Glucagon-like peptide-1s (GLP-1s) have emerged as a transformative class of medications for managing type 2 diabetes (T2DM) and obesity, conditions that significantly impact workplace productivity and healthcare costs.
As employers increasingly face decisions about including GLP-1s in health benefit plans, understanding their advantages and drawbacks is critical. This whitepaper provides a balanced analysis of the pros and cons of GLP-1s, tailored to the needs of employers. It highlights clinical efficacy, potential cost savings from improved employee health, and challenges such as high costs and side effects.
Supported by recent research, this article aims to evaluate the clinical evidence, economic considerations, and strategic implications for employer-sponsored health plans.
The rising prevalence of obesity among working-age adults presents a growing challenge for employers. According to the Centers for Disease Control and Prevention (CDC), more than 40% of U.S. adults are obese, a figure projected to reach 50% by 2030 (CDC, 2023).
These conditions contribute to absenteeism, reduced productivity, and escalating healthcare costs. GLP-1s, such as semaglutide (Ozempic, Wegovy), liraglutide (Victoza, Saxenda) and Tirzepatide (Mounjaro, Zepbound), offer promising solutions by addressing both glycemic control and weight management.
Originally approved for type 2 diabetes, several GLP-1 RAs are now FDA-approved for chronic weight management in individuals who are obese or overweight and have at least one weight-related comorbidity. However, their adoption in employee health plans requires careful consideration of benefits versus costs and risks.
GLP-1s are highly effective in improving glycemic control and promoting weight loss, two critical factors in managing T2DM and obesity. Semaglutide has been shown to achieve an average weight loss of 15% in patients with obesity (Wilding et al., 2021).
For employers, this translates to healthier employees who are less likely to experience complications such as neuropathy or cardiovascular events, potentially reducing absenteeism and disability claims.
Beyond glycemic control and weight loss, GLP-1s offer cardiovascular and renal protective effects. A study in Nature Cardiovascular Research demonstrated that GLP-1s reduce the risk of myocardial infarction, stroke, and cardiovascular death in patients with T2DM (Polley et al., 2024). Similarly, research from Washington University School of Medicine found a decreased risk of kidney conditions among GLP-1 users (Al-Aly et al., 2025).
These benefits can lower long-term healthcare costs and improve employee longevity and productivity, key considerations for employers managing workforce health.
By addressing obesity and T2DM, GLP-1s may enhance workplace productivity. Obesity-related conditions often lead to reduced on-the-job performance and absenteeism. A study by PwC (2024) suggests that healthier employees, supported by treatments like GLP-1s, could be more productive, potentially offsetting some treatment costs through improved output.
For employers, this represents an opportunity to maintain a competitive workforce while reducing indirect costs associated with chronic illness.
Emerging research indicates GLP-1s may have applications beyond T2DM and obesity, such as reducing the risk of dementia and addiction (Al-Aly et al., 2025). These additional benefits could further enhance employee well-being, potentially decreasing mental health-related absences and supporting a holistic approach to workplace wellness.
The primary barrier to widespread adoption of GLP-1s is their cost. Medications like semaglutide can exceed $1,000 per month, posing a significant financial burden for employers.
A study in JAMA Health Forum (2025) found that while GLP-1s yield impressive clinical results for obesity, their expense often renders them cost-ineffective under current pricing models. For employers, this raises questions about return on investment, particularly if coverage extends to a large population of employees.
GLP-1s are associated with common side effects, including nausea, vomiting, and diarrhea, which can affect employee comfort and productivity. Yao et al. (2024) noted that gastrointestinal adverse events are particularly pronounced with high-dose administration, with some patients discontinuing treatment as a result.
A real-world study in JAMA Network Open reported a discontinuation rate of approximately 10% due to side effects (Collins et al., 2024). For employers, this could lead to temporary productivity losses or increased healthcare utilization for symptom management.
While GLP-1s are effective initially, their long-term benefits may diminish. Research suggests that weight loss effects wane after 1-2 years, with some patients regaining weight (Yuan et al., 2024). This aligns with anecdotal evidence from clinicians on X, noting that hunger suppression decreases over time, potentially requiring additional interventions.
Employers must weigh the sustainability of these treatments against the need for ongoing coverage, as chronic use may not guarantee lasting outcomes.
Though rare, GLP-1s carry risks of serious adverse events, including pancreatitis, bowel obstruction, and gastroparesis. A study comparing GLP-1s to another (Big Fat Surprise, 2023). These risks, while infrequent, could lead to significant health and legal liabilities for employers providing coverage, necessitating careful risk management strategies.
Despite the clinical promise of GLP-1 RAs, many employers and insurers are struggling with whether and how to include these drugs in health benefit plans. The core issue is cost – GLP-1s can exceed $1,000 per member per month, which poses a significant challenge, especially when treating obesity, a non-mandated coverage area. Unlike diabetes, for which drug coverage is generally expected, obesity treatment is often viewed as discretionary.
Employers must balance workforce well-being with financial sustainability. Some have introduced tiered or conditional coverage models, linking access to outcomes or requiring participation in behavioral programs. Additionally, pairing GLP-1s with lifestyle programs could enhance outcomes and cost-effectiveness, as suggested by Omada Health (Shao, 2023). However, these strategies are often met with administrative hurdles and concerns over fairness, particularly when weight loss drugs generate widespread employee demand.
For insurers and self-insured employers, the rising popularity of GLP-1s – fueled by media attention and patient advocacy – has become a flashpoint in benefit design, reflecting a broader debate about whether obesity should be treated as a chronic disease in parity with other conditions. Insurance carriers frequently respond by implementing prior authorization, restricting usage to certain diagnoses, or excluding coverage entirely.
GLP-1s offer significant advantages for managing T2DM and obesity, with downstream benefits for employee health and workplace productivity. However, their high cost, side effects, and uncertain long-term efficacy present substantial hurdles.
Employers must carefully evaluate these factors against their workforce needs and budget constraints. As research evolves and pricing models adjust, GLP-1s may become a more viable option. For now, a strategic, data-driven approach to coverage is recommended to maximize benefits while minimizing risks.
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