Medicare is set to expand coverage to weight-loss drugs targeting obesity—but it looks more like another quick ‘fix’ that will make even more Americans drug-dependent, while enriching the coffers of the drug companies. Action Alert!
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THE TOPLINE
- A bill in Congress seeks to allow Medicare coverage for anti-obesity ‘skinny jabs’ like Ozempic and Wegovy, which could add $3 trillion in expenses, raising concerns over taxpayer funding and potential dependency on lifelong medications without addressing the root causes of obesity.
- While these drugs have shown effective short-term weight loss, they come with risks like serious side effects, including suicide, high cost, and a need for indefinite use.
- Instead of funneling trillions into drugs that primarily benefit Big Pharma, we need to advocate for investments in preventive care, better nutrition, and lifestyle programs that target the root causes of obesity for more sustainable health outcomes.
The debate over whether Medicare should cover GLP-1 receptor antagonist anti-obesity drugs like Ozempic and Wegovy raises critical questions about the future of healthcare spending and our approach to treating chronic health conditions. While these drugs have become immensely popular following huge hype on social media, expanding Medicare to cover them would represent a massive transfer of taxpayer dollars to Big Pharma. Instead of addressing the root causes of obesity—like poor nutrition, lack of exercise, and environmental factors—this move would pour trillions into drugs that demand long-term or lifelong use and perpetuate dependency without offering true, lasting solutions. What’s more, it could all be for nothing as more information surfaces over high drop-off rates induced by adverse reactions from users of the drugs, as well as their link to self-harm, suicidal thoughts, and suicide itself. Predictably, the FDA claims they have found no link between these drugs and the risk of suicidal ideation. No doubt that might have something to do with its revolving doors with drug makers, in this case, most notably, Novo Nordisk and Eli Lilly.
Currently, Medicare is prohibited from covering anti-obesity medications, although coverage is allowed for these drugs when they are FDA-approved for other conditions like diabetes or heart disease. However, a bill in Congress seeks to remove this restriction, potentially leading to an additional $3 trillion in Medicare expenses. This is no small price tag, especially considering the surge in demand for these medications. Prescriptions for Ozempic and Wegovy skyrocketed by 300 percent between 2020 and the end of 2022, reaching nine million prescriptions in just the last quarter of 2022 alone.
Ozempic, a once-weekly injection, contains semaglutide, a drug that mimics a hormone called GLP-1 that regulates hunger and fullness (satiety). The drug helps patients feel less hungry by slowing down digestion and altering how the body processes sugar. A 2021 study showed that people taking the drug lost an average of 15% of their body weight over 68 weeks—twice the success rate of older weight loss drugs. Adverse reactions aside, here’s the catch: to maintain the weight loss, you have to stay on the drug. Once you stop, the weight tends to come back. Heard that before?
Proponents argue that this is no different from taking a statin or blood pressure medication to manage chronic conditions, where long-term use is expected. But we should be wary of normalizing lifelong dependency on any drug that merely manages symptoms without solving the underlying problem. The rising tide of obesity isn’t just about dysregulated satiation—it’s about a complex interplay of diet, lifestyle, stressors, and a wide range of metabolic, genetic, and environmental factors. Targeting just one piece of this puzzle with drugs like Ozempic is a quick, but incomplete, fix that ignores the broader picture while bringing with it a catalogue of additional problems, including adding to the mental health burden of America.
Then there’s the side effects and costs associated with these drugs. Without insurance, the monthly cost is around $1,000, a prohibitive expense for most Americans. Side effects include nausea, vomiting, and muscle loss, while more severe complications such as pancreatitis, gallbladder issues, and thyroid problems have also been reported. Then you have the mental health impacts linked also to other anorectic drugs, such as the self-harm and suicidal ideation problems associated with semaglutide shown in the recently published JAMA case control study based on World Health Organization (WHO) records. The FDA updated its label in 2023 to warn about the risk of ileus, a dangerous condition where the intestines become blocked. This is likely in response to several personal injury lawsuits that have been filed against the drugmakers where intestinal blockage was claimed to be linked to the drug.
There’s also evidence that these drugs can reduce other cravings and compulsive behaviors, potentially altering brain chemistry in ways that extend beyond appetite like alcohol, gambling, smoking, and skin picking. While this might sound promising, it raises ethical concerns about using such powerful medications for long-term treatment. It also points to reasons why we could start seeing large-scale prescribing of these powerful medications for off-label reasons.
The push to make Medicare cover these drugs is ultimately a boon for pharmaceutical companies, not for public health. Instead of relying on expensive, lifelong medications, we should be focusing on root-cause solutions—like exposing the problems linked with ultra-processed foods, promoting intermittent fasting and low-carb diets, lifestyle changes, and targeted supplementation. There’s ample research supporting the use of certain supplements as part of a preventive care regimen that can save our healthcare system billions of dollars. How about also targeting our exposure to endocrine disrupting chemicals and PFAS, both of which are linked to obesity? Or helping people find better ways of transforming or offsetting stress in their lives? These are all scientifically proven strategies that can lead to lasting health improvements without the burden of continuous medication.
Rather than expanding Medicare’s role in funding Big Pharma, Congress should invest in programs that promote healthy lifestyles and preventive care. Obesity is a complex condition requiring a holistic, multi-faceted approach, not a one-size-fits-all drug solution that increases drug-dependency, enriches the pharmaceutical industry, and ignores the broader public health crisis.
Action Alert! Write to Congress opposing HR 4818. Please send your message immediately.
