States & Healthcare Insurance Companies Are Stopping Weight Loss Drugs Coverage

Over the weekend, I read that the state of North Carolina is cutting off coverage of anti-obesity medications for state employees, citing soaring costs and a lack of agreement on pricing from drugmakers.

These anti-obesity injectable weight loss drugs are the rage from the Hollywood elite to shoppers at your neighborhood bodega.  

Case in point: last year, at this time, I didn’t know anyone on these drugs. Last week, three friends told me they were either using or had taken the drugs. And all three knew countless other people using them.

These drugs work by making people feel fuller and eat less, with some side effects. Two of my friends admitted they suffered from diarrhea and stomach pain while using the drugs.

According to reports, patients who took the highest dose of Mounjaro, a diabetes drug from Eli Lilly Co. that’s in testing as an obesity treatment, lost an average of 50 pounds.

North Carolina’s decision affects a class of drugs known as GLP-1s, which treat diabetes and help with weight loss. Medications like Wegovy, Ozempic, and Zepbound have soared in popularity but are expensive and require long-term use.

According to Forbes, many more state-backed plans don’t cover GLP-1s for weight loss, but the ones that do are trying to limit rapidly increasing costs. 

Connecticut introduced a trial lifestyle-management program for state employees seeking the drugs for weight-loss treatment in July after spending on the class rose 50% annually since 2020. Virginia tightened restrictions on which Medicaid enrollees can receive them for obesity.

When Ozempic is prescribed off-label for weight loss, it is often not covered by insurance. Why? Because the Affordable Care Act doesn’t mandate that health insurers cover obesity or overweight medications or surgeries.

Due to increasing costs, some health insurance companies and employers are also halting coverage of Ozempic, Wegovy, and GLP-1 drugs.

The private healthcare system Ascension stopped coverage on July 1, 2023, stating that weight loss and anti-obesity drugs will no longer be covered in its pharmacy benefit to its nearly 140,000 employees.

What does this mean to people taking the drug? 

My friends using Ozempic and Mounjaro lost significant weight, but their insurance stopped covering the cost after six months. Without insurance, the average monthly price of Mounjaro is between $1,000 to $1,200, depending on the pharmacy. All three have gained back the weight they lost. 

Routinely, when Ozempic is prescribed off-label for weight loss, insurance does not cover it. Why? Because the Affordable Care Act doesn’t mandate that health insurers cover obesity or overweight medications or surgeries.

If your health insurance no longer covers your prescription, is Noom or Weight Watchers a solution?

 Although most of my friends think weight loss companies adding weight loss drugs to their arsenal is a cop-out, if you can no longer afford these drugs, these weight loss programs might help with weight loss maintenance. 

Let’s start with Noom. For years, Noom has promoted itself as a psychological path to weight loss. Now, Noom believes adding these injectable drugs to your program makes the outcomes much better.  

WeightWatchers members can also get weight loss drugs. The WeightWatchers telehealth clinic: a reworked version of Sequence’s telehealth services.

After Oprah appeared on the Red Carpet promoting The Color Purple, people speculated about her weight management. Oprah told People magazine that she’s using one of the weight loss drugs that are commercially known as Ozempic, Wegovy, or Mounjaro.

Sadly, many one-time dieters see results from injectable weight loss drugs as far more reliable and easily obtained than from these habit-changing programs. But many of my friends who are desperately trying to lose weight feel taking these drugs is cheating. The weight loss industry has brainwashed them into believing weight loss is about willpower. I believe it’s about an individual’s body chemistry. Many people have a physical addiction to the fat, salt, and sugar formulas of popular foods. These people can’t stop at one potato chip; they eat the entire bag. Other people suffer from obsessive thoughts about food, which Rosie O’Donnell refers to as ‘food noise.’ In a recent interview, she spoke about how Mounjaro helped calm these thoughts in her head. I found her Plus SideZ podcast interview enlightening.

For many, these weight loss drugs are improving lives and health outcomes.

Novo Nordisk also offers a patient assistance program that provides Ozempic at no cost. To be eligible, you must be a U.S. citizen or legal resident with a total household income at or below 400% of the federal poverty line.

Rosie O’Donnell Treated Her Sleep Apnea, So You Should Too!

“I had a problem that I was kind of embarrassed about,”says Rosie O’Donnell. “I was tossing, turning, and snoring like a buzz saw.”

Every night, millions of people like Rosie miss out on countless hours of sleep because of sleep apnea—and many more cases go undiagnosed!

Many women going through menopause assume they have insomnia, but they may have sleep apnea. Moreover, the two conditions have similar symptoms, including daytime fatigue, mood problems, and decreased work productivity. This is why it’s so important to be tested for sleep apnea rather than try to treat your condition with over-the-counter sleep aids or blame the quality of your duvet for maintaining a healthy night’s sleep.

Sleep Apnea Myth: “I’m a light sleeper.”

Studies have shown over and over again that you, as a patient, are very poor at predicting whether or not you have obstructive sleep apnea. This is because it only happens while you are sleeping.

Sleep Apnea Myth: “I don’t snore.”

Many people think obstructive sleep apnea is severe snoring. But many people with mild to moderate conditions may not snore at all. Remember that snoring, by definition, means that one is still breathing (somewhat). Apnea means total blockage. So,if you are not breathing, you are not snoring.

Rosie’s doctor said that when she underwent a sleep test, they discovered she was waking up over 200 times during the night, and she stopped breathing for almost forty seconds.

However, this severe condition affecting many people with diabetes is treatable.

Sleep apnea is a blockage of the airway, making it difficult to breathe. When this happens, your body wakes up so you can breathe, resulting in sleep loss.

Once a proper diagnosis was reached, Rosie was treated with CPAP, or a continuous positive airway pressure machine. She admitted that after one night of use with the CPAP she noticed an incredible difference.

Could sleep apnea be slowly ruining your life and hurting your health? You’ll never know until you get tested like Rosie O’Donnell. There are many options for getting an official diagnosis of sleep apnea, including a home sleep test.

Obstructive sleep apnea (OSA) alters glucose metabolism and promotes insulin resistance. Over time these consistently higher glucose levels lead to a higher A1C and a diagnosis of type 2 diabetes.

We’re talking about nighttime diabetes management with musical inspiration from Gladys Knight & The Pips courtesy of SONY Music.

Gladys Knight doesn’t have diabetes, but the disease is as close to her heart as the memories of her mother, Elizabeth Knight, who died of complications from the disease in 1997. The five-time Grammy award winner never misses an opportunity to voice the message of early detection and treatment of diabetes.

Gladys shares her final words of wisdom: ”Do something about diabetes … Know more, do more!” Knight feels nearly as passionate about spreading that message as she does about the incredible singing career her mom helped her launch some 54 years ago.

Guests include Stacey Harris aka The Diabetic Pastry Chef, Mary Ann Hodorowicz, RD, LDN, MBA, CDCES, CEC, SleepyHead Central founder Tamara Sellman RPSGT, CCSH, Poet Lorraine Brooks and Mama Rose Marie.