Still a lot of questions on weight loss drugs

New drugs used for weight loss may also reduce the risks of heart attacks. A pharma company wants Medicare to cover the drugs, but a federal ban prevents Medicare from covering weight loss drugs. Should they be covered?

The costs of providing weight loss drugs for Medicare patients could be in the billions at a time when we’re trying to reduce Medicare costs. As more people use these drugs, though, there are some concerns.

A new lawsuit from a woman with type 2 diabetes alleges that the makers of the drugs Ozempic and Mounjaro did not provide adequate warnings for the severity of stomach problems caused by the popular medicines.

In the lawsuit, a patient asserts that she was “severely injured” after using Ozempic and Mounjaro and that the pharmaceutical companies failed to disclose the drugs’ risk of causing vomiting and diarrhea due to inflammation of the stomach lining and the risk of stomach paralysis.

The prescribing labels for Mounjaro and Ozempic state that each “delays gastric emptying” and warn of the risk of severe gastrointestinal adverse reactions. The prescribing labels for both drugs state that the most common side effects include vomiting, diarrhea, and stomach pain.

The prevalence of obesity in older adults, classified using body mass index (BMI), continues to rise over time. Recent estimates from the National Health and Nutrition Examination Surveys demonstrate that adults over age 60 have obesity rates exceeding 37.5% in males and 39.4% in female.

Obesity prevalence among older Americans is increasing at an alarming rate. In a single generation—between 1988-1994 and 2015-2018—the share of U.S. adults ages 65 and older with obesity nearly doubled, increasing from 22% to 40%. During the same period, the percentage of older men with obesity rose from 20% to 38%, while obesity prevalence among older women increased from 24% to 42%. The U.S. Centers for Disease Control and Prevention (CDC) defines obesity as having a body mass index (BMI) of 30 or higher. The CDC notes that BMI is an indirect measure of body fat that does not distinguish between excess fat, muscle, or bone mass.

BMI is not a diagnostic tool but a helpful starting point to identify potential health risks. The CDC recommends BMI be used to “track weight status in populations” and “as a screening tool to identify potential weight problems in individuals.” However, a new study builds on evidence that body mass index (BMI) alone does not fully capture the risk of death, particularly for a US population that is increasingly obese and racially diverse.

As I see it, the real issue is whether these drugs lead to permanent weight loss or are they just a temporary fix. Right now, the evidence seems to show that patients gain their weight back as soon as they stop the medication. In addition, newly prescribed patients are reporting more severe side effects.

The medical community needs to weigh in on this debate. Should Medicare spend billions to cover these drugs, or should other approaches be taken? I’m not sure that patients over 65 would want to take these drugs because of potential side effects, but approving them will depend on pharma lobbying dollars.