GLP-1 Prescriptions for Weight Loss Soar, Reshaping Obesity Treatment Landscape

The pharmaceutical industry is witnessing a dramatic surge in the use of glucagon-like peptide-1 (GLP-1) agonists for weight management, despite recent supply challenges and concerns over high costs. This trend is reshaping the obesity treatment landscape and creating significant opportunities for drug manufacturers.

Unprecedented Growth in GLP-1 Prescriptions

According to a recent analysis by nonprofit Fair Health, the percentage of overweight or obese adults prescribed GLP-1 drugs jumped from 0.3% in 2019 to 2.05% in 2024, representing an almost sevenfold increase. The demand for these medications specifically for weight loss is even more striking when excluding patients with Type 2 diabetes, with a staggering 1,961% increase in prescriptions over the same period.

Currently, three GLP-1 drugs are FDA-approved for weight management: Novo Nordisk's Saxenda and Wegovy, and Eli Lilly's Zepbound. These medications have quickly become blockbusters, with Novo Nordisk reporting $9.9 billion in combined sales from Wegovy and Saxenda in 2024, while Eli Lilly's Zepbound generated $4.9 billion in its first full year on the market.

Challenges and Controversies Surrounding GLP-1 Adoption

Despite their rapid adoption, GLP-1 drugs face several obstacles. High list prices, exceeding $1,000 per month for standard doses, have raised concerns about the financial burden on payers and patients. As a result, fewer than one in five employer-sponsored plans covered GLP-1s for weight loss in 2024.

To address these concerns, manufacturers have begun partnering with pharmacy benefit managers. Novo Nordisk and Eli Lilly recently struck deals with Cigna's health services subsidiary to offer discounts and cap patient copays. Similarly, CVS Caremark agreed to give Wegovy preferred access on its standard formulary.

The use of GLP-1s has also sparked debate within the healthcare community. HHS Secretary Robert F. Kennedy Jr., leading the "Make America Healthy Again" movement, has criticized the pharmaceutical industry for profiting from obesity treatments, arguing that the issue could be better addressed through lifestyle changes. This sentiment may have influenced the Trump administration's decision to decline Medicare coverage for obesity drugs, citing potential costs of $40 billion over a decade.

Implications for the Obesity Treatment Landscape

The rise of GLP-1s appears to be impacting other obesity treatments. Fair Health's report noted a decrease in bariatric surgeries coinciding with increased GLP-1 prescriptions, suggesting these medications may be replacing more invasive interventions for some patients.

However, concerns remain about the long-term effects of GLP-1 use. Some research has indicated a higher risk of depression, anxiety, and suicidal ideation among patients taking these drugs. Additionally, the report found a decrease in behavioral healthcare services associated with increased GLP-1 prescribing, raising questions about the comprehensive management of obesity.

As the obesity crisis continues to grow, with more than 40% of Americans affected and projections reaching 50% by 2030, the role of GLP-1 agonists in treatment strategies is likely to remain a topic of intense discussion and research in the coming years.