Obesity is not a choice or a moral failing. It is a chronic, multifactorial disease with metabolic, behavioral, psychological, and environmental underpinnings. As employers, benefits managers, and health plan stewards, you must ask: Do you have all the pieces you need to manage obesity effectively? Offering a single tool will rarely suffice.

What Is a Weight Management & Metabolic Health Program?

A weight management and metabolic health program is a coordinated intervention set designed to address obesity and its underlying metabolic irregularities over time. These programs typically combine:

• Clinical evaluation of metabolic markers (for example, insulin resistance, lipid profiles, inflammation) ¹
• Nutritional counseling customized to metabolic needs
• Frequent and ongoing monitoring, follow-up, and adjustment
• Behavior change support, including coaching and psychological or mental health resources
• Physical activity and exercise guidance to preserve muscle and improve metabolism
• Medication support when clinically appropriate (including GLP-1 or including obesity GLP-1 agonists and other weight loss agents) ³

A high-performing program does not treat obesity simply as excess weight. Instead, it views obesity as a chronic disease that requires continuous management and adaptation.

Direct Primary Care

Obesity affects more than 40 percent of U.S. adults and is a major contributor to type 2 diabetes, cardiovascular disease, nonalcoholic fatty liver disease, certain cancers, osteoarthritis, and sleep apnea¹. Recognizing obesity as a disease rather than a behavioral failure shifts the paradigm. It demands a coordinated multi-pronged strategy, not a simplistic “eat less, move more” approach.

The causes of obesity are complex. Genetic predisposition, hormonal dysregulation, gut microbiota, psychosocial stressors, sleep disruption, food environment, and socioeconomic factors all play roles². Because of this complexity, no single solution such as a pill or injection can resolve the disease in isolation.

GLP-1 medications such as semaglutide and tirzepatide have demonstrated promising results in clinical trials for weight loss and improvements in metabolic health markers³. However, real-world adoption, drug discontinuation, and weight regain remain significant challenges. One analysis found that more than 50 percent of patients using GLP-1s for weight management stopped treatment within 12 months³. After discontinuation, biological adaptations lead many to regain much of the lost weight within a year. These patterns underscore that GLP-1s are powerful but only one piece of a broader strategy.

The Cost and Employer Dilemma

Employers contemplating coverage for GLP-1s face a difficult tradeoff. On one hand, these medications are expensive and can significantly increase pharmacy spending. A recent survey indicated employers are rethinking their strategy and many employers covering these medications today are considering a change. High discontinuation rates and uncertain long-term value make ROI calculations complex.

On the other hand, effective obesity management and improved metabolic health can reduce downstream costs associated with diabetes, cardiovascular disease, joint issues, and productivity loss⁴. Employers must decide whether to cover GLP-1s, and if they do not, how else to invest in comprehensive wellness and chronic condition management programs.

Benefits to Patients and Providers

For Patients

• Improved metabolic outcomes, including better insulin sensitivity and blood pressure
• Sustainable weight loss when combined with behavioral interventions
• Reduced risk of obesity-related comorbidities
• Enhanced quality of life, mobility, and mental well-being
• Lower likelihood of requiring invasive procedures such as bariatric surgery

Programs that integrate behavioral and psychological support help patients address emotional eating, stress, and motivation, which are often critical to long-term success.

For Providers

• Structured care pathways for chronic obesity management
• Data and feedback loops that allow for continuous monitoring and early intervention
• Clearer alignment with evidence-based best practices
• More efficient coordination between primary care, nutritionists, and behavioral specialists

Providers participating in holistic programs are better positioned to support patients in achieving sustainable outcomes rather than focusing solely on short-term weight loss².

Key Questions for Your Point Solution

When evaluating or designing a weight management and metabolic health program, consider the following questions:

1. Does the program address underlying metabolic dysfunction rather than just weight loss?
2. Are healthy behaviors supported over time, not only during initial engagement?
3. Is psychological or behavioral support part of the design?
4. If medications such as GLP-1s are offered, are they integrated within a structured clinical framework?
5. Does the program emphasize preservation of lean muscle mass through physical activity and nutrition?
6. Is there flexibility to adapt the program as patient needs and results evolve?
7. Do providers have sufficient training and resources to sustain engagement?
8. Is there a clear cost-benefit analysis and a defined measurement strategy for ROI?

Takeaways & Recommendations

Effectively addressing obesity requires viewing it through the same lens as other chronic diseases, with a long-term management strategy rather than a quick fix. Employers, providers, and health plan leaders must recognize that no single intervention can succeed in isolation. A comprehensive weight management and metabolic health approach combines medical treatment, behavioral support, nutrition, and ongoing engagement. While GLP-1 therapies have shown promise, they are only one component of a multifaceted solution. Without lifestyle changes and behavioral health integration, the long-term success of these medications is limited. Employers evaluating whether to cover GLP-1s should consider both the financial implications and the broader care framework necessary for success. Those that do offer coverage can maximize outcomes by ensuring these medications are paired with coaching, nutritional counseling, and continued follow-up. For those unable to include them, investing in alternative wellness initiatives and chronic condition management programs can still demonstrate support for employee health. Ultimately, effective obesity management depends on aligning all available tools (clinical, behavioral, educational, and organizational) to create a system that promotes sustainable metabolic health over time⁵.

¹FAIR Health. (2024). Obesity and GLP-1 Drugs: A FAIR Health White Paper. Retrieved from https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/Obesity%20and%20GLP-1%20Drugs%20-%20A%20FAIR%20Health%20White%20Paper.pdf
²McKinsey Health Institute. (2025). The Path Toward a Metabolic Health Revolution. Retrieved from https://www.mckinsey.com/mhi/our-insights/the-path-toward-a-metabolic-health-revolution
³American Journal of Clinical Nutrition. (2025). GLP-1 Clinical Trial Findings. Retrieved from https://ajcn.nutrition.org/article/S0002-9165%2825%2900240-0/fulltext
⁴Cigna/Evernorth. (2024). Employer Strategies for Sustainable GLP-1 Coverage. Retrieved from https://newsroom.cigna.com/employer-strategies-for-sustainable-glp1-coverage
⁵Luminare Health. (2025). GLP-1s and the Cost of Obesity. Retrieved from https://www.luminarehealth.com/site/media/Files/LH-3270-White-Paper_GLP-1s.pdf