To stay on weight-loss drugs, Americans cut doses

Doctors advise most patients on GLP-1 obesity drugs such as Wegovy and Zepbound to stay on them to keep the weight off, but as more US insurers restrict coverage people are trimming costs by stretching doses or forgoing expenditures like vacations to pay for the medication out of pocket.

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A half dozen doctors who spoke with Reuters said insurance coverage has tightened in 2025 as many employers drop it for the expensive GLP-1 drugs. While patients on these medications are counseled on proper diet and exercise, clinical trials show that people who stop taking these drugs are apt to regain weight. Novo Nordisk's Wegovy and Eli Lilly’s Zepbound are weekly injections with US insurer list prices of more than $1,000 a month. For customers willing to pay cash, both drugmakers will ship directly for $499 a month if refills are purchased at fixed intervals.

“A significant number of my patients now pay cash,” said Dr. Nidhi Kansal, an obesity specialist at Northwestern Medicine in Chicago. “People find a way to scrounge up $6,000 a year, which sucks, because that’s a vacation or two.” More than a billion people worldwide are obese, according to the U.N. World Health Organization, which has said the GLP-1 drugs could help end the obesity pandemic.