Medical Weight Management for Overweight and Obese People

Frequently Asked Questions

Q1 – Why is BMI used to measure overweight and obesity?

Body Mass Index (BMI) is a widely used tool to screen for overweight and obesity by relating a person’s weight to their height. This calculation provides a single number that healthcare providers can use to estimate the amount of body fat an individual may have.

Furthermore, it is a quick and simple calculation that does not require specialized equipment, making it easy to assess during routine office visits. The measurement is non-invasive and inexpensive to obtain.

Q2 – How much weight do you lose on medical weight loss?

On average, patients participating in medical weight loss programs can expect to lose approximately 1 to 3 pounds per week. However, this rate can fluctuate, and the total amount of weight loss achieved can be substantial. 

For instance, a study published in the Journal of General Internal Medicine indicated that patients in a medically supervised weight loss program lost an average of 11.1 pounds over a 12-week period. Another study in Obesity found that a program including meal replacement shakes, medication, and lifestyle counseling resulted in an average weight loss of 34 pounds over 16 weeks.

Q3 – What is the most successful medication for weight loss?

Among the most effective weight loss medications currently available are the glucagon-like peptide-1 (GLP-1) receptor agonists. This class of drugs mimics a natural hormone in the body that helps regulate appetite and blood sugar levels. 

Several GLP-1 agonists have been approved for weight loss, including semaglutide (marketed as Wegovy and Ozempic), tirzepatide (marketed as Zepbound and Mounjaro) and liraglutide (Saxenda).

Q4 – What insurance plans cover weight loss medication?

Some Medigap and Medicare Advantage plans designed for retirees may include coverage for obesity treatments, so it’s essential to check the specifics of those plans.   

Medicaid, a joint federal and state program providing healthcare coverage to low-income adults and children, has varying policies on weight loss medication coverage depending on the state. Some state Medicaid programs might cover certain weight loss drugs, often requiring prior authorization to ensure medical necessity.

Q5 – How to get insurance to cover weight loss medication?

To increase the chances of obtaining insurance coverage for weight loss medications in the US, individuals should first thoroughly review their insurance policy to understand the specific details of their coverage. 

If the insurance plan requires prior authorization for the specific medication, the patient and their provider will need to complete the necessary steps to obtain this approval. 

The coverage might be initially denied. Patients have the right to appeal a denial of coverage and should act quickly to initiate the appeals process, often requiring a letter from their prescribing doctor.

Q6 – Does insurance cover weight loss medication?

In the US, coverage for weight loss medications is complex and often not guaranteed. Medicare, the federal health insurance program for individuals aged 65 or older and certain younger people with disabilities, generally does not cover medications prescribed solely for weight loss due to legal restrictions. 

However, if a medication like Ozempic or Mounjaro is also approved by the FDA for treating another medical condition, such as type 2 diabetes, and is prescribed for that purpose, Medicare might offer coverage.

Q7 – How much is Mounjaro without insurance?

Ozempic or Wegovy without insurance coverage in the US can exceed $15,000 per year, translating to over $1,000 per month. Given that Mounjaro (tirzepatide) is in a similar class of medications and has comparable efficacy to Ozempic and Wegovy, it is reasonable to infer that its cost without insurance in the US would likely fall within a similar high range.

Q8 – Is it OK to buy prescription drugs from Canada?

Despite the general prohibition, there is a growing movement to allow the importation of prescription drugs from Canada to help lower drug costs for Americans, as medications are often significantly cheaper in Canada due to government regulations on drug pricing. 

Some states in the US have been actively pursuing the importation of certain prescription drugs from Canada through specific programs and with FDA authorization. Florida became the first state to receive such authorization in January 2024.

Q9 – Can a U.S. citizen get prescriptions in Canada?

US citizens can generally get prescriptions filled by licensed pharmacies in Canada. However, Canadian pharmacies typically cannot accept prescriptions directly from US doctors. Instead, the US prescription usually needs to be reviewed and “cosigned” by a Canadian physician.

To avoid this hassle you can directly order medications from Canadian prescription referral service like Pandameds.Com which accepts US prescriptions and provides genuine medications.

Q10 – Is there anything over the counter like Ozempic?

No, there are no over-the-counter (OTC) medications that work exactly like Ozempic. Ozempic, and similar weight loss drugs like semaglutide, tirzepatide, and metformin, are only available with a prescription.

In the UK, orlistat (brand name Alli) is available over the counter, but it works differently than Ozempic and is not as effective for weight loss.