2. Obesity is a growing epidemic in the United States. By 2030, it is estimated that 1 in 2 adults will
have obesity. As one of the largest sponsors of healthcare, employers are ultimately left to shoulder
the burden of rising costs associated with obesity and weight-related comorbidities. In fact, employers
spend over two times more per year in medical, sick day, short-term disability, and workers’
compensation claims on an employee with obesity compared to an employee at a healthy weight.
While many employers offer wellness and weight management programs aimed at promoting weight
loss, these benefits are often ineffective due to poor participation, negative employee perceptions,
and barriers to care.
A new class of anti-obesity medications known as GLP-1s are transforming the treatment landscape.
Studies have shown that the most recently approved GLP-1s can help patients achieve dramatic results
with up to 15% loss in body weight, which has led to a surge in demand. Next-generation therapies are
already in development and show even more profound results in clinical trials. FDA approval of these
agents is anticipated in the next 1 to 3 years.
Due to the effectiveness of these breakthrough medications, 47% of U.S. adults who have heard
about weight loss medications said they are interested in trying them. As the demand continues to
grow rapidly, employers are under increasing pressure to respond. But they must first answer two
important questions: can the potential benefits of workforce weight loss, including direct and indirect
cost savings for the company, justify the high cost of covering GLP-1s? And if someone is taking a
GLP-1, is it a forever medication?
This guide will reveal the potential benefits of GLP-1s, why they may not be for everyone, and the
importance of a multidisciplinary, stepped care approach to sustain long-term health outcomes
and control costs.
U.S. adults will have
obesity by 2030
of U.S. adults who have heard
about weight loss medications
are interested in trying them
employers spend 2X more
on employees with obesity than
employees at a healthy weight
Obesity is driving the demand for GLP-1s—
and it’s costing employers.
The Employers’ Guide to GLP-1s | 2
3. For decades, individuals struggling with obesity have faced limited treatment options. Traditional diet
programs, while noninvasive, have failed to produce clinically significant weight loss (defined as 5% or
more reduction in body weight sustained over the long term). Surgeries such as sleeve gastrectomy and
gastric bypass have demonstrated strong clinical efficacy. However, only 1% of the eligible population
chooses to undergo surgical treatment due to safety concerns. In the absence of effective, accessible
treatment options, the obesity epidemic has continued to worsen.
GLP-1s offer hope for treatment that is effective, yet noninvasive. Clinical trials have shown that
one GLP-1 medication in particular helped participants achieve an average of 12.4% weight loss at
68 weeks of treatment versus placebo. GLP-1s can play a powerful role in overcoming the body’s
biological barriers to weight loss. No matter how healthy some people eat or how much they exercise,
they hit a plateau. Others have cravings as soon as they start to lose weight. Why? Due to metabolic
adaptation—the many hormones that regulate appetite and weight kick in to block further weight
loss. Even with a proven behavior change program like Noom—which has helped 57% of members
with obesity achieve 5% or more weight loss1
—we recognize that for a subset of users, biology plays a
role that psychology alone cannot solve. GLP-1s help people overcome these biological barriers, while
encouraging healthier long-term habits by building confidence and providing hope.
The treatment gap is beginning to close with
groundbreaking anti-obesity medications
Lap Band Gastric Bypass/Sleeve
GOOD EFFICACY BUT
RISKY & INVASIVE
Closing the treatment gap.
The Employers’ Guide to GLP-1s | 3
4. While GLP-1s have surged in popularity over the
past year for their weight loss benefits, GLP-1s
have been around for nearly 20 years. In 2005,
Exenatide became the first GLP-1 approved by the
FDA to treat type 2 diabetes; additional GLP-1s for
type 2 diabetes soon followed. These medications
work by mimicking incretin—a hormone that
regulates the amount of insulin released into the
blood after eating. When blood sugar levels start
to rise after someone eats, GLP-1s stimulate the
body to produce more insulin. The extra insulin
keeps blood sugar at normal levels, which in turn
helps control type 2 diabetes. Because GLP-1s are
so effective, the American Diabetes Association
now recommends GLP-1s over insulin as the
first injectable for the majority of patients with
type 2 diabetes.
Over time, researchers noticed GLP-1s seemed
to decrease appetite and promote weight
loss, leading to its testing as an anti-obesity
medication. In 2014, Saxenda became the first
FDA-approved GLP-1 for weight loss in adults with
obesity. The medication works by targeting areas
of the brain that regulate appetite and prompts
the stomach to empty more slowly, making
people feel fuller faster and for longer. In 2021,
Wegovy became the second GLP-1 approved
by the FDA to treat obesity.
A landmark study published in the
New England Journal of Medicine
in 2021 found that patients taking
Wegovy lost an average of 15% of
their body weight within 15 months.
Because of its impressive weight
loss results, Wegovy is considered a
major medical breakthrough in the
treatment of obesity.
GLP-1s have proven effective for weight loss, but
not all obesity is the same—and not everyone
with a high BMI needs medication. Just like any
disease, obesity has many underlying causes
and contributing factors, including genetics
and epigenetics, other underlying medical
conditions, hormones, obesogenic medications,
mental health, social determinants of health,
and much more. BMI can be a helpful starting
point to identify patients who may be eligible
for anti-obesity medications, such as GLP-1s,
but BMI alone is an insufficient measure of an
individual’s overall health, risks, and preferences.
A comprehensive evaluation is critical before
patients are prescribed medication.
At Noom, members in Noom Med—our clinical
obesity care program—begin their care journey
with comprehensive lab testing and an in-depth
evaluation by clinicians trained in obesity care.
Clinicians work one-on-one with each member
to develop a care plan based on their unique
clinical profile and needs. Clinicians only
prescribe medications to those who medically
qualify and provide ongoing support to review
progress, monitor side effects, and adjust
dosage as needed. Approximately 60% of
Noom Med members are prescribed medication.2
For members who don’t meet the clinical criteria
for medication or choose not to take one, they
can continue to work with their clinician, who can
help uncover underlying causes of weight gain
and provide a higher level of support.
GLP-1s have been on
the market for years.
One size doesn’t fit all.
The Employers’ Guide to GLP-1s | 4
5. GLP-1s alone aren’t enough to achieve successful and sustainable weight loss. In fact, GLP-1s are
indicated specifically as an adjunct to a reduced calorie diet and increased physical activity. For
patients to see long-term success, GLP-1s need to be paired with lifestyle change—which has been
the cornerstone of obesity treatment. “Medication greases the wheels, but it doesn’t drive the train.
As recommended by the Obesity Medicine Association, nutrition, physical activity, behavior, and
medication management have to work together to achieve long-term health outcomes,” said
Linda Anegawa, a board-certified physician in obesity medicine and Chief of Medicine at Noom.
Beneficial lifestyle interventions for weight loss include behavior change to adapt to a lifestyle of
healthier eating and regular physical activity, learning about eating triggers and adjusting thought
patterns, stress management, and improving sleep habits. At Noom, our clinicians pair personalized,
evidence-based clinical care—which includes medications as appropriate—with our proven behavior
change program to help members overcome the biological and psychological barriers to weight loss.
The result? Members are empowered with the biological support to jumpstart weight loss with the
long-term behavior change to make it last.
In a recent study where Noom supported over
65,000 patients on Saxenda, we found that
members achieve 3X more weight loss at
6 months and 6X more weight loss at 12 months
when engaged in Noom’s behavior change
program plus medication (Saxenda), compared
to medication alone.3
Noom + Saxenda Noom without Saxenda Saxenda without Noom
At 6 months
At 12 months
The Employers’ Guide to GLP-1s | 5
6. Given obesity is a chronic disease, does that mean GLP-1s are a lifelong commitment? Not necessarily.
While a segment of the population may inevitably need GLP-1s long-term due to complex biological
factors, coupling GLP-1s with behavior change can minimize the number of individuals that remain on
medication for an indefinite period of time. These medications can be an effective tool to jumpstart
weight loss and encourage compliance with lifestyle change measures, but they should be prescribed
with the intention of off-ramping, as appropriate.
At Noom, when we prescribe GLP-1s and other anti-obesity medications, our goal is to match medication
duration with patient need. Our clinicians work closely with each member to determine if and when
they can safely taper off of medication based on their individual clinical needs and progress. When
the clinician and member decide that the member is ready to taper off, they step down and continue
in the behavior change program for longitudinal support sustaining their health outcomes. We expect
to reduce GLP-1 use by at least 40% over a 2-year period by prescribing and tapering members off of
medication when appropriate.4
Are GLP-1s a forever medication?
The Employers’ Guide to GLP-1s | 6
7. Recent data shows that 2 in 3 large employers have been covering medications
for obesity for at least 3 years. As the demand for GLP-1s continues to increase,
it’s no surprise that GLP-1 drugs are now among the top-cost drugs for employers.
The net cost for every person on Wegovy is about $9,000 per year. If just half of
those eligible sought GLP-1s for weight loss, prescription costs could increase by
more than $840 per member per year across the entire population. According
to research from Morgan Stanley, anti-obesity medications will also encourage
more people to seek treatment for obesity—estimated at 25% compared to only
7% today. Now more than ever, employers need a proactive GLP-1 strategy to
eliminate unnecessary spend and reduce overall healthcare costs.
HOW EMPLOYERS CAN
CONTROL GLP-1 SPEND
GLP-1 coverage guidelines
Provide obesity care benefits
based on a stepped care model
Partner with providers who
practice evidence-based care
At Noom, we support organizations in all of these
areas. Our unique care model pairs a broad
spectrum of care with personalized support that
is tailored to each member’s unique biology and
lifestyle. Members are guided to the right care at
the right time—only stepping up to medication as
appropriate to match the right level of investment
to the best health outcome.
With Noom, we make it easy to prove the ROI of
your obesity care investment. There’s no upfront
cost to offer our program to your population. You
only pay for the outcomes that matter—including
initial weight loss and maintained weight loss
after medication. All of this supports our ability
to help employers contain costs while improving
Controlling the cost curve.
The Employers’ Guide to GLP-1s | 7
8. To learn more about how Noom can help organizations
drive total population health outcomes, visit us at
Noom internal database analysis.
Noom Med preliminary internal analysis.
Feasibility Assessment of Weight Loss Outcomes of Saxenda
Users vs Non-Users Enrolled in the Noom Program, 2018-2021.
Noom Med internal ROI analysis.
Want to learn more?
The Employers’ Guide to GLP-1s