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Obesity is one of the most urgent public health and workforce challenges. A complex metabolic disease shaped by genetics, hormones, metabolism, socioeconomic factors, and environment, it’s closely tied to Type 2 diabetes and other high-cost conditions.
Obesity is the only major chronic condition that is not routinely covered by health plans. Though the AMA recognized obesity as a disease in 2013, it's still seen by many as a personal failing, fueling policies that restrict treatment and ignore the true costs of obesity. We need to move from blame to biology.
Excluding it from coverage harms health and business outcomes
Obesity raises the risk of over 200 conditions, including Type 2 diabetes (nearly 90% of people with Type 2 diabetes have overweight or obesity), heart disease, stroke, and 40% of cancers.
Treating obesity cuts the cost curve in half
Obesity costs employers $12,735/year in medical, absenteeism, presenteeism, and disability expenses, while OMMs coverage only costs $6,000/year. Tirzepatide has been shown to reduce the incidence of developing Type 2 diabetes by 94%. On average, people with diabetes incur annual medical expenditures of $19,736, of which approximately $12,022 is attributable to diabetes. After 2 years the medical cost trend of a patient taking GLP-1s was half that of the control group driven largely by a 44% reduction in major adverse cardiac events.
Obesity care must be inclusive and responsive to these disparities
Class II and III obesity disproportionately affect Black and Hispanic adults. Social determinants of health like income, education, and food access play a role and must be considered in care approaches.
While diet and exercise are key components of obesity management, they aren’t enough for everyone. Most people regain lost weight within two years—highlighting the need for lasting solutions. Employers can lead the fight against obesity by offering equitable, evidence-based care that includes covering lifestyle therapy, medications, and surgery—treatments proven to improve health and reduce long-term costs. Even modest weight loss (5-10%) provides major health benefits. Coverage of these proven treatments is lagging far behind the science.
Counseling options are effective and underused
Counseling that provides education and support facilitates long-term weight management. Medical nutritional therapy (MNT) offers structured dietary guidance, while intensive behavioral therapy (IBT) helps change habits and behaviors. These therapies are inexpensive, yet access to them is limited by most health plans.
OMMs are often covered for diabetes, not obesity
GLP-1s are hormone replacements that provide on average 14-25% weight loss. In addition, tirzepatide was shown to reduce Type 2 diabetes risk by up to 94%. These medications work better when combined with lifestyle management.
Patients still need medication and lifestyle management with surgery
Surgery is the most expensive treatment and yet the most commonly covered. Without lifestyle management and medications post-surgery, weight regain is common.
Bias and stigma aren’t just personal; they’re built into systems
Despite the data, obesity remains vastly under-treated—largely due to stigma and misconceptions. Bias shows up in hiring, wages, healthcare, and wellness programs. It delays diagnoses, limits treatment access, and harms mental health, triggering stress responses that worsen obesity and chronic disease. Employers have an opportunity to shift the narrative by fostering weight-inclusive cultures. That includes recognizing weight bias, addressing bullying through policy, and designing wellness efforts that focus on health, not weight. Treating obesity starts with treating people with respect.
Support health for all with inclusive, proven programsWellness programs should focus on reducing health risks like high blood pressure or A1C, not pounds lost, and reward healthy behaviors such as exercise and good nutrition. Employers should make wellness accessible to everyone by offering nutritious food options at work events, ensuring stairwells are safe and inviting, and creating a culture that supports all body sizes and health needs. Inclusive, stigma-free programs benefit all employees, at every size and health status.
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