GLP-1 Therapies in Real-World Weight Care: Provider Insights on Adoption, Adherence, and Outcomes

1. From your perspective as a weight care service provider, how has the rapid adoption of GLP-1 therapies reshaped employer and health plan approaches to obesity management?

Before GLP-1s, obesity management was neglected. There was no real plan or employer focus on obesity. GLP-1s have completely changed that. For good and bad, never has a drug been demanded by consumers like this. The good thing is that there now is a focus on obesity and the upside of treating it properly in terms of improved cardiometabolic outcomes.

2. What misconceptions do employers and health plans most commonly have about GLP-1–based weight care, and how do behavior-first models help correct them?

Most employers and health plans today are reacting to employee GLP-1 demand. GLP-1s are seen as a cost that should be minimized so barriers to access are raised using strict prior authorization requirements. And I get it, the way they are currently being prescribed without any form of continues care and lifestyle intervention, this approach makes sense. I would even argue that in this setting, the GLP-1s shouldn't be covered at all. 

Instead, I suggest a proactive strategic approach where GLP-1s are always used as part of a strategic cardiometabolic intervention. Meaning that employee or patient segments where the GLP-1s can generate a positive ROI are actively engaged and GLP-1s are only used as part of a holistic intervention with behavioral intervention in front to control and reverse cardiometabolic conditions .

3. How does positioning GLP-1s as one component of a broader weight care program - rather than a standalone solution - change patient outcomes in the real world?

Weight care programs without GLP-1s have never shown to be effective. And GLP-1s without lifestyle intervention only works for a short period of time. We need to combine them both. And when we do, we see at Embla that you can achieve weight loss outcomes seen in clinical trials in the real world but using only around ⅓ of the normal dose.

4. What role does behavioral intervention play in determining whether GLP-1 therapy becomes a short-term weight loss tool or a sustainable long-term health solution?

If you only do GLP-1s there is no doubt the weight will come back on when you stop them. They don’t cure obesity - they suppress appetite while you’re on them. If your lifestyle or environment has not changed while on the GLP-1s, everything will be as before when you stop the GLP-1s.

On the other hand, what we see in the Embla data is that if you use the GLP-1s to help make conscious changes to your lifestyle, there is a 78.5% chance that you can stay off the meds after you discontinue them.

5. Based on real-world data, what are the most significant drivers of adherence in GLP-1–supported weight care programs?

That GLP-1s are used strategically with intent and a personal connection with a trusted coach. You need long term goals to endure a long journey, GLP-1s give the early motivation to stay on a road you previously had to exit and a deep connection with a trusted coach keeps that motivation going after the early high weight loss rate powered by the GLP-1s start to decrease into more natural levels.

6. Where do you see the biggest drop-offs in GLP-1 continuity, and how can care design - not medication changes - address these challenges?

If you use the normal dosing, too many drop-off due to side effects within the first months. If you have no understanding of how these drugs should really be used, no coach to help you set and long term strategy and keep you motivated, you will drop off after 3-6months as soon as the weight loss rate starts to slow. 

7. How do employer-sponsored GLP-1 programs balance cost containment with clinical effectiveness, especially amid rising demand and long-term use concerns?

Today, many don’t do this in a good way. They raise high prior-authorization barriers. This solves one part of the equation - containing cost. But, clinical effectiveness remains low with poor care dominating the market. This strategy is not effective when facing massive demand from employees - it's like trying to stop a wave instead of surfing it. You just get tumbled but don't reap the benefits. The strategy we recommend is to cover GLP-1s for weight loss and obesity but only in a sustainable way. Meaning, that coverage is always tied to an intensive lifestyle intervention - no adherence to the intervention means coverage is ended. Care is continuous and personalized. A few visits to the dietician won't cut it, people need to feel seen by a trusted partner with multiple monthly touch points to really start changing their lives.

8. How do real-world weight loss and metabolic outcomes in behavior-first GLP-1 programs compare with expectations shaped by clinical trial data?

Our published data shows that you can get the same weight loss outcomes but using a fraction of the normal dose of the GLP-1s using a personalized, multi-disciplinary and continuous approach. We also see a significantly higher chance that you can sustain the weight loss if you want to discontinue the GLP-1s. Clinical trials have shown fast regain for almost all while we see in our data that 78.5% who discontinue a GLP-1 can maintain their weight loss without needing GLP-1 therapy again. A few need rescue treatment and others a small dose GLP-1 dose. Overall, the opportunity for great outcomes using less GLP-1 is wast. 

9. How should employers and payers evaluate success in GLP-1–enabled weight care beyond simple weight loss metrics?

They should look at how much GLP-1 is being used. Less GLP-1 means a more affordable program and less side effects improving the ROI to the plan and the quality of life of employees. Also measure cardiometabolic biomarkers alongside weight outcomes - these improvements are what drives short-term reduction in claims related to chronic care of cardiometabolic conditions and long-term prevention of claims related to actual catastrophic cardiovascular events.

10. Looking ahead, how do you see behavior-first weight care models shaping the sustainable use of GLP-1 therapies over the next five years?

Health plans and employers have a chance now to shape the GLP-1 culture completely. Consumer will always be quick fix with failed long-term results. Tying proper behavior-first care models with GLP-1 coverage is the way to create a new long-term successful culture for GLP-1s and behavior-first weight care models are central to winning in this transformation.