinical oversight when medications are part of the treatment plan. When these elements are aligned through connected care, employers are better positioned to support sustainable weight loss, improve outcomes, and manage costs responsibly.
Overview: Obesity in the U.S.
America continues to grapple with rising obesity rates. CDC data show that obesity prevalence in the U.S. has increased substantially over the past several decades, with more than two in five adults now meeting clinical criteria for obesity.1
Conditions like heart disease, stroke, type 2 diabetes, certain cancers – all linked to obesity – are causes of serious, sometimes life-threatening, illness. Diabetes already affects 14% of the U.S. adult population, with millions more at risk of developing it, presenting a call to action for addressing weight loss treatment as a means of prevention.2
42% of adults $170+ billion
prevelence of obesity in the U.S.1 annual related medical costs in U.S.3
These health problems bring with them a hefty price tag. The annual medical cost related to obesity in the U.S. is estimated to exceed $170 billion, and adults living with obesity incurring substantially higher medical costs each year than those at a healthy weight.³ This growing financial impact continues to be a concern for employers and plan sponsors striving to balance affordability with meaningful health benefits.
Public interest in weight loss remains high. Recent surveys indicate that a substantial share of U.S. adults have attempted to lose weight in the past year, and interest in prescription weight-loss medications, including GLP-1s, continues to grow.4 At the same time, awareness of potential side effects and long-term considerations has prompted increased scrutiny from regulators, clinicians, and employers alike.5
Common approaches to weight management: What works and what doesn't?
Safe and lasting weight management is a journey that looks different for every individual. Safe and lasting weight management is a journey that looks different for every individual. As a result, a wide range of approaches has emerged to address overweight and obesity, from self-directed diet and exercise efforts to behavioral interventions, medications, and surgery.
Let’s take a look at these common approaches and consider their potential outcomes.
Self-managed weight loss attempts
For most people, losing weight and keeping it off is not easy – especially when managing diet choices and exercise schedules independently. And yet, more than 160 million Americans are on a diet at any given time, spending more than $70 billion each year on commercial weight-loss plans, supplements and related.6
These self-managed attempts at diet and exercise tend to bring initial results, but frequently, the lost weight is regained within months, due to challenges such as a strict regimen of denial, unappealing food choices, or time commitments to physical activity. Indeed, 65% of U.S. adults believe that willpower alone is usually not enough to lose weight and keep it off.7 Obesity treatment often benefits from a more sustainable strategy aligned with health status, clinical evidence, and program goals, instead of relying on individual efforts alone.
Lifestyle and behavioral modifications
Lifestyle and behavioral modifications remain a cornerstone of evidence-based weight management. Clinical guidelines consistently recommend nutrition education, physical activity, and behavior change strategies as foundational components of obesity treatment.8
Increasingly, research highlights the importance of addressing behavioral health factors — such as stress, depression, and anxiety — that can influence eating behaviors, motivation, and long-term adherence. Behavioral health support is now widely recognized as a critical component of sustaining weight management over time and advancing whole health outcomes.9
Or, when initial treatment plans are unsuccessful, medication-assisted weight loss in conjunction with behavioral therapy can help meet goals for clinical outcomes. This demonstrates how a whole health approach provides a set of keys to unlock the potential for long-term, holistic results. Those keys may include a connected provider team, a health-first mindset, progress tracking, and behavioral health care that continues even after weight loss goals are met, to support lifestyle wellness and ongoing weight maintenance.
Prescription medications and surgery
Medications may be used as part of a broader weight management strategy for some individuals. Newer GLP-1 medications, originally developed for type 2 diabetes, have demonstrated the ability to support clinically meaningful weight loss when used alongside lifestyle, diet, and exercise changes.
Real-world studies, however, suggest that a significant share of patients discontinue GLP-1 therapy earlier than expected, often before achieving sustained benefit.10 Side effects, cost, and challenges with long-term adherence remain important considerations for employers and plan sponsors evaluating coverage decisions.
Surgical interventions may be appropriate for individuals with severe obesity, though surgery alone does not address the behavioral and psychosocial factors that influence long-term outcomes. Coverage and eligibility vary based on plan design, clinical criteria, and individual evaluation.
We see that successful weight management isn't a one-size-fits-all formula; rather, it involves an evidence-based, individualized, multi-faceted approach for lasting results. And today, a topic of much discussion is if and when GLP1s should be leveraged to support weight loss efforts in light of exploding consumer demand.
Weight loss, GLP-1s, and impacts on employers' pharmacy benefits
As GLP-1s gain visibility as obesity drugs, employers are increasingly considering their role within pharmacy benefits. Coverage decisions are often driven by a desire to support employee health while managing affordability and ensuring appropriate use.
Surveys show that many employees view GLP-1 coverage as a desirable benefit, yet employers continue to weigh rising demand against concerns about long-term costs, utilization, and outcomes.7 Thoughtful benefit design, informed by clinical evidence and real-world data, remains essential.
Leveraging these medications, however, introduces concerns around cost and appropriate use.
In closing: CarelonRx perspectives
The impact of obesity on health and wellness, and the economic burden it brings with it, make it a pressing issue for health plan sponsors and their plan members. The role of GLP-1s for weight management is an industry influence on pharmacy benefits design, utilization, and cost management.
Strategy & Savings: We know that shaping pharmacy benefits with the right strategies in place – like ensuring clinically appropriate, evidence-based use of GLP-1s with rigor around prior authorization – can help keep healthcare costs in check. And when it comes to treating obesity, a condition that requires long-term management, the savings are vital for employer plan sponsorship and pharmacy benefits.
Engagement & Outcomes: In addition to clinical rules application, lifestyle and behavioral modifications are another bedrock of sustainable weight management outcomes. When members engage, they learn fundamental changes in diet, exercise, and mindset that have lasting impacts on their health. Embracing these changes from the start gives them control over their weight loss journey, empowering them to make healthier choices that can help prevent other related health events and conditions.
Safety & Support: While GLP-1s may work for many when results are monitored and use is appropriately managed, the significant value of psychosocial support throughout a weight loss journey should not be overlooked. It's also crucial to provide support for members being treated with GLP-1s for weight loss who are seeking to wean off these medications. Controlled transition off drug therapy to natural weight management methods helps mitigate weight regain, so members can enjoy the ongoing rewards of maintaining their body weight and reaching their health goals.
Additionally, providing the member with the resources needed to sustain their enhanced lifestyle is another key factor in their success. This includes not only the nutritional aspects, but behavioral and mental health support, as well – key advantages brought to the treatment plan by a whole health approach.
Employers and health plan sponsors play an important role in addressing these concerns due to the level of influence they can have on their employees' health behaviors and healthcare resources.
CarelonRx recommends providing support and advocacy over the course of each member’s journey, including the digitally focused weight management program CarelonRx brought to market for those challenged with an obesity diagnosis. The program is supported by CarelonRx’s deep clinical oversight, including formulary and prior authorization strategies to ensure clinically appropriate use of GLP-1 medications. This integrative approach provides reassurance for employers and plan sponsors as they address the ongoing use and impact of GLP-1s.
And it is this kind of integrative approach to weight management that fosters true whole health benefits.
References
1 Centers for Disease Control and Prevention (CDC): Adult obesity facts: updated 2024.: cdc.gov
2 Centers for Centers for Disease Control and Prevention [CDC]: National Diabetes Statistics Report: 2024: cdc.gov
3 Centers for Centers for Disease Control and Prevention [CDC]: Consequences of obesity: cdc.gov
4 KFF: Poll: Nearly Half of Adults Would Be Interested in Prescription Weight-Loss Drugs, But Enthusiasm Fades Based on Lack of Coverage and Risk of Regaining Weight: August 2023: kff.org
5 U.S. Food and Drug Administration: FDA adverse event reporting system (FAERS): Potential signals of serious risks: 2023–2024: fda.gov
6 Harvard Health Publishing: Diet and Weightloss: 2022: health.harvard.edu
7 Pew Research Center: How Americans View Weight-Loss Drugs and Their Potential Impact on Obesity in the U.S.: February 2024: pewresearch.org
8 American Journal of Managed Care (AJMC): A Review of Current Guidelines for the Treatment of Obesity,:December 2022: ajmc.com
9 Rubino F, Puhl RM, Cummings DE, et al. Ending stigma of obesity: An international consensus: The Lancet Diabetes & Endocrinology: 2023: thelancet.com
10 Wharton S, Astrup A, Endahl L, et al.: Treatment persistence with GLP-1 receptor agonists in real-world settings: JAMA Network Open: 2023: jamanetwork.com
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