How employers can address obesity through a health equity lens

The obesity crisis is a growing business and health challenge for employers. A recent study from the Milken Institute found that obesity and overweight factors among employees in the nonfarm civilian workforce cost about $425.5 billion, including a combined $146.5 billion in higher medical costs to employers ($89.8 billion) and employees ($56.7 billion). Meanwhile, the rise in GLP-1s and other weight loss medications have rapidly broken into the mainstream national conversation, leading to a shortage for some brands and some new limitations in coverage. As a result, those who most need the medications are losing access.

The effect of the crisis is even more profound considering that obesity is a sign of deeply rooted health and racial inequities linked to income levels, education, geographic location and more. According to a study from the Kaiser Family Foundation, obesity rates are higher for Black (43%), Native Hawaiian and Other Pacific Islander (43%), American Indian and Alaska Native (39%), and Hispanic (37%) populations than White adults (32%).

Virtual primary care

Amid shortages of GLP-1s and varying clinical needs, employers can pave the way for a more equitable approach to weight management and treating obesity. Virtual primary care is a key enabler because it allows for accessible, highly personalized care for employees at scale and combats the effects of health care deserts.

Health care deserts hinder access to critical services in many areas of the country. Research shows that more than a third of the population lives in an area that lacks access to health care services such as primary care providers and hospitals. The impact of deserts is magnified in specialized fields such as obesity medicine, underscoring the role of virtual services in expanding access.

If designed well, virtual care appointments can facilitate continuous checkpoints with the same trusted physicians, keeping care consistent, personal and creating mutual accountability between the physician and patient. In a 2021 study that compared 2019 and 2020 telehealth usage, appointment no-show rates for nonsurgical specialties decreased, suggesting televisits can improve patient access. Virtual primary care can also provide greater access to nutrition and exercise counseling that is proven to augment GLP-1s and, if linked to food delivery services, can overcome food deserts in underserved populations.

Doctors continue to expand their virtual care access. A study surveying physicians on virtual care adoption found that 84% of the sample utilized virtual care at least weekly, with 40% using it daily. The trend is even more prominent in younger physicians ages 49 and under, according to the same study. In my own safety net practice in Washington D.C., I offer virtual care options, particularly for follow-up visits and mental health appointments.

Virtual care does present new challenges in terms of tracking the lifestyle changes that patients must make to graduate from medications, but there are solutions. By incorporating online features such as Bluetooth weighing scales and glucometers, these gaps can be mitigated.

Access to supplemental weight management tools

With the majority of weight management happening outside of the doctors’ office, it’s advantageous for employers to provide additional weight loss tools to employees.

The high demand for GLP-1s, as well as ongoing advisement on weight management, necessitates services outside of traditional methods of care to stay on track and create lifestyle changes that work in tandem with medication.

For patients with type 2 diabetes, for example, many patients are unaware that reversal is possible, or they are aware but don’t have access to physicians that offer this kind of specialized support. Research-backed companies like Virta provide highly individualized, virtual approaches to diet and lifestyle changes that can overcome these barriers.

Similarly, Noom’s clinical obesity management solution leverages psychology and science to drive behavioral change for individuals’ weight loss journeys. This virtual supplementary care combats the challenge that many patients face surrounding the lack of access to nutritionists and coaching due to a variety of factors – from provider shortages to difficulty making appointments.

As the physician shortage continues to put strain on access to care across the country, employers can look to benefits that supplement traditional care and keep patients engaged and on the right path in between visits.

Related: Inflation, weight loss drugs drive ACA premiums higher

Specialized physicians

While virtual care is critical to achieving equitable weight management, it is also imperative that the physicians providing this care are specifically trained on the subject. Doctors that have completed specialized training in GLP-1 prescribing and utilize clinically driven protocols to provide the most accurate care and guidance possible have the necessary experience to offer insight and research-backed advice to patients.

The science of GLP-1s continues to evolve with new medications and new indications, but barriers to access due to payer coverage and prior authorization changes persist alongside this growth. By utilizing specialized care teams, employers can ensure that their employees are benefitting from the latest progress within GLP-1s without encountering unnecessary hurdles to access.

The increasing demand for weight-loss medications will continue to permeate throughout the country, putting pressure on employers to meet increasing demand among employees while also working to manage costs. By utilizing innovative approaches to how care is delivered and monitored through providers, employers can maximize the health and wellness of their employee base while improving health equity.

Dr. Shantanu Nundy, Chief Health Officer, Accolade