Experts from UT Southwestern, University of Colorado, Cato Institute, and Obesity Action Coalition share what evidence currently shows about GLP-1 function and effectiveness and discuss how to ensure patient access, affordability, and safety.
GLP-1 receptor agonists (GLP-1s)—better known by brand names Ozempic, Wegovy, Mounjaro, or Zepbound— are often referred to as “miracle drugs.” GLP-1s were originally developed to help regulate blood sugar in people with type 2 diabetes. They also contribute to substantial weight loss for people with obesity and show promise in helping to manage other conditions, such as cardiovascular disease and substance use disorder.
On October 8, 2025, the National Academy of Medicine’s Health in the Headlines series brought together experts who have studied, prescribed, and worked with patients taking these drugs to discuss what GLP-1s actually can—and can’t—do, how safe they are, if they are worth the cost, and what can be expected from these “miracle drugs” in the future.
This article explores five key takeaways from the conversation.
Obesity Is a Complex Chronic Disease and Still Highly Stigmatized
Obesity is a chronic and complex disease requiring management throughout a person’s life, explained Jaime Almandoz of UT Southwestern Medical Center. The chronic nature of obesity becomes evident when people discontinue use of GLP-1s. A person taking Wegovy is likely to lose approximately 12% of their body weight, on average, but if they abruptly stop taking the drug, they will likely regain 2/3 of that weight. This “rebound effect” shows that the drug was working well to manage their obesity, but when they stopped using it, the weight returned—much like what would happen to someone with elevated blood pressure or high cholesterol. GLP-1s, while highly effective, are therefore only one piece of a multidisciplinary health care puzzle.
Alex Azar, former Secretary of the US Department of Health and Human Services, noted that there is little stigma around taking a statin to manage high cholesterol, but using a GLP-1 to help with weight loss can be perceived by some as “taking the easy way out.” Panelists emphasized that this perception, despite its inaccuracy, persists and may stand in the way of patients accessing these effective treatments or staying on them long-term. Studies have found that the majority of people who start taking GLP-1s stop taking them within a year, and after stopping, about half begin to take the drug again.
“We need to acknowledge the complexity of the disease [of obesity] and the complexity of well-managed care, and that the relationship between the two is key.” – Tracy Zvenyach
GLP-1s Are Safe
Although GLP-1s have only recently become well-known to the public, they have been used to treat diabetes for 20 years, and there are many studies that show that these drugs are both safe and effective. These studies generally show improvements in overall health and some specifically show their potential to lower the risk of heart attack and stroke.
Despite their overall safety profile, older adults taking GLP-1s who have frailty or a history of heart attack or stroke may need additional clinical support to ensure that they are meeting their nutritional needs and getting sufficient physical activity to mitigate reductions in muscle mass and function. These drugs can also produce side effects that may spur changes in eating habits, which can lead to safety risks or worse health outcomes if not appropriately managed.
However, due to the relative expense and scarcity of GLP-1s, online retailers and compounding pharmacies are making alternative formulations available, and many patients are wondering if these alternative formulas are also safe and effective.
The answer from the panelists was a resounding I’m not sure. Since these formulations are regulated differently from name brands, there is often inconsistency in how they are assembled, labeled, and dosed, making it challenging for doctors to understand exactly what their patients are taking and how it might affect them.
While formulations prescribed by a doctor are generally safe, panelists emphasized that maintaining open communication with your care team while taking a GLP-1 is a best practice to ensure that lifestyle adjustments can be made to support continued adherence and improved health.
“I think the policy challenge isn’t whether to use GLP-1s, but how to do so in a more equitable and sustainable way.” – Jaime Almandoz
GLP-1s Are Expensive, But Changes Are Coming
It is often reported that GLP-1 drugs can cost more than $1,000 a month. Yet, insurance coverage and discount programs for individuals can actually reduce the cost by half or more, making these drugs more affordable, but still out of reach for many Americans, explained Tracy Zvenyach of Obesity Action Coalition. There are a number of methods to reduce the out-of-pocket cost of these drugs, including subsidies and increasing insurance coverage, but Govind Persad of the University of Colorado Law School noted that it is also critical to ensure that incentives—many of which are monetary—remain for drug developers to continue to innovate in this field while simultaneously maximizing patient access now. Jeffrey Singer of the Cato Institute also proposed that making these drugs available without a prescription might reduce cost, increase access, and decrease stigma, but this change would likely take many years and receive pushback from clinicians.
Federal insurers like TRICARE and Medicaid also cover some obesity treatments, and Medicare is currently working to overcome a regulatory barrier to covering GLP-1s. This change will likely broaden access to GLP-1s, as approximately 20% of Americans receive benefits from Medicare.
Additionally, most GLP-1s currently on the market are delivered via injection, but research and development is underway on pill-based forms. These new options will likely increase competition and further drive down prices for individuals and insurers. Although none of the panelists could predict what the cost of these drugs would be over the next year, they agreed that the status quo for GLP-1 prices will be changing—soon.
“If we have a drug that is reducing the complications of diabetes and obesity, then there should be a decrease in the trajectory of health care spending.” – Jeffrey Singer
Are GLP-1s Worth the Cost? Probably
The role of GLP-1s in preventing and managing cardiometabolic conditions may reduce future health care expenditures by avoiding doctor’s visits, emergency room care, additional medications, and productivity loss. Although more research is needed to determine whether these savings can offset the upfront cost of these drugs, the trend lines appear positive, said Zvenyach. One recent paper found nearly 39,000 cardiovascular events were avoided when patients had access to obesity treatment, along with improvements in chronic kidney and liver diseases.
However, precise analysis of the relationship between the cost of paying for GLP-1s and the return on investment—cost savings due to increased productivity and reduced health care utilization—may become challenging as, in the United States, there are few mechanisms and incentives to produce these data and analyze them over the long term, Persad noted. Cost-effectiveness is not black and white, and accumulating data from real-world use could assist decision makers in making choices about coverage in the future.
Panelists also challenged listeners to think beyond simple dollars and cents and consider the holistic value these drugs provide to patients—including dramatic improvements in quality of life, fewer doctors’ visits and medications, and the ability to do activities they couldn’t do before. These positive improvements also have real value, even if they don’t directly impact the bottom line.
“In an ideal world, you would have insurers comparing the burden of covering GLP-1s to the burden of paying for all the other challenges related to long-term chronic disease management. Unfortunately, it’s not happening.” – Govind Persad
Just Increasing Access to GLP-1s Is Not Enough
Despite the abundance of attention to the cost of GLP-1s and some patients’ challenges in obtaining the drugs, panelists emphasized that access to drugs does not equal access to care.
“Wraparound care”—an approach to health care that includes mental health, social services, and lifestyle change support—is critical for ensuring success while on a GLP-1. Almandoz explained that when an individual loses a significant amount of weight, many other functions and reactions within the body change as well—reduced muscle mass can result in increased risk of falling, appetite changes can result in malnutrition, and existing frailty can be exacerbated. Care that includes integrated nutrition and physical activity support, as well as associated lifestyle modifications, can help ensure patients maintain improved health for a longer duration. Long-term success for patients taking GLP-1s likely looks like patient-centered care programs where individuals aren’t just receiving the drug but are also placed within a supportive framework that can monitor their health and adjust treatments or approaches as needed.
“If we conflate access to drugs with access to quality multidisciplinary care, we’re going down the wrong path altogether. These are effective, game-changing medications, but they need to be used appropriately.” – Jaime Almandoz
Watch a recording of the full discussion about GLP-1s below.
Tune in to Health in the Headlines, a free webinar series from the National Academy of Medicine held on the second Wednesday of every month from 3:00-4:30 pm ET. Health in the Headlines brings together experts from opposing viewpoints to discuss timely health topics, encouraging conversation that transparently combines scientific evidence and personal, cultural, and policy values. Sign up for updates and watch recordings of past webinars.
Disclaimer: This article was prepared by Jenna Ogilvie, Ogilvie Editorial, and reviewed by Alex Azar, Jaime Almandoz, Govind Persad, Jeffrey Singer, and Tracy Zvenyach.
Statements, recommendations, and opinions expressed in the webinar and this summary article are those of individual presenters and participants. These views are not necessarily endorsed or verified by the National Academy of Medicine or the National Academies of Sciences, Engineering, and Medicine and should not be construed as reflecting any group consensus.
The information provided in this article is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.
