Marisa Peryer, Senior Photographer

73.6 percent of adults in America are overweight with 41.9 percent of adults suffering from obesity. 

Semaglutide, more commonly known as Ozempic, was initially developed to manage Type 2 diabetes. However, it has grown in popularity as a weight loss treatment. As the scope of use for Ozempic continues to grow, its rising costs and limited insurance coverage have made Ozempic difficult to obtain for populations who need it the most.

“About 30 percent of my job is fighting insurance. Medicare does not cover these medicines,” said Brian Wojeck, an assistant professor of medicine in endocrinology at the Yale School of Medicine. “Even with all the powers of my department and Yale at large, my patients that really need and deserve these drugs cannot get started on them.”

Wojeck explained that the lack of accessibility reflects a broader trend in the healthcare system.  Insurance companies often limit coverage for weight-loss medications because they see weight management differently than treatments for chronic diseases like diabetes. 

Oftentimes, these criteria can change over time on the basis of cost. 

“I’ve had plenty of patients that have responded to the medicine. We’re doing great on the medicine. Suddenly insurance is no longer covering it, and patients start regaining weight, and their comorbidities start getting worse,” said Wojeck. 

Obesity, which Ozempic regulates, is often linked with other diseases, Wojeck explained. It can cause and contribute to diabetes, hypertension, cardiovascular diseases, cancers and more. Wojeck added that treating obesity as a primary disease is really important for “the longevity of a good portion of our population.” 

Treating obesity is particularly difficult to manage for those in lower socioeconomic brackets. 

Wojeck pointed to studies showing that processed foods contribute to weight gain. People who work two or three jobs and do not get enough sleep also have a harder time regulating body weight, he added. 

“All these things are working against people of lower socioeconomic status,” Wojeck said. 

Without coverage, Ozempic costs $936 per month, making it inaccessible to the populations that need it the most. This can force physicians to consider alternative ways to address obesity with treatments that patients may be less fit for. 

To address Ozempic inaccessibility, many pharmaceutical companies distribute cheaper alternatives, which may not be as safe. 

“Many compounding pharmacies have sprung up to make versions of these drugs available, however the quality of these preparations may be uneven, which might pose a safety concern in some cases,” said Dr. Daniel Drucker, a Canadian endocrinologist was one of the first investigators to discover GLP-1, the functional hormone that semaglutide acts upon, and to demonstrate the drugs’ weight loss capabilities.

The availability of Ozempic can also open many doors for patients who previously did not qualify for specific surgeries. 

Dr. Daniel Wiznia ’06, the co-director of Yale’s Avascular Necrosis Program, said Ozempic can reduce the risk for orthopedic and bariatric procedures. 

Additional positive effects of Ozempic include improving cardiovascular health and kidney health, according to Wiznia. When coupled with weight loss, these factors can help decrease the possibility of surgical complications. 

“One of the levers that we can pull is getting patients’ blood sugars under control and getting patients to lose weight,” Wiznia said. “If your blood sugars are high throughout surgery, you’re at higher risk of infection, blood clot, poor wound healing, delayed wound healing and drainage from the wound.”

Wiznia shared the same frustration about insurance not covering his patient’s use of Ozempic before surgery. 

Wiznia explained that with the use of Ozempic, patients who were previously not eligible for surgery now meet the requirements for the procedure safely. Yet, as some patients do not qualify for Ozempic, they subsequently do not qualify for surgeries.

By 2030, it is estimated that one in two adults will be obese.