It’s true of most diets. The difference here is the $1000 per month… possibly forever
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Personally, I would probably sit tight for now. His obesity isn’t a fire that needs to be put out right this moment. As more info comes back about these drugs, and as it gets reported more in the media, he may reevaluate on his own.
The other thing to remember is that even without weight loss there are plenty of ways to reduce cardiac and other risks that sometimes go along with obesity. For example, statins (Lipitor etc) are very good at reducing cholesterol if that is an issue. Likewise, if blood pressure is an issue, there are pills for that. If sleep apnea is an issue, that can be treated with c-pap.
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I have lost 100 pound on Mounjaro. I’ve been at maintenance dose since February. I currently take 1 injection every 3 weeks instead of weekly. This is making it affordable for me, with no weight gain in 9 months.
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If you don’t mind my asking, do you still enjoy eating? When I had Covid I lost my sense of taste and it was just horrible. I didn’t want to eat and it made me depressed. Just curious .
I do enjoy food that third week but my tastes have changed. I now crave salt and not sweets. The first 2 weeks I just eat because I have to and get little pleasure from it.
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Regarding insurance and employer costs, note that the list price of a year of Wegovy is about as much as the average cost of a year of medical care for an older (but non-Medicare) person in the US. If even a small percentage of employees in an employer group start using Wegovy, that will be a noticeable increase in costs if it is covered under the employer group plan.
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At current retail prices in the US, it would be. But in most of the world these medicines are far more affordable, in the $150-300 range per month. Domestic Insurance companies which do authorize it have negotiated far lower rates than retail for their reimbursement
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Right. So point being, sadly most often no matter how a person lost their weight, they most often regain it.
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The new, affordable one they was just released apparently requires a patient to be obese and have at least one risk factor (eg HTN or diabetes). So wonder what they will cover for a maintenance plan once the patient no longer meets those criteria.
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If you are taking an anti hypertensive medication for high blood pressure and your blood pressure goes down to normal with it, they don’t make you stop the drug just because it is working! They may be able to lower the dose for maintenance, however.
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Which drug are you referring to? I believe there are folks who lose weight and successfully D/C their antihypertensives. I know of several. If the med is not needed and a person maintains a normal BP, there is no reason to stay on a med that is not needed. They just have to Monitor their BP
Insurance companies could pay for other weight loss programs like Weight Watchers or even the programs that provide food for a much lower cost to the insurer, but most haven’t done that. They could provide gym memberships or free exercise programs at much less than $1000/mo but most don’t do that.
I don’t think they are going to jump on the ‘we will pay’ bandwagon, especially if it is going to be ‘forever’ at $1000/mo.
Many insurers didn’t pay for fertility treatments until state laws were changed to require it. It was expensive but for a specific amount of time. Some insurers even limited it to 5 cycles, or a certain time period. Would the insurers covering semaglutide get to say “Well, we’ll cover it for 6 months, but if you don’t lose 20% of your weight, you’re out”?
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Oh, absolutely. If they lose weight they may well be able to discontinue their anti hypertensive. My analogy is that drugs don’t work when you stop taking them, and that antiobesity meds are no different. We shouldn’t expect a treatment for a chronic disease to work when you withdraw it, unless something else changes. BTW, the labeling for Zepbound is not different from Wegovy. BMI 30 or more or 27 or more with comorbidities like hypertension or elevated cholesterol.
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I wonder if this class of drugs will begin to be thought of like antidepressants or ADHD medication.
I guess you can live without them but your quality of life is better with them.
I think that this is one case where science has made strides faster than the actuaries can forecast the benefits.
Obesity causes as many health issues as smoking. Drugs to help prevent smoking are covered. I hope that this class of drug will find the same approval.
My husband is on a biologic medication. Every year his doctor has to go through hoops so that he continues to have this medication approved. It’s expensive but the benefits far outweigh the cost.
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Correct- as I mentioned, the new drug is for obesity and I thought also one comorbid condition. I think what some people think is that the med is a panacea and they don’t have to change their eating behaviors. The weight will just fall off. And in some cases that may be true. My point was that with any diet, if people don’t modify their eating/activity patterns and then maintain those modified behaviors (go back to unhealthy patterns), the weight will most likely return. These meds are not without side effects. Some people report nausea, vomiting, GI distress (indigestion, constipation), fatigue, and in some cases, stomach paralysis. There re two rule-outs (a family hx of thyroid CA b/c this can cause C-Cell tumors, or a family hx of multiple endocrine neoplasia syndrome type 2. ) Pancreatitis, gall bladder issues, kidney issues, hypoglycemia and others (available to read on their websites) are also risks. Some of the “side effects” (sensation of fullness, appetite suppression and the indigestion issues) can also be helpful with the weight loss goal. But of course, when the med is d/c’d , the side effects will abate. So no surprise if the person hasn’t made personal behavioral changes, the weight will likely come back.
As for d/c-ing anti -HTN meds, of course one doesn’t stop it if it is still needed. They stop it when it is no longer needed.
Many companies, with their insurers, offer no cost (or low cost) wellness programs. My DH’s company offers a free gym membership but you must send them evidence that you have attended a certain # of times/month. They offer a program called the “sword” program, and I have used it for at-home physical therapy, at no cost to me. They send me a tablet and trackers that I wear when doing the prescribed exercises , and I text/message with the PT. Pretty nifty, and a free benefit. I haven’t looked, but they may likely offer other wellness programs at no cost (perhaps nutrition, smoking cessation… IDK). But point is, many companies DO offer these types of benefits.
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The med is what changes the eating behaviors.
It gives a person satiety, and because of that the eating decreases. When the med is withdrawn, the person’s baseline hunger returns, and so the body again seeks more calories, and they regain the weight.
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I’m watching a guy on YouTube called “The Carpetbagger”. He’s been using it for several months and you can see he’s dropped a ton of weight. (Well, maybe 30-35 lbs.) He does say it makes him a little queasy at times.
While the patient is in the med and the person is less hungry and their appetite shrinks, they can modify their eating behavior accordingly. They need to maintain the behavioral
Change to maintain the weight loss.
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The behavior changes because the appetite changes. When the appetite returns after the meds are discontinued, the behavior comes back. They are following their appetite the entire time, whether they are off or on the med. It’s easy to eat according to appetite. It’s so hard to eat against your appetite that very few people can sustain it long-term. This is true for people that are trying to gain weight or lose weight. Some underweight people struggle just as much with overweight people in trying to deny their appetite.
My stomach was bothering me today because I had indigestion and bloating from lunch. I was out at a nice dinner tonight and didn’t want to eat much. You couldn’t have paid me to eat another bite. I felt overly full even though I’d eaten much less than the others at my table. I took some antacid and an hour later I was feeling normal, but quite hungry and wishing I’d eaten more. That’s appetite for ya.
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Changing behavior is a learned skill.
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