Despite the growing prevalence and impact of obesity in America, it took Medicare over 40 years to cover bariatric surgery, one of the first treatments for the disease. The decades-long delay in providing coverage for bariatric surgery in Medicare meant that an entire generation of Americans died from obesity-related diseases while waiting for access to life-saving treatment.
Let’s not do the same for obesity medications.
In the early 2000s, though not a Medicare beneficiary at the time, my own successful gastric band surgery inspired me to march on Capitol Hill and fight for American seniors’ right to access bariatric surgery. Now, twenty years later, I am in the shoes of those I marched for: living with obesity and without access to the most effective treatments on the market for the chronic disease. It is past time for federal policymakers to ensure that all Americans, especially those on Medicare like me, can access safe and effective FDA-approved treatments for obesity.
So much has changed since I walked in the halls of Congress two decades ago. After 20 years, I had my gastric band removed due to medical complications and quickly regained the weight it had helped me lose. I know that I am not alone in this. The prevalence of obesity for American adults has increased by over 10 percent in the past two decades and is expected to surpass 50 percent in the next five years.
This epidemic doesn’t just represent statistics. It translates to millions of Americans facing reduced quality of life, shortened lifespans, and diminished ability to participate fully in their communities and workforce while our healthcare system buckles under the pressure of preventable diseases. Obesity alone costs the country almost $173 billion per year. Conditions related to obesity, including heart disease and stroke, have serious economic ramifications as well, leading to $168 billion in lost productivity and costing our health care system another $254 billion per year.
The numbers don’t lie: there is an obesity crisis in the U.S. Fortunately, America’s innovation economy has kept up with this growing crisis. New technologies and continued investment into critical research and development has led to the discovery and production of lifesaving obesity medications, commonly known as GLP-1s. These breakthrough medications not only deliver the most substantial weight loss results we have ever seen, but they also improve cardiovascular health, reduce diabetes risk, and help patients reclaim their quality of life.
New GLP-1 treatments are a clear, commonsense solution. So why am I, and millions of other Americans, still struggling to access these lifechanging, FDA-approved treatments?
Unfortunately, Medicare continues to cling to outdated policies that prohibit coverage of obesity medications under the Medicare Part D prescription drug program. Although the American Medical Association has recognized obesity as a complex disease — a stance now embraced by numerous federal agencies and states that provide comprehensive obesity care coverage — Medicare beneficiaries remain left behind by policies that haven’t kept pace with medical progress.
As a result, the more than two-thirds of Medicare beneficiaries living with obesity, just like me, cannot access or afford these treatments.
When I could no longer safely rely on my gastric band to help manage my weight, I hoped to take a GLP-1 to address my obesity. But because of this antiquated regulation in Medicare, my treatment would have cost me over a thousand dollars a month. On a restricted income, that price is simply not feasible.
I was lucky enough to be able to afford tirzepatide to treat my obesity through a compounding pharmacy, as another medication I rely on is included in my dose. The impact was immediate. Since I began taking the medication, my condition has improved dramatically. I can stand up to prepare meals for my family, run errands, and even walk up to five thousand steps a day. After seeing the positive impact that obesity treatment had in my own life, I know how important it is for every American who needs it to have access.
I find it promising that the Trump administration wants to “Make America Healthy Again.” In this commitment, though, I call on Trump to focus on solutions that increase access to innovative obesity treatments. Earlier this year, the Trump administration chose not to move forward with a proposal that would have expanded access to obesity treatments in Medicare. However, an agency spokesperson stated that the administration may consider a policy change in the future after further review. I encourage careful review of this policy. Too many American lives are affected.
Additionally, federal lawmakers recently introduced the Treat and Reduce Obesity Act, bipartisan, bicameral legislation that would directly provide Medicare beneficiaries with access to safe and effective tools to treat obesity. As a Medicare recipient, I encourage policymakers across Washington to advance policies like this one, that address the obesity crisis and provide beneficiaries with much needed tools to treat their disease.
Our country is ignoring the remarkable scientific breakthroughs we have witnessed in obesity treatment and management — and we’re losing lives because of it. Every American deserves to live a healthy, productive life. We cannot let obesity stand in the way.
Sandi Henderson is a resident of Oxnard, Calif., and a member of the Obesity Action Coalition.
