Pricey Weight Loss Drugs - To Cover or Not To Cover

Author: Laci Loew, XpertHR Senior Global Analyst, HR Strategy and Insights

Date: July 11, 2023

According to the Centers for Disease Control and Prevention (CDC), more than 70 percent of adults in the U.S. are overweight or obese. Obesity frequently leads to a variety of concerning and chronic medical conditions, including:

Pharmas are quickly stepping up. Mounjaro, Ozempic, Saxeda, Tirzepatide and Wegovy, are among examples of newly released GLP-1 drugs proving very effective in treatment of these chronic conditions. More than that, consumers of the drugs are noting a significant and additional side-benefit - weight loss.

One user, weighing more than 300 pounds and diabetic, said, "I like to eat bad food and drink a lot." Another obese user responded with, "One of the things I've always dealt with was a constant hunger; (with this drug), it went away."

Given the evidence-based health benefits paired with today's pointed focus on employee well-being, even though most employers currently don't cover these costly pharmaceuticals, should they be required to do so?  With open enrollment only a few months away, it's a question worth asking.

The Case For

Heck yes, employers should cover these drugs. They get at the root of physical health issues, regardless of whether those issues are self-induced or because of heredity, that plague so many in the workforce. If employees are healthy, they tend to be happier, more engaged, and of course more productive.

Sure, organizations are always challenged with holding down the rising costs of healthcare, and adding coverage of these drugs to employee benefit plans will spike their costs. Wegovy, for example, has a retail price of approximately $1,300.00 monthly.

But is the annual benefit cost spike a smaller price to pay than the alternative price of losing key talent to competition whose benefit plans are inclusive of weight loss drugs? And what about the unanticipated costs of ponying up medical payments on behalf of those employees who don't get the drugs, end up with a heart attack and undergo major surgeries?

If one considers the CDC's estimate that the medical cost of obesity and derivative conditions is nearly $173 billion annually in 2019 dollars, choosing to not cover is going to be a hard case to justify.

The Case Against

Heck, no. Obesity - the largest cause of chronic medical conditions - is not a medical disease but is a "way of life" choice that many employees willingly elect. Organizations should not be accountable for covering employees' poor eating habits and unhealthy lifestyle choices.

Moreover, consumption of these GLP-1 drugs seems to be a forever type situation. Studies have found that two-thirds of patients gained the weight back after they stopped taking Wegovy. So, sustaining preferred weight levels is dependent upon long-term use of the drug. This nearly guarantees that employers are strapped with a very costly employee benefit offering that may never end.

Next, covering the drug ad infinitum doesn't teach employees to assume accountability for their lifestyle choices. Rather, it basically is a free ticket to long-term maintenance of weight control at the employer's expense.

And The Best Choice Likely Rests In Between

Leaders in between the "yea and nay" camps are willing to cover these expensive drugs for the short-term to focus on improving the long-term holistic well-being of employees who stand ready and committed to making responsible choices and taking accountability for their actions.

In this "in between" strategy, employers provide benefit coverage of the GLP-1 pharmaceuticals for six-to-nine months while simultaneously offering employees a proven weight reduction and maintenance solution like Golo or Noom. With this two-punch solution, employees can count on the drugs to step in while they build new eating and lifestyle habits enabled by support communities and coaching check-ins.

Using the combination of science and psychology, overweight employees, self-inflicted or not, are armed with a long-term sustainable solution and employers' associated expenses are more reasonable, and in some cases even capped.

Your Opinion

Upon considering the evidence, it appears this is not an either-or situation. Perhaps the issue is far deeper than obese employees who end up with resultant chronic health conditions and choose diets above the average daily recommended caloric intake and exercise plans far below recommended per day minimums. Regardless of how they got to where they are, someone must take responsibility for fixing the issue. Is it the employer? The employee? Both? Or neither? If neither, then who is it?

  • Do providers of low-cost, high-caloric food sources like McDonald's, Taco Bell, Arby's, KFC, and Burger King have some accountability?
  • Should they be held to some minimum level of nutritional value foods?

What about environmental, cultural, economic influences that drive the average American to overeat and become addicted to unhealthy foods - should policy enforcers and lawmakers bestow greater responsibility upon themselves to help influence societal choices that tend to preclude obesity and its byproducts?


Considering all the evidence and input, will your 2024 Benefit Offerings include coverage of expensive weight loss drugs? For how long? It's not too early to consider these questions and others, including:

  • Will coverage enhance the organization's well-being strategy and the employee's experience?
  • Or will lack of any coverage ignore well-being and instead prompt disengagement and a lack of productivity?

Whatever the decision, leaders and benefits managers have the responsibility to minimize long-term organizational healthcare costs and maximize employee well-being. Done well, the outcome will be a values-based strategy improving the overall employee experience and enhancing the company and brand reputation.