The conversation around weight loss has shifted in dramatic ways in recent years as both the medical community and society at large grapple with new weight loss drugs such as Ozempic and Mounjaro. The names of these drugs are splashed across the front pages of various media outlets as they have taken on an increased importance in the world of pop culture and beyond.
Several famous names including Oprah, Elon Musk, Kelly Clarkson, Tracy Morgan, and more have spoken publicly about their use of Ozempic in recent years, and endorsements of these types of drugs appear to be appearing frequently in social media.
However, many now wonder what the medical community truly thinks of these drugs and if they should get on board with trying them. According to a recent Sermo poll, 37% of surveyed physicians are concerned about the lack of regulation. After all, doctors must consider the cost of weight loss drugs from multiple perspectives, including financial, ethical, and clinical. With that in mind, let’s take a closer examination of what physicians are thinking about these drugs.
Table of contents
- Are weight loss drugs suitable for your patients?
- Most popular weight loss drugs and their cost
- What is the most affordable weight loss drug?
- Why are weight loss drugs so expensive?
- Ethical considerations of prescribing weight loss medication
- Should physicians prescribe medication when lifestyle changes alone might suffice?
- Are weight loss drugs worth the cost, financially and otherwise?
Are weight loss drugs suitable for your patients?
When it comes to weight loss medications, several factors must be carefully considered before making any recommendations. Physicians must consider if weight loss drugs should be the default prescription for patients who struggle with their weight. Patients must first meet certain criteria to be considered for drugs like these, including the following:
- BMI greater than 30: a patient with a BMI that is greater than 30 is classified as obese and may be considered for weight loss drugs such as Ozempic or Mounjaro.
- BMI greater than 27 and with a weight-related comorbidity: a patient with a BMI greater than 27 who also has a weight-related comorbidity such as type 2 diabetes, hypertension, and sleep apnea might also be considered.
However, just because a patient meets the criteria does not mean that they should automatically be prescribed a weight loss drug. It is also important to consider factors like the cost of weight loss injections and other related expenses. Not every patient can necessarily afford certain treatment options, and it is best to offer every patient a path forward that makes sense given their life circumstances.
Additionally, patients should also be informed about lifestyle changes that they can make to work towards their weight loss goals. A GP on Sermo shared, “Obesity medications are a treatment option that can help some people lose weight and improve their health, but they are not a one-stop solution. They are most effective when combined with lifestyle changes, such as a healthy diet and regular exercise, so that the patient achieves better long-term results.”
One family medicine doctor noted that obtaining weight loss drugs can be an uphill battle for many patients, “I find that many insurances are not covering weight loss medications and patients are obtaining the weight loss medications through online or alternative health spas. I try to implement lifestyle modifications in addition to weight loss medications. Unfortunately, it takes much effort from the patient to change lifelong habits.”
This is part of the reason why some physicians try a variety of approaches with their patients to help them lose weight. There were some interesting insights uncovered in a Sermo poll regarding physicians’ use of weight loss drugs and their feelings about the topic. When physicians were asked if they prescribe drugs to treat patients with obesity, here were the results:
- Yes, branded medications only: 27%
- Yes, compounded medications only: 4%
- Yes, both branded and compounded medications: 17%
- No, but I work with patients on lifestyle modifications: 24%
- No, I don’t treat obesity: 27%
Evidently there are a wide spectrum of approaches, demonstrating that there is still a considerable amount of debate even within the medical community about the ethics and effectiveness of prescribing weight loss medications.
Most popular weight loss drugs and their cost
We now must discuss the dollars and cents cost of some of the most popular weight loss drugs on the market. Failing to do so would leave out critical information that patients, and physicians, use to make important choices about their care.
Physicians considering various drug options should explore the Sermo drug ratings directory to gain a better sense of what is available, and how it’s rated by other physicians. Below are some of those cost figures:
- Ozempic: between $990-$1,050 per month
- Mounjaro: between $1,000-$1,200 per month
- Wegovy: $1,300-$1,500 per month
- Saxenda: between $1300-$1,500 per month
The list of popular drugs goes on, but there are varying costs for different weight loss medications depending on the specific brand that is prescribed. Additionally, it should be noted that these costs are factoring in that the patient does not carry medical insurance. Sadly, when surveyed, 38% of physicians said that insurance does not cover the cost of weight loss drugs for their patients.
Many physicians have expressed that while the overall cost of these medications remains high, it is still significantly lower than the cost taking no action to treat one’s obesity, with 53% of physicians agreeing with this notion. There are health risks to leaving obesity untreated that may ultimately prove more costly than the financial burden of weight loss medications.
What is the most affordable weight loss drug?
When considering the cost of weight loss medications, many patients are eager to identify the most affordable options available. With budgets under pressure, there is still strong interest in pursuing weight loss treatments where feasible. As a result, patients often seek out the most cost-effective solutions on the market.
Phentermine
Not only is Phentermine a much more affordable option than some name-brand weight loss drugs, coming in at a monthly cost of just $30-$50, but many patients are turning to it because of a shortages as noted by a GP on Sermo, “There has been an increase in the use of phentermine due to the shortage of ozempic”. This has created challenges for patients who depend on Ozempic for its primary purpose—managing their diabetes.
Diethylpropion
Many physicians are also recommending Dethylpropion to their patients to work on their weight loss until they reach a point where they can afford the name-brand options, with one family medicine physician sharing, “For many years (since residency), I have used a combination of phentermine and diethylpropion (formerly known as Tenuate) I have the patients take one for 3 days and then switch to the other, going back and forth every 3 days. Does it work? yes. Does it prevent tolerance from developing? It seems to. Usually one works better than the other, but it is not always predictable which one that will be.”
Zepbound
Another option on the table is Zepbound. The out-of-pocket cost can be as low as $25 per month with some insurance plans, and that is affordable on nearly any budget. “Articles regarding GLP 1 say that patient who started Zepbound lost weight 22% compared to ozempic only 12 to 18 % over the 12 months course.” shared one physician on Sermo, while another stated, “The trial data on Mounjaro/Zepbound shows that at the 10-15 mg per week range, the typical patient is losing around 20% of body weight, mostly adipose tissue.” This drug can be a lifeline for those who want to try an effective weight loss medication but can’t afford the name brands.
Why are weight loss drugs so expensive?
It can be frustrating for many patients to learn about the expected costs of the weight loss drugs that could potentially change their lives. They want access, but they are often out of their price range, and this leaves many wondering why weight loss drugs are so expensive to begin with. That is a reasonable question, and one that has many answers. Among the factors that contribute to the high cost of weight loss medications are:
- Years of expensive research – It takes several years for a pharmaceutical company to fully develop the weight loss drugs that they ultimately send to market. That research is costly and time-consuming. To recoup those investments, the pharmaceutical company must charge a high price. Doing so might price some consumers out of the market, but it helps the company continue to fund the research and development of new drugs.
- Lack of competition - Name-brand weight loss drugs have an impressive reach with the public, although they are not the only option. Generic alternatives don’t necessarily work as well for many patients, and this lack of competition means that the name-brand drugs can be priced high. Companies rely on the fact that some patients will still purchase name-brands regardless.
- Lack of regulation on drug pricing - Unlike in most other countries, the United States does not put any regulatory force on drug companies in terms of their pricing. This means that they are free to price their drugs at whatever price point makes sense to them.
These factors all conspire to keep weight loss drug prices high and additional factors that ultimately determine the price patients pay include dosage and duration of the treatment, insurance coverage, and eligibility for discount programs. “As a medication for diabetes, most patients are being prescribed for weight management, but sometimes insurances don’t approve, making it an accessibility issue. Even when prescribed for T2DM, have to come across insurance denial” shares a physician on the Sermo drug ratings directory page for Ozempic, while another speaks to inaccessibility, “With the cost of the medication, insurance companies are putting up too many barriers to this medication.”
Ethical considerations of prescribing weight loss medication
Physicians must weigh multiple factors before prescribing weight loss medications, including not only the cost but also the ethical implications involved.
- Patient informed consent
It is a bedrock principle of medicine that patients should be fully informed before they take any type of medication. This means that they should be informed both about what the medicine can do and about any potential negative side effects. “Extreme nausea is a common side effect that might affect patient tolerance. Would use with caution if the patient is planning a pregnancy. Great drug for obesity with comorbidities” writes an Internal Medicine physician.
When it comes to weight loss medications, physicians should avoid pressuring patients into treatment. This includes refraining from comments about a patient’s weight that could be perceived as judgmental or negative. Such remarks may inadvertently influence patients to accept medication they may not truly want or need.
- Accessibility concerns
Many physicians consider it to be an ethical concern that many prescription weight loss drugs are only accessible to a small segment of the population (i.e. those who can afford them). A physician on Sermo says, “I love to use it! But it’s a nightmare for patients to access. Both in terms of supply and insurance coverage. This class of drugs could be transformative, if insurance covered it and supply wasn’t an issue.”
Is it ethical to offer a solution that only a small percentage of the population can afford? There isn’t a clear-cut answer. If you are concerned about accessibility for your patients, then you should try to be upfront and honest with them.
- Highlighting body weight issues
Some have begun to question whether society places disproportionate emphasis on body weight, potentially overlooking other important aspects of health. When physicians prescribe weight loss medications, there is a risk of reinforcing this narrow focus—emphasizing weight over the broader, more complex picture of an individual’s overall health.
Should physicians prescribe medication when lifestyle changes alone might suffice?
There is no silver bullet when it comes to weight loss. One Rheumatologist based in the United States said, “Patients with obesity need to be reminded that weight loss medications are part of the treatment for obesity and does not replace previous recommendations such as healthy diet, exercise, etc. Availability of weight loss medications does not mean that patients should not eat healthier, exercise, etc.” While another stated, “These drugs are great if people can alter their behaviors, which they won’t do. So they will stay on them until insurance refuses to continue to pay; then they will complain.”
That said, weight loss medications deserve recognition for the significant benefits they have provided to many patients. While they should not be viewed as the first or sole approach to weight management, they represent a valid and effective option for patients facing obesity and related comorbidities.
Are weight loss drugs worth the cost, financially and otherwise?
The debate surrounding weight-loss medications is ongoing and likely to persist. The rapid surge in popularity of certain name-brand drugs has outpaced much of the medical community’s ability to respond, prompting some physicians to call for a more measured approach—one that carefully considers the financial and ethical implications of prescribing these treatments.
What remains clear is that the high cost of prescription medications is unlikely to change in the near future. Pharmaceutical companies must invest substantial resources into developing and bringing these drugs to market. Coupled with minimal regulatory constraints on pricing, these factors contribute to sustained high costs and limited accessibility for many patients.
