Employers aren’t expanding coverage of GLP-1 obesity drugs: survey
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As new GLP-1 drugs enter the U.S. market and groundbreaking Medicare coverage emerges, one thing remains the same: Most employers still don’t cover these weight-loss drugs.
Many health plans are actually finding ways around this.
“It’s a struggle trying to keep costs down,” Justin Held, director of training programs for the nonprofit organization International Foundation for Employee Benefit Plans, said in an interview. “They appear to not offer coverage for weight loss but instead focus on how to support the overall health of their employees.”
Findings are taken from: A survey released Tuesday By IFEBP, which includes more than 33,000 member companies or public institutions. Survey conducted on nearly 300 employer health plans in the US in June
According to the survey, about 36% of employers said they provide GLP-1 coverage for both diabetes and weight loss; This rate is the same as in 2025 and higher than 34% in 2024.
Meanwhile, 60% of employers said they only offer coverage for diabetes; this rate was 55% in 2025 and 57% in 2024. Roughly 45% of plans cover GLP-1s for other approved conditions, such as obstructive sleep apnea and heart disease, it said.
It’s no surprise that employer weight loss coverage is flat from last year.
Health plans have long resisted the high costs of covering GLP-1 drugs. Eli Lilly And Novo Nordisk, To cut costs, plans have restricted coverage or stopped it altogether as demand soared, especially in the United States.
Held said cost remains the primary driver in employer decisions regarding GLP-1 coverage. Respondents said drugs accounted for 11.4% of annual demands in 2026; this rate was 6.9% in 2023.
But employers are finding other ways to support workers who want to use these medications.
“The cost burden is so great that while they want to take advantage of these benefits to recruit and retain these people, they say there are other ways to do it,” Held said.
Approximately 27% of employers encourage their employees to obtain GLP-1 through a direct-to-consumer platform, while 21% force workers to use FSA, HSA, or integrated HRA dollars for treatments.
As costs rise, this becomes “a great opportunity for employers to communicate the benefits they already offer in this area,” Held said.
For example, 74% of plans said they offer disease and chronic care management, 61% provide nutritional counseling, and another 61% offer bariatric surgery. Employers also cover benefits such as lifestyle modification programs, other non-GLP-1 medications and nondrug interventions for weight loss, he said.
So what will it take for more employers to adopt GLP-1 coverage for obesity and foot the bill?
What could move the needle, Held says, is evidence that covering these drugs ultimately reduces costs in other areas. This might look like fewer knee replacements and bariatric surgeries, or higher productivity and better health outcomes.
“If these things are happening, then they might say it would be worth it to offer full coverage for weight loss as well, because the impact on other areas of our organization is so positive,” he said. “But we haven’t seen that yet.”
Although some studies and estimates suggest that GLP-1’s downstream savings could offset higher costs in the healthcare system, no widely measured evidence of this is yet available based on real-world data.
We may get a first look at what the savings look like after a newly launched 18-month program that allows Medicare to cover GLP-1s for obesity for the first time.
By then, approximately 9% of employers are considering adopting GLP-1 coverage for obesity. We will continue to monitor to see how this may change over time.
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