The ColoHealth Health & Wealth Newsletter
October 2024
Vol. 14, Issue 13

We Need To Talk About Weight Loss Drugs

Since earning my Master’s degree in Nutrition and Exercise Science from Colorado State University, I’ve always believed in promoting health and wellness. 

My passion lies in guiding individuals towards making the best choices to lead healthier lives. 

Many people have asked about my position on weight-loss medications, such as Wegovy, for those who are significantly overweight and have not been successful with diet and exercise alone.

That’s a hugely important issue: Approximately 70% of American adults are overweight, and 42% are obese. Obesity carries significantly elevated risk of serious health issues, including heart attack and stroke.

In recent years, drug companies have introduced two promising semaglutide, under the brand names Ozempic and Wegovy, that have shown themselves to be very effective in helping patients with diabetes manage their weight.

For many people, these drugs have life-saving potential.

Until this year, however, these drugs were only approved for use with diabetics. Not for weight loss alone. 

On March 8, 2024 the U.S. Food and Drug Administration (FDA) expanded the approved uses of the drug Wegovy. This new indication allows Wegovy to be prescribed for reducing the risk of major cardiovascular events in adults who have both cardiovascular disease and are overweight. 

Is Wegovy Safe?

While side effects and complications thus far have been rare (nausea is the most common, but it is an appetite suppressant!), there have been a few reports of intestinal blockage associated with the drug. But that also, thankfully, has been rare so far.

There is a long list of other side effects, from difficulty swallowing to slurred speech and seizures, that are also rare, but possible.

There is one common effect of these drugs that everyone should be aware of, and that’s the loss of muscle along with fat. Semaglutides have been associated with significant loss of lean body mass along with the fat tissue most people are trying to get rid of.

This is natural, and to be expected. It’s exactly what happens when people try to lose weight simply by reducing calorie intake without a resistance exercise component.

Unless you are willing to hit the gym on a regular basis, and consume a healthy amount of protein to help your body repair and construct new muscle tissue, your body transformation could be to go from a large pear-shape to a smaller one.

To counteract this effect, I recommend talking to your doctor about an exercise regime: Specifically, anaerobic resistance training like weightlifting, pushups, squats, lunges, kettlebells, and the like. Anything that gets your muscles burning and allows you to work to muscle failure.

When you do this multiple times per week, and do some walking, running, or swimming on your recovery days, this will help reduce the loss of lean muscle mass, and possibly even result in muscle gain, even as you shed that excess fat. 

Is Wegovy Covered By Insurance? 

That depends on your plan. Insurance coverage for Wegovy can vary significantly, and there are a few things you should know:

1. If Wegovy is on the formulary, your insurance company may require prior authorization and documentation of medical necessity from your doctor. You may then need to demonstrate continued weight loss in order for them to continue paying for your prescription. Which is one more reason to work out regularly, in addition to taking Wegovy as directed and eating healthy foods. 
2. Some plans may require proof of failed weight loss attempts through diet and exercise before covering Wegovy. I recommend doing your best to make progress the natural way, rather than relying on a drug. That said, I know if it were that easy, everyone would already be doing it and we wouldn’t need Wegovy or any other pharmaceutical weight loss assistance. 
3. Even when covered, insurance plans may place Wegovy in a higher tier with significant cost-sharing for patients. So you’ll have some significant out of pocket costs. If this is an issue, you can try going through a drug discount program such as GoodRx. 
4. Generic semaglutide medication is available, which may be available for less than $250 per month. 

FROM OUR BLOG: Can You Use Your HSA to Pay for Medically-Recommended Weight Loss Costs? 

If your healthcare plan doesn’t cover Wegovy, or if you are a member of a health sharing program that allows for more flexibility, there are some financial assistance programs that can help with the cost:

1. Novo Nordisk Patient Assistance Program – The manufacturer of Wegovy, Novo Nordisk, offers a patient assistance program that can provide the medication at no cost to eligible patients based on income and insurance status.
2. Wegovy Savings Card – Novo Nordisk offers a savings card program for eligible patients with private or commercial insurance. With this program, patients may pay as little as $0 for a 28-day supply of Wegovy for up to 13 fills, subject to a maximum savings of $225 per 28-day supply.
3. Pharmacy Discount Programs – Some pharmacies offer discount programs that may provide reduced prices on prescriptions, including Wegovy.
4. Health Savings Accounts (HSAs) and Flexible Spending Accounts:  If you have an HSA, you may be able to use these funds to cover the cost of Wegovy. However, it’s a good idea to ask your doctor for a letter of medical necessity, in case the IRS ever challenges the deduction. 
5. NovoCare – This program by Novo Nordisk provides resources to help with insurance verification, prior authorizations, and coverage, cost, and affordability options.
6. Cash-paying option – For patients with commercial insurance who do not have coverage for Wegovy through their plan,  or for those who are cash-paying, Novo Nordisk offers a reduced price of $650 per 28-day supply. This is something health sharing plan members should look into, as health sharing isn’t insurance and plan members are considered cash payers. 
7. Cash discounts. Some providers offer direct discounts for people paying in cash. Check with your provider or pharmacy. 

 Eligibility criteria and terms may apply to these programs, so patients should contact Novo Nordisk directly or visit their website for the most up-to-date information on what’s available. 

Your healthcare providers may also be able to help you find the most affordable option. Or, don’t hesitate to reach out to your Personal Benefits Manager to get you connected to the right health care program for your specific needs.

Keep in mind that Wegovy is not a miracle drug, and is intended to be used as part of a comprehensive plan that includes a healthy diet and regular exercise. 

Pharmaceuticals always come with risks, which is why I personally recommend a paleo diet, intermittent fasting, and weight lifting. But for some people, this medication may be just the right addition to help you reach your wellness goals.

To Your Health and Wealth,

Wiley P. Long III
President- ColoHealth

The ColoHealth Health & Wealth Newsletter is published monthly and emailed to subscribers at no charge. Subscribe now to stay on top of the critical information you need to know about health insurance, healthshare plans and managing your finances to achieve financial security.

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