As many well know, America has a persistent – and rising – epidemic of obesity. According to the Centers for Disease Control and Prevention (CDC), more than one in three American adults in 23 states are obese. Just a decade ago, no state had that high a rate of obesity. Worse, no state has fewer than one in five adults who are obese. These disappointing results indicate that obesity rates continue their unabated upward trend.
As Americans increasingly grow overweight, obesity-related chronic diseases, particularly heart disease and Type 2 diabetes, continue their rise. Up to 90 percent of U.S. adults with Type 2 diabetes are obese or overweight, and obesity contributes up to 50 percent of new Type 2 diabetes cases. These staggering statistics illustrate the lingering and life-threatening consequences of failing to address the obesity epidemic.
Given the undisputable correlation between obesity and Type 2 diabetes, the Centers for Medicare & Medicaid Services (CMS) has proposed a rule that would allow Medicare and Medicaid to authorize beneficiaries to receive GLP-1 class of medications for the treatment of obesity. That proposed rule needs to be enacted.
GLP-1s hold the promise of being the greatest advance in reducing obesity-related ailments. How effective are GLP-1s? In 2023, the American Association for the Advancement of Science (AAAS) designated them the Breakthrough of the Year, noting "... a new class of therapies is breaking the mold, and there's a groundswell of hope that they may dent rates of obesity and interlinked chronic diseases."
Denting “rates of obesity and interlinked chronic diseases” would mark a sea change in healthcare. The reduction of obesity-related ailments would result in an improved quality of life for tens of millions of Americans and inevitably lead to a reduction in the long-term – and increasing – healthcare costs associated with these afflictions. As I noted in an October column in RealClearHealth, “Heart disease, for which obesity is a major contributing factor, remains the leading killer of adults in the United States. Strokes and diabetes, which also correlate strongly to obesity, are the fifth and eighth leading causes.”
There are some who believe we can address America’s obesity epidemic solely with diet and lifestyle changes. They’re missing the point. GLP-1 medications are proven appetite suppressants. They effectively – and rapidly – bring about the diet and lifestyle changes that inevitably result in weight loss.
The rationale that led to these medications being made available for patients with Type 2 diabetes only reinforces the justification to make them available through Medicare and Medicaid to treat obesity. For CMS to authorize billions of dollars for the treatment of diabetes while simultaneously denying patients access to medications that address that chronic conditions’ primary and underlying cause would be irrational and counterproductive. Moreover, continuing such a policy would not be in the best interests of the patients these programs were created to serve.
By instituting the proposed rule, CMS has a unique opportunity to effectively change the trajectory of a persistent affliction that has heretofore effectively resisted treatment. Approving access to GLP-1 medications for the treatment of obesity for Medicare and Medicaid recipients would invariably lead to positive and lasting outcomes for millions of Americans. And by so doing, CMS can also stem the tide of the rising costs associated with the chronic afflictions correlated to obesity.
GLP-1 medications are already helping millions of Americans shed pounds, offering hope for stemming our nation’s exploding increase of cardiovascular disease and diabetes. Millions more would benefit from expanding coverage for these life-changing drugs to Medicare and Medicaid recipients. By so doing, we can improve the overall health and well-being of our citizens, while ultimately reducing the staggering costs associated with treating the chronic conditions linked to obesity.
Gerard Scimeca is chairman and general counsel for CASE, Consumer Action for a Strong Economy, a free-market oriented consumer organization he co-founded.
