GLP-1 for Weight Loss: Evidence, Eligibility, Coverage

Is GLP-1 approved to help with weight loss?

GLP-1 medicines and weight loss

Medicine	For weight loss	How it is taken	Trial result
Wegovy	FDA approved	weekly injection or daily tablet	14.9% weight loss
Zepbound	FDA approved	weekly injection	20.9% weight loss
Foundayo	FDA approved	daily tablet	11.1% weight loss
Saxenda	FDA approved	daily injection	7.4% weight loss
Ozempic	Not an approved use	weekly injection	Not listed
Rybelsus	Not an approved use	daily tablet	Not listed
Mounjaro	Not an approved use	weekly injection	Not listed
Trulicity	Not an approved use	weekly injection	Not listed
Victoza	Not an approved use	daily injection	Not listed
Byetta	Not an approved use	twice-daily injection	Not listed

Sources: FDA label (DailyMed).

Who qualifies?

GLP-1: who qualifies

Who sets the rule	Who qualifies
Ozempic	Adults with type 2 diabetes: it lowers blood sugar when used with diet and exercise.
Ozempic	In adults with type 2 diabetes and heart disease, it lowers the chance of death related to the heart, heart attack, or stroke.
Ozempic	It lowers the chance of heart-related death, kidney failure, and worsening kidney disease in adults with type 2 diabetes and chronic kidney disease.
Wegovy	Injection and tablets lower the risk of heart attack, stroke or heart-related death in adults with heart disease plus obesity or overweight.
Wegovy	With diet and activity, it helps with long-term weight loss and keeping the weight off. It covers adults with obesity, children aged 12 and older who have obesity, and adults with overweight and a weight-related condition.
Wegovy	For adults, it treats MASH liver disease with moderate to advanced scarring (no cirrhosis) (injection).
Wegovy	For adults, the tablets are approved for weight loss and heart risk.
Rybelsus	Adults with type 2 diabetes: it lowers blood sugar when used with diet and exercise.
Rybelsus	It lowers the risk of heart attack, stroke or heart-related death for adults with type 2 diabetes at high risk.
Mounjaro	With diet and exercise, it lowers blood sugar in adults and children 10 and older with type 2 diabetes.
Mounjaro	It lowers the risk of heart attack, stroke or heart-related death for adults with type 2 diabetes at high risk.
Zepbound	Adults qualify with obesity, or with overweight plus a weight-related condition. When combined with diet and activity, it supports weight loss over the long term and helps keep weight off.
Zepbound	This medicine treats obstructive sleep apnea that ranges from moderate to severe in adults with obesity.
Foundayo	Adults qualify with obesity, or with overweight plus a weight-related condition. When combined with diet and activity, it supports weight loss over the long term and helps keep weight off.
Trulicity	With diet and exercise, it lowers blood sugar in adults and children 10 and older with type 2 diabetes.
Trulicity	In adults with type 2 diabetes and heart disease, it lowers the chance of death related to the heart, heart attack, or stroke or several heart risk factors.
Saxenda	The focus is lasting weight reduction and keeping the weight off, using diet and activity. It covers adults and young people aged 12 and older (over 60 kg) who have obesity. Adults who have overweight and a weight-related condition are also covered.
Victoza	With diet and exercise, it lowers blood sugar in adults and children 10 and older with type 2 diabetes.
Victoza	In adults with type 2 diabetes and heart disease, it lowers the chance of death related to the heart, heart attack, or stroke.
Byetta	Adults with type 2 diabetes: it lowers blood sugar when used with diet and exercise.
Medicare GLP-1 Bridge	BMI 35 or higher, no condition needed
Medicare GLP-1 Bridge	Uncontrolled blood pressure, heart failure, or CKD 3a+, along with BMI of 30 or higher
Medicare GLP-1 Bridge	Prediabetes, PAD, or a previous heart attack or stroke, together with BMI of 27 or higher
Typical commercial plan (Aetna policy)	BMI 30 or higher
Typical commercial plan (Aetna policy)	BMI 27 or higher with a weight-related condition
Typical commercial plan (Aetna policy)	first comes a diet and activity program that lasts 6 months

Results from weight loss trials

GLP-1 trials in weight loss

Trial	Medicine	Who took part	Length	People	Main result	Comparison
STEP 1	Wegovy	Adults with obesity or overweight, without diabetes	68 weeks	1,961	14.9% weight loss	2.4% on placebo
OASIS 4	Wegovy	Adults with obesity or overweight, without diabetes	64 weeks	307	13.6% weight loss	2.4% on placebo
SURMOUNT-1	Zepbound	Adults with obesity or overweight, without diabetes	72 weeks	2,539	20.9% weight loss	3.1% on placebo
SURMOUNT-5	Zepbound	Adults with obesity, without type 2 diabetes	72 weeks	751	20.2% weight loss	Not listed
SCALE Obesity and Prediabetes	Saxenda	Adults with obesity or overweight, without type 2 diabetes	56 weeks	3,731	7.4% weight loss	3% on placebo
ATTAIN-1	Foundayo	Adults with obesity or overweight, without diabetes	72 weeks	3,127	11.1% weight loss	2.1% on placebo

Trial sources: STEP 1 (FDA label (DailyMed)), SURMOUNT-1 (FDA label (DailyMed)), SURMOUNT-5 (PubMed), SCALE Obesity and Prediabetes (FDA label (DailyMed)), ATTAIN-1 (FDA label (DailyMed)).

What is different for weight loss?

Label details are from FDA: FDA label on DailyMed.

Coverage for weight loss

Medicare Part D does not cover a GLP-1 taken only for weight loss.

The Medicare GLP-1 Bridge sets Wegovy at $50 per month when you meet its rules.

In places where Medicaid pays for weight-loss GLP-1s, prior authorization is normally required.

Sources: humana.com, CMS, KFF.

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