In the realm of healthcare and weight management, a fascinating link between greater weight loss and greater savings has come to light. This cross-sectional study delves deep into the implications of weight reduction on annual healthcare expenses.

Unraveling the Connection between Weight and Savings

Section 1: The Initial Link

In adults with overweight or obesity, losing as little as 5% of bodyweight can lead to significant savings. For instance, in a study of 13,435 adults with employer-sponsored insurance and 3,774 with Medicare, it was found that such a weight loss could translate to a savings of about 8% in annual healthcare expenses, approximately $670 per year. This savings was consistent regardless of the type of insurance, be it employer-sponsored or Medicare. And interestingly, the savings increased with a greater percentage of bodyweight lost. The money saved was estimated to be a result of changes in body mass index (BMI). For each percentage-point increase in BMI over 30, there was an average increase in annual healthcare spending of $326 (P = 0.006), with differences seen by race and ethnicity.

Section 2: Savings by Condition

A reduction in weight of 25% was estimated to save $2,849 per year, with reductions in annual spending seen across numerous chronic disease conditions. The largest reductions in total healthcare spending by BMI lowering were projected for individuals with diabetes and arthritis. In those with hypertension, losing 15% bodyweight was estimated to reduce healthcare spending by $1,112 per year versus a reduction of $4,950 per year for the same weight loss in those with arthritis. These data, published on December 5, 2024, in JAMA Network Open, are crucial as patients, clinicians, healthcare policy experts, and insurers grapple with the high cost of glucagon-like peptide-1 (GLP-1) receptor agonists for weight loss and the large number of people who could benefit from them.

Section 3: Potential Limitations

However, Dhruv Kazi, MD, from Beth Israel Deaconess Medical Center/Harvard Medical School, cautioned against a one-sided interpretation. He pointed out that more than half of all adults in the United States are eligible to receive semaglutide for weight loss, diabetes, or prevention of recurrent CV events. He emphasized that a cross-sectional analysis cannot estimate the downstream cost reductions, such as fewer heart attacks. There may be other reasons why people are overweight and other drivers of costs. But he also agreed that the analysis is directionally correct, stating that people with overweight and obesity have higher healthcare costs and the relationship is not linear.

Section 4: Future Considerations

Thorpe and coauthor Peter J. Joski looked at deidentified survey data to further explore the potential to decrease healthcare spending. Depending on the amount of weight to be lost, the savings varied. For an adult with a baseline BMI of 30, losing 5% of their bodyweight was projected to lower annual healthcare spending by $441. And for someone with a starting BMI of 45, the same 5% loss could save more than $1,400 annually. An accompanying editorial by a government health policy analyst noted that the study makes several assumptions, such as no unobserved differences between people with different BMIs and that the cumulative health effects of obesity can be fully reversed through weight loss. But Thorpe disagreed, stating that others have carried out similar research with microsimulation models and shown similar results.Ultimately, Thorpe believes that while these analyses can help payers forecast the cost-savings perspective of new weight-loss medications, they can also be used to optimize prescribing strategies. Coupling GLP-1 agents with lifestyle modification plans like the Diabetes Prevention Program can increase the opportunity for support and guidance in using the medications. And with the expected reduction in drug costs over the coming years, the situation is set to improve further. Importantly, the US Centers for Medicare & Medicaid Services has proposed changes to allow GLP-1 receptor agonists to be a covered benefit for Medicare patients for the treatment of obesity. Kazi agreed that GLP-1 drugs could be transformative if used correctly but argued that the cost-saving arguments may be overblown. There is hope with the Inflation Reduction Act and the expected drop in prices of newer injectable weight-loss formulations like retatrutide.