Four Ways Obesity Medicine Providers Can Support Access to Obesity Care

Sponsored by Eli Lilly and Company

In recent years, I have seen first-hand how the field of obesity medicine has changed dramatically to better meet patients’ clinical needs. We now know that there is no one-size-fits-all solution to treating this disease, and that comprehensive obesity care consists of a range of evidence-based options, such as medical nutrition therapy, intensive behavioral therapy (IBT), surgery and FDA-approved medications.

As an endocrinologist, physician scientist and advocate for people living with obesity and diabetes, I am grateful to be part of the transformation that is happening in obesity medicine and contributing to advancements in patient care.

It is critical that health care providers can leverage every tool in the obesity care toolbox to develop the best treatment plan for their patients. Unfortunately, this is not the reality for many providers today, particularly as insurance coverage for obesity care remains a significant obstacle.

Coverage varies significantly depending on an individual’s health plan – where someone lives, what job they have or whether they have private or public insurance can determine the types of interventions patients can access. For example, Medicare does not cover the latest obesity management medications (OMM) for chronic weight management indications, and has limits on which providers can administer IBT. At the state level, many Medicaid programs do not offer coverage for obesity treatment, and coverage policies are continually changing. And, even if individuals have one of the 36% of employer plans that cover GLP-1s, they may still face obstacles accessing treatment, as many insurers require prior authorization or step therapy.

Obesity medicine specialists have the power to improve the outlook and support patients facing barriers in accessing obesity care. Here are four ways you can help:

1. Empower your patients with information on how to navigate insurance coverage challenges.

For many patients, learning you don’t have coverage for needed care can be frustrating and disappointing. Figuring out what to do next can also be overwhelming, but there are resources that can help. For example, the EveryBODY Covered campaign, an Alliance for Women’s Health and Prevention (AWHP) program that is sponsored by Lilly,, recently created a resource to support individuals in navigating obesity care coverage and denials. Sharing this resource – and resources like it - with your patients can help them understand why coverage may have been denied and what steps they can take to access obesity care.

2. Ensure your clinical care team understands approved indications for obesity medicines and can help patients address coverage challenges quickly.

Providers are often the key to helping patients access specific prescribed treatments. There are many templates and guides available to help your team understand the latest obesity treatment options and tackle common insurance obstacles to help your patients access care. For example:

• Learn how and why to code for obesity to document treatment effectively and help your patients gain coverage for needed care.
• If a patient is denied care, the Obesity Action Coalition (OAC) has developed a sample appeal letter that you can send to an insurance provider.

3. Help educate other providers who may not be as familiar with obesity medicine.

Many health care providers are still catching up with the latest developments and clinical guidelines in obesity medicine. Consider sharing educational resources with your colleagues in other specialties, such as:

• Lilly’s Comprehensive Obesity Care educational series for providers on collaborative approaches to weight management.
• The University of Connecticut’s Rudd Center for Food Policy and Health Supportive Obesity Care resources, which can equip healthcare professionals with knowledge and tools to provide respectful, supportive and compassionate care to patients of all body sizes.
• The Obesity Medicine Association’s (OMA) Academy, with evidence-based, peer-reviewed clinical obesity education.
• Standards of Care in Overweight and Obesity from the American Diabetes Association, offering comprehensive standards for reducing weight stigma and improving care for people living with overweight and obesity.

4. Stay informed and advocate for better coverage.

By staying informed and raising your voice, and encouraging your patients to do the same, you can help improve coverage for obesity care. Here are actionable steps you can take to advocate for obesity care coverage at the local and national levels:

• Join the EveryBODY Covered network to stay informed about advocacy opportunities and access educational resources.
• Send a letter to your Congressmembers supporting the passage of the Treat and Reduce Obesity Act (TROA), legislation that would close obesity care coverage gaps for Medicare beneficiaries.
• Visit the OAC Action Center to find opportunities to advocate in your state.
• Print and share this EveryBODY Covered resource with your patients about how they can get involved.