March 28, 2025
GLP-1 agonists, commonly known as diabetes and weight loss medications, are continuing to increase in usage across the country. Data from 2024 indicates that more than 15.5 million Americans reported having used these medications. As the popularity and use of drugs such as Wegovy, Ozempic and others continue, companies and claims professionals will need to remain aware of their effect on workers’ compensation claims and management strategies.
Connecting workplace injuries, weight loss drugs and employee health
Claims professionals and leadership teams will need to consider a multitude of factors as they navigate the weight loss medication landscape. As obesity is a prime example of a comorbidity that can negatively impact an injured employee’s recovery, return to work and performance, and create risks for other conditions such as high blood pressure and heart disease, these drugs will continue to be positioned as effective strategies for a healthier workforce.
Though obesity is often not compensable under workers’ compensation, the risks and potential delays in recovery could lead companies to consider weight loss medications as viable options to reduce injuries. It’s imperative that business leaders work with claims examiners, physicians, medical professionals and nurse case managers to ensure employees are aware of the potential significant side effects of these drugs. In addition, if they are to be covered, it is crucial to have an exit strategy. This plan should include defining durations, compensability and ongoing assessments to provide guardrails and guidance for workers’ compensation claims in this area.
Key considerations for claims administration
A 2024 survey shows that the claims industry is already seeing the effect of the growing popularity of weight loss medications, as there has been an 8% jump in employer coverage and 8.9% of organisations’ total annual claims are for GLP-1 drugs.
As this number is expected to rise, there are several cost considerations to keep in mind moving forward when administering and assessing workers’ compensation claims. These include:
- Several states have presumptions in place for cardiovascular disease and diabetes associated with first responders.
- These drugs have been approved by the U.S. Food and Drug Administration (FDA) for reducing cardiovascular risk.
- Have a strong utilization review plan that uses all available guidelines to ensure you are covering what is required.
- Work closely with your carrier and employer on a strategy for those cases where you think it can make a difference in a positive way.
- Be prepared to cover other items associated with the significant side effects.
Alternate treatment options
Finally, a key aspect of employee education around healthy lifestyles that support a productive, efficient and available workforce is offering clear guidance and tips for alternate treatment options. These can serve two additional purposes – to provide options that may be lower in price, as well as options that are more likely to be covered under workers’ compensation, if GLP-1 drugs are not.
Some examples of alternatives include:
- Exercise programs
- Bio-psycho-social models that emphasize and educate employees on how all three factors are connected and influence health and potential illnesses
- Nutrition and behavior therapies
- Other FDA-approved medications outside of weight loss drugs
- Bariatric surgeries and procedures
- Wearable tech, which can provide personalized, helpful data throughout the day
The alternatives could also be used as adjunct treatments to the GLP-1 medications to help with the ultimate success of the drugs.
