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GLP-1s have emerged as an effective but expensive weight loss treatment. Should employers cover them?
Obesity isn’t just a matter of physical appearance, it can lead to serious health problems, like type 2 diabetes, cardiovascular disease, respiratory issues, metabolic syndrome and certain cancers. The prevalence of obesity reached a record high 39.9% of American adults in 2022. So it’s no wonder that GLP-1s and their promise of significant weight loss have taken the medical world (and pop culture) by storm.
Originally developed to manage blood sugar (glucose) levels in people with type 2 diabetes, glucagon-like peptide-1 (GLP-1) receptor agonists, such as Ozempic, Mounjaro and Wegovy, surged in popularity when discovered to have a dramatic impact on weight loss. The number of U.S.-based patients without diabetes who started taking GLP-1s for weight loss increased 700% from 2019 to 2023 — and their usage only continues to grow as people seek to shed excess pounds and improve their physical wellbeing.
An October 2025 report from the Gallup National Health and Well-Being Index found the percentage of American adults classified as obese has now fallen nearly three points to 37%. While it’s impossible to know how much of that decline was a direct result of GLP-1s, it’s worth noting that the share of Americans who report taking a GLP-1 injection for weight loss has more than doubled since February 2024, from 5.8% to 12.4%.
Among U.S.-based employees, that number is considerably higher, as one-third say someone in their household has received a prescription for a GLP-1 drug within the last 12 months, according to the Alight 2025 Employee Mindset Study. Of those prescriptions, 89% were reportedly filled. The majority of people who chose not to fill the prescription did so because of the high cost of GLP-1s, which typically run $800 to $1,300 per month without insurance.
Weighing the costs vs. benefits of GLP-1s
Not surprisingly, the pressure is mounting on employers to cover these powerful drugs. Mindset data shows nearly three-quarters (71%) of employees feel it’s important for employer-provided health insurance to cover GLP-1s. While a growing number of employers have expanded coverage for GLPs-1s as a treatment for obesity, others have held off, primarily due to the high cost.
Granted, this is not an easy decision to make. After all, GLP-1s are doctor-prescribed, often for medically necessary, rather than purely cosmetic, reasons. In addition, there is a growing acceptance of GLP-1s as a useful tool not only for treating diabetes and obesity, but also for lowering the risk of major cardiovascular events like heart attack and stroke, lowering blood pressure and cholesterol, improving fatty liver disease, slowing kidney damage, alleviating the symptoms of rheumatoid arthritis and even reducing the risk of early macular degeneration.
2025 Alight Employee Mindset Study
The 2025 Employee Mindset Study delves into key areas such as employee wellbeing, workplace culture, benefits engagement, total rewards and technology.
Despite the growing list of GLP-1 health benefits, U.S. employers are still reluctant to cover them in their plans, particularly for weight loss, according to a 2025 survey report from the International Foundation of Employee Benefit Plans. While 55% of employers say they cover GLP-1s for diabetes only and 36% cover the drugs for diabetes and weight loss, literally 0% cover them for weight loss alone. Looking ahead, 17% say they are considering offering coverage of GLP-1s for weight loss, but over half (53%) are not.
When employers don’t cover GLP-1s for weight loss, employees and their dependents may be tempted to seek out cheaper alternatives from compounding pharmacies. Unfortunately, compounded GLP-1 alternatives lack FDA approval, leaving patients exposed to risks like contamination, dosage errors and unverified efficacy. The FDA has issued a warning about compounded GLP-1s, citing their documented links to serious adverse events, including overdoses leading to hospitalization and higher incidences of diarrhea, gallbladder inflammation and suicidality.
Making a deal that benefits the employer and employee
So where does this leave employers? More than three-quarters (79%) report an increased interest in GLP-1s among covered workers. Still, the hefty price tag is holding many companies back from jumping in feet-first and including GLP-1s for weight loss in their health plans.
Employers face many considerations when debating whether GLP-1s have a place in their wellbeing strategy — not the least of which is that obesity is a leading risk factor for diabetes, cancer, hypertension, depression, back pain and more. That’s not only a health issue, it’s a financial one. According to Vida Health, medical costs for people with obesity are 81% higher than for those at a healthy weight. What’s more, indirect costs from obesity, such as reduced productivity and increased absenteeism, are significant, with some studies placing the cost to employers at more than $11 billion annually.
For companies seeking to help their people lessen the risk of developing life-altering conditions — while reaping a reduction in healthcare costs — it makes sense to cover GLP-1s for obesity. However, a carte blanche approach might not be the best strategy. Instead, it may be best to limit eligibility to individuals with a high BMI or certain comorbidities. Companies could also consider requiring concurrent participation in nutrition/healthy eating, exercise/physical fitness or weight loss programs.
That’s a bargain that employees are willing to make. In fact, 83% say they would support a healthy weight program to have GLP-1s covered by insurance. Results can be measured in terms of weight loss, BMI reduction and a decrease in comorbidities. By teaching individuals to adopt healthier lifestyles and providing support to help them safely taper off GLP-1 medication when the time comes, employers empower people to reach and maintain their target weight. The cost of the GLP-1s then becomes a healthy investment without sustaining the cost long-term, as in the case of an employee developing diabetes or other weight-related diseases and needing lifetime medication management.
Unfortunately, employees report limited availability of such programs. Just 20% of Mindset respondents say they have access to a nutrition, healthy eating or weight loss program, but 70% say they would find value in such an offering. The combination of such programs can be quite powerful. Employers may want to consider adding them, not only to offset the costs of GLP-1s, but also to provide additional support to overweight employees and dependents and turn the tide on some of their healthcare costs.
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