Healthy Returns: Employers aren't expanding coverage of GLP-1 obesity drugs – many are finding ways around it

Photo illustration of a group of weight loss medications on a white background.

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As new GLP-1 drugs enter the U.S. market and landmark Medicare coverage rolls out, one thing remains the same: Most employers still aren't covering those drugs for weight loss.

Many health plans are actually finding ways around it.

"It's a battle to try to keep costs down," Justin Held, director of educational programs at the International Foundation of Employee Benefit Plans, said in an interview. "It seems like they're not necessarily offering coverage for weight loss, but they're instead focusing on how to support the overall health of their workers."

The findings are from a survey released Tuesday by that nonprofit organization, IFEBP, which includes more than 33,000 member companies or public institutions. It was conducted in June on almost 300 employer health plans in the U.S.

Around 36% of employers said they provide coverage of GLP-1s for both diabetes and weight loss, the same as 2025 and up from 34% in 2024, the survey said.

Meanwhile, 60% of employers said they offer coverage for diabetes only, up from 55% in 2025 and 57% in 2024. Roughly 45% of plans said they cover GLP-1s for other approved conditions, such as obstructive sleep apnea and heart disease.

The fact that employer coverage of weight loss is flat compared to last year is no surprise.

Health plans have long balked at the high costs involved with covering GLP-1 drugs from Eli Lilly and Novo Nordisk, especially as demand soars in the U.S. To curb costs, plans have restricted coverage or stopped it entirely.

Cost remains a primary driver in employer decisions around GLP-1 coverage, Held said. In 2026, respondents said the drugs accounted for 11.4% of annual claims, up from 6.9% in 2023.

But employers are finding other ways to support workers who want to use those drugs.

"The cost burden is so great that they're saying, there's other ways you can do this while still wanting to use those benefits to recruit and retain those folks," Held said.

Around 27% of employers encourage employees to obtain GLP-1s through a direct-to-consumer platform, while 21% are pushing workers to use their FSA, HSA or integrated HRA dollars for the treatments.

Held said as costs go up, it becomes a "great opportunity for employers to communicate the benefits that they're already offering in this space."

For example, 74% of plans said they offer disease and chronic care management, 61% provide nutritional counseling, and another 61% offer bariatric surgery. Employers said they also cover benefits such as lifestyle modification programs, other non-GLP-1 drugs and medication-free interventions for weight loss.

So, what will it take for more employers to adopt coverage of GLP-1s for obesity and foot the bill?

What could move the needle, according to Held, is evidence that covering those drugs ultimately reduces costs in other areas. That might look like fewer knee replacements and bariatric surgeries or higher productivity and better wellness outcomes.

"If those things are happening, then they might say it's worth it to offer full coverage for weight loss as well, because the impact on the other areas of our organization is so positive," he said. "But we just haven't seen that yet."

While some studies and estimates suggest that the downstream savings of GLP-1 could offset the high costs to the health-care system, there has yet to be any widespread measured proof of that based on real-world data.

We may get a first glimpse of what savings are like after a newly launched 18-month program that is allowing Medicare to cover GLP-1s for obesity for the first time.

Until then, around 9% of employers are considering adopting coverage of GLP-1s for obesity. We'll keep watching to see how that might change over time.

Feel free to send any tips, suggestions, story ideas and data to Annika at a new email: [email protected].