In the United States, obesity has become increasingly common and impactful, yet it took over four decades before bariatric surgery was included as a covered treatment under Medicare. This delay meant that countless Americans suffered and even died from conditions related to obesity while waiting for access to crucial care.
Let’s not allow history to repeat itself when it comes to obesity medications.
Back in the early 2000s, I wasn’t on Medicare, but after successfully undergoing bariatric surgery, I found myself advocating for access to such procedures for older Americans. Now, two decades later, I feel as if I’m still fighting for those I once marched for. Many continue to live with obesity and lack access to the most effective treatments available. It’s crucial for federal policymakers to ensure that all Americans, particularly those on Medicare, can access safe and effective, FDA-approved obesity treatments.
Things have definitely changed since my march through the halls of Congress. Years later, I had to remove the stomach band due to complications, and I quickly regained the weight I had lost. I know I’m not the only one who has faced this kind of struggle. Over the past 20 years, the percentage of adults who are obese in the U.S. has risen by more than 10%, and projections suggest it could exceed 50% in the next five years.
This isn’t just a matter of numbers. It means millions of Americans are dealing with a decreased quality of life and shorter life expectancies. The strain on the healthcare system is palpable, leading to costs of around $173 billion each year due to obesity alone. When you factor in related health issues like heart disease and strokes, the economic toll climbs higher, resulting in productivity losses of $168 billion and healthcare costs amounting to $254 billion annually.
But there’s some hope. The innovation economy in the U.S. is responding to this urgent crisis. Ongoing investments in new technologies and significant R&D have led to the emergence of GLP-1 medications—drugs that not only offer unprecedented weight loss results but also enhance cardiovascular health and lower the risk of diabetes. They genuinely help improve lives.
So why is it so difficult for me and many other Americans to obtain these life-changing FDA-approved treatments?
Sadly, Medicare remains stuck in an antiquated policy that disallows coverage for obesity drugs under the Part D prescription program. Although obesity is recognized as a complex disease by the American Medical Association, many federal agencies and states still adhere to policies that don’t keep pace with healthcare advancements.
This results in over two-thirds of Medicare beneficiaries with obesity, like myself, unable to access or afford these essential treatments.
When I could no longer count on my stomach band to manage my weight safely, I turned to GLP-1 medications to address my obesity. However, because of the outdated Medicare regulations, the treatment would cost me over $1,000 monthly—a price that’s simply beyond reach.
Fortunately, I was able to obtain tilzepatide through a personalized pharmacy formulation that I could afford due to another medication I require. The results were immediate. Since starting the treatment, my condition has improved significantly. I can prepare meals for my family, run errands, and even walk 5,000 steps a day. Experiencing the positive effects of this treatment firsthand has shown me how vital it is for all Americans needing these resources.
The commitment to “make America healthy again” needs to focus on increasing access to innovative treatments for obesity. Earlier this year, the Trump administration opted not to move forward with a proposal aimed at expanding Medicare’s coverage for obesity treatments. However, a spokesperson suggested that they may consider policy changes after a thorough review. It’s imperative that this policy is carefully examined, as many lives are at stake.
Additionally, some federal lawmakers have introduced the bipartisan Obesity Act, which aims to provide Medicare beneficiaries access to safe and effective tools for managing obesity. As someone who relies on Medicare, I urge lawmakers in Washington to push these policies forward, equipping beneficiaries with the necessary tools to combat this obesity crisis.
We can’t overlook the remarkable scientific breakthroughs we’ve witnessed in obesity management. Every American deserves the chance to lead a healthy and fulfilling life. Ignoring obesity isn’t an option.
