The gut health crisis: Impact of GLP-1 medications on digestive wellness

As we know from recent research conducted by the National Institutes of Health, gastrointestinal (GI) conditions remain highly prevalent in the U.S., with 61% of Americans, or nearly 2 in 3, reporting experiencing a GI issue at least once per week. Painful GI symptoms can result from a multitude of things: an unknown allergy, undiagnosed digestive disorder like IBS, GERD or IBD, stress, traveling, or simply not exercising enough. Now, providers and employers are also dealing with GI side effects from popular GLP-1 medications, which are used to treat type 2 diabetes and weight loss. While these drugs have helped millions of Americans overcome the detrimental effects of obesity and diabetes, the digestive symptoms associated with their use have been shown to significantly impact quality of life, creating knock-on effects and costs for employers.

GLP-1 medications: What are they and how are they impacting employers?

Glucagon-like peptide-1, or GLP-1, is a class of medications used to treat type 2 diabetes and obesity. They mimic the GLP-1 hormone, which the body naturally produces to help regulate blood sugar, appetite, and digestion. GLP-1 medications help lower blood glucose levels, prevent the liver from releasing too much sugar into the bloodstream, and increase feelings of fullness by activating areas of the brain to tell the body that it’s full, which, in turn, helps reduce appetite.

According to a recent study by UCLA Health, the number of people in the U.S. who have been prescribed a weight loss drug has increased 40-fold over the past five years. This correlates with the United States’ increasing obesity rate, which is currently 41.9%, double the obesity rate in the 1970s. The rising prevalence of this condition is reflected in the growing overall cost of weight management in the U.S.—more than $173 billion according to the CDC— much of the burden and costs landing on employers’ plates.

Leading employer groups have addressed the cost of GLP-1 medications through a filtered or a tiered approach: first better identifying which employees could benefit from the drug (sometimes in partnership with PBMs via stricter prior-authorization rules), then supporting those patients through their weight-management journeys with offerings beyond the drug. Intuitively, this approach makes sense – not all patients should be on a GLP-1, and those who could benefit from one should be adherent to the pharmacologic regimen for as long as it’s helping with weight loss. One of the biggest issues with these weight-loss drugs as reported by providers and patients alike are the side effects, one of the primary reasons for non-adherence or for patients opting not to use the drugs at all: according to research from the Blue Cross Blue Shield Association, 58% of patients discontinue use before reaching a clinically meaningful health benefit. Most of those side effects are digestive related.

How GLP-1 medications affect the gut

According to Harvard Health, gastrointestinal symptoms like nausea, vomiting, diarrhea, and constipation are by far the most common side effects of GLP-1 drugs. In fact, up to 85%approximately 50% of patients on GLP-1 medications experience GI side effects.

And not only are these GI-related side effects extremely prevalent for GLP-1 users, patients on these medications are at an increased risk of severe symptoms and pathologies, including stomach paralysis, pancreatitis, and bowel obstruction. Researchers have found that people taking GLP-1 drugs were 66% more likely to be diagnosed with gastrointestinal issues than those who were not.

Therefore, when employers consider implementing GLP-1 protocols or accessibility within their organizations, support for GI symptoms must also be a top priority. For employers to ensure the maximum return on their GLP-1 investment, the patients who are a right fit for the drugs need to take them long enough for the intended weight-loss effect to take hold; if nausea, vomiting, diarrhea and other GI symptoms derail the patient journey, then the entire initiative is less effective than expected.

Related: Wegovy, Ozempic and siblings post 39% increase in Q2 sales

GLP-1 side effects are the tip of the iceberg: GI conditions are the biggest problem employers haven’t heard of

The GI adverse effects of GLP-1s are just the tip of the iceberg for employers to examine the true cost of digestive health in their populations. Overall direct health care costs for GI conditions are estimated to be $136 billion each year in the U.S., closely rivaling obesity ($173 billion) and significantly more than heart disease ($113 billion) and mental health disorders ($99 billion).

One in four employees are diagnosed with digestive conditions. Indirect costs include decreased work productivity (by 108 days per year), worker turnover, medical leave (GI is the #2 reason for short-term disability leave), and absenteeism (more than the common cold!). Due to stigma, people with GI issues may not be as open to discussing their conditions, leaving many employer benefit leaders unaware of the prevalence and impact.

The bottom line: patients on GLP-1 medications need gut health tools, and employers can help

As more Americans become GLP-1 patients, it is vital that they are supported in their gut health journey, too. Offering comprehensive, seamless obesity and digestive health support is the best way for employers to address rising costs of both conditions while maximizing their ROI on GLP-1 drugs.

Sam Jactel, Founder and CEO of Ayble Health and Dr. Mythili Pathipati, Chief Medical Officer of Ayble Health