How Would the New Administration’s Nominations Impact Obesity Care?

Feb. 4, 2025
Expert notes that insurance coverage remains poor for obesity as a medical condition

President Trump’s nomination of Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services (CMS) has generated buzz across the healthcare industry. When it comes to obesity treatment, Medicare and Medicaid only cover Ozempic for diabetes treatment – not for off-label use like obesity. With obesity care coverage limited, and with Robert F. Kennedy Jr. (RFK), a known opposer to Ozempic and obesity treatments beyond lifestyle changes, to become Secretary of Health and Human Services (HHS), the future of accessible obesity care is unknown. 

Brooke Boyarsky Pratt, CEO and co-founder of knownwell, a primary care company specializing in obesity, recently spoke with Healthcare Innovation about the potential impact on obesity care with the current administration’s nominations. 

What does the current landscape look like regarding obesity treatment?

More physicians are becoming certified in obesity medicine than ever before. Last October, the largest class in U.S. history passed their board certification test, bringing the total number of ABOM (American Board of Obesity Medicine) certified physicians to just under 10,000. Still, it is a major challenge for providers to source qualified specialists to treat patients with unmet needs through generalized primary care.   

Many telehealth companies now prescribe GLP-1 medication, which, on the positive side, has increased access. However, with the rise in telehealth providers, there is less focus on comprehensive, long-term obesity care.

Compounded GLP-1s are not tested for safety or efficacy, and just as concerningly, are being prescribed online by many companies through a patient taking an asynchronous survey. This risks unsafe medication being prescribed to patients who are not appropriate for GLP-1s. 

Insurance coverage remains poor for obesity as a medical condition for many patients. 

Could you talk about future obesity treatment coverage under Medicaid and Medicare?

As more research is published about the health benefits associated with GLP-1s, like sleep apnea, heart disease, and Alzheimer’s, I expect increased access for those seeking treatment coverage under Medicaid and Medicare. TROA, the Treat and Reduce Obesity Act, is also receiving broader support in congress.

There has been a lot of progress in the last year or so for the obesity care movement. Today, more doctors are going beyond the outdated measure of BMI to diagnose obesity. Plus, more pediatric patients have access to proper obesity care than ever before, propelled by the Academy of Pediatrics’ recent recommendation of weight-loss drugs for some younger patients.

U.S. obesity rates have also dropped for the first time in a decade. There is still much progress to be made, but with the movement heading in a positive direction, more and more people will finally receive the care they deserve.

However, Medicare and Medicaid programs are all citing concerns about GLP-1 costs.

What could Dr. Oz's and RFK’s appointments mean for the future of obesity coverage?

From their public statements, Dr. Oz and RFK Jr. appear focused on the comprehensive treatment of obesity.

Otherwise, it is too early to say, though we know an important aspect of Making America Health Again is comprehensive obesity coverage.

Over 100 million patients are insured through either Medicaid or Medicare, and over 70 percent of these patients are overweight or obese. Ensuring that these patients have coverage for evidence-based, effective obesity treatment is critical not only for these patients but also for the health of the U.S. population at large.

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