8 Strategies for Managing Healthcare Costs When Treating Obesity

The financial side of losing weight may not be the first thing on your mind when you’re living with obesity. But between doctor’s visits, prescription medications, healthy foods, and fitness programs, the cost of managing the condition can add up fast.

If you feel overwhelmed by these expenses, you’re not alone.

“Many patients share that the cost of healthy eating and gym memberships can feel prohibitive,” says Nina Paddu, DO, an obesity medicine physician at Maimonides Medical Center in Brooklyn, New York. “In addition, certain anti-obesity medications are often too expensive out of pocket, or patients face high deductibles. As a result, even when these treatments are medically appropriate, access can be limited.”

The good news: With the right strategies, it’s possible to control obesity-related healthcare expenses and achieve your weight management goals.

1. Save on Doctor’s Visits

Because obesity is a chronic condition that requires ongoing care, you may have to see your care team more frequently, which can lead to higher medical expenses.

“People can reduce costs by choosing in-network providers,” says Dr. Paddu, meaning physicians who have contracts with your insurance company and often offer services at a lower rate. Check your insurance provider’s website to find doctors who are in your network.

Community health centers and nonprofit clinics may be other lower-cost options to explore. They often provide services on a sliding scale, based on your income, which can make visits with primary care doctors or specialists more affordable.

2. Check if a Medication Is Covered by Insurance

Newer prescription medications for obesity, such as GLP-1 and dual GIP/GLP-1 receptor agonists, can be highly effective at helping people with obesity lose weight, but they can also be expensive.

“I think a lot of people don’t end up pursuing [this type of] treatment, because they’re afraid of the cost involved with it,” says John Morton, MD, a professor of surgery and the medical director of bariatric surgery at Yale School of Medicine in New Haven, Connecticut.

Out-of-pocket costs can vary widely, though, and GLP-1s can cost significantly less if they’re covered by your insurance. If you’re considering a GLP-1, contact your insurance provider to determine if the drug is covered under your plan and what you’ll need to pay.

If the medication isn’t immediately covered, there are a few steps you can take:

• Check if you meet your plan’s eligibility criteria. Insurance companies may require a certain body mass index (BMI), an obesity-related health condition, participation in a lifestyle program, or previous use of other weight loss treatments to approve a GLP-1.
• Review health conditions. GLP-1s are more likely to be covered if they’re prescribed for type 2 diabetes, heart disease, or other obesity-related health issues than for weight loss alone.

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   If you have a related condition, your provider can help determine if the medication may be appropriate and covered under that diagnosis.
• Submit a prior authorization. This is a request your doctor submits to the insurance company to determine if the prescribed treatment is medically necessary and covered by your plan.
• Request a letter of medical necessity. If you don’t meet the eligibility criteria, ask your doctor if they can provide a letter of medical necessity that explains why you need the medication.

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• Appeal a denial. If coverage is denied, you can submit a request for an internal appeal, which is conducted by your insurance provider, or an external appeal, which is done by an independent third party.

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3. Seek Out Discounts

Even if you don’t have insurance or your plan doesn’t fully cover the obesity medication you were prescribed, there are ways to reduce costs.

“Pharmaceutical companies offer savings programs for medications,” says Paddu. “These may include discounts for patients using insurance or reduced pricing for those paying out of pocket through direct-to-patient pharmacy programs, where medications are shipped to the home at a lower cost than typical retail pharmacies [charge].”

Check the medication manufacturer’s website to learn more about their savings programs and eligibility requirements.

You may also consider:

• Prescription assistance programs, which can help uninsured or underinsured people find free or discounted medications.
• Third-party programs that provide discount cards for medications
• Telehealth platforms that offer GLP-1 medications as part of a holistic weight loss program

Dr. Morton also recommends checking with your employer. “Some employers may not cover your medication through insurance, but they may reimburse you if you’re paying out of pocket.”

4. Ask Your Doctor About Lower-Cost Alternatives

“If [GLP-1 medications] are not covered, it can make sustained weight loss more challenging,” says Paddu. “I try to ensure cost does not become a barrier to progress by exploring alternative strategies.”

These may include older weight loss drugs that are less expensive than GLP-1s.

“Other options are called legacy drugs, and some of them are considerably more affordable,” says Morton.

5. Use FSA or HSA Funds for Eligible Expenses

Health savings accounts (HSA) and flexible spending accounts (FSA) allow you to set aside money before it’s been taxed to help pay for healthcare costs. They are typically offered as part of your employer’s health benefits package.

You may be able to use HSA and FSA funds to cover qualified medical expenses, such as:

• Doctor’s visits and copays
• Hospital stays
• Deductibles and coinsurance
• Prescription medications, including weight loss drugs
• Over-the-counter medications

• Gym memberships
• Personal training
• Fitness equipment
• Weight loss programs and counseling
• Dietitian or nutritionist visits

To get reimbursed for these expenses, you will need to submit the letter of medical necessity, along with the receipt or claim form, to your HSA or FSA administrator.

6. Try Free or Low-Cost Workouts

The cost of a monthly gym membership can vary widely, depending on where you live, what type of facility you join, and which amenities it offers.

“Gym memberships can be helpful, but they are not essential,” says Paddu. “Many people achieve excellent results with home-based workouts, resistance bands, and walking outdoors — all of which are low cost or free.” Talk to your doctor before starting any new exercise routine.

Other inexpensive ways to get moving include:

• Jogging, biking, or hiking
• Joining a local walking club or recreational sports league
• Doing body weight exercises, such as planks, push-ups, and squats
• Following along with online workout videos
• Using household items, such as water bottles or canned goods, to strength train
• Buying affordable equipment, such as a fitness ball, light dumbbells, or a jump rope

If you prefer working out in a gym setting, there are still ways to keep costs manageable:

• Consider more affordable options, such as community centers, YMCA locations, and budget gyms, which often offer lower monthly rates or off-peak pricing.
• Ask if the gym offers discounts, promotions, or financial assistance.
• See if you can use your FSA or HSA to cover your gym membership if your doctor provides a letter of medical necessity.
• Check if your employer’s benefits plan includes discounts or reimbursement for gym memberships.

7. Eat Healthy on a Budget

• Plan meals, and shop with a list to reduce impulse buys.
• Build meals around nutrient-dense, versatile staples, such as beans, eggs, lentils, and whole grains.
• Buy nonperishable staple foods in bulk.
• Take advantage of coupons, sales, and store rewards programs.
• Buy frozen fruits and veggies, which are less expensive than fresh produce and offer similar nutritional value.
• Opt for store brand and generic products over more costly brand-name products.

If nutrition counseling or dietitian visits are part of your obesity treatment plan, you may be able to use your FSA or HSA to cover them if your doctor provides a letter of medical necessity.

8. Talk With Your Care Team About Your Finances

Discussing your financial concerns with your doctor can feel uncomfortable, but it’s an important part of obesity care.

“There is no need for embarrassment. These are very common concerns,” says Paddu. “A good clinician will work collaboratively to develop a treatment plan that is both effective and financially sustainable.”

Ask your doctor about the expected out-of-pocket costs of medications, follow-up care, and other services, and be honest about what seems manageable for your budget. They may be able to suggest lower-cost alternatives, adjust your management plan, or help connect you with financial assistance programs or other resources.

“I always tell patients not to be afraid to ask,” says Morton. “Different hospitals, cities, and states may have programs to help cover costs, or there may be foundations that will cover your care. It’s worth asking to find out what’s available.”

While the initial cost of treating obesity may seem high, it can pay off over time in reduced medical expenses, lower insurance premiums, and a reduced risk of related health conditions. Think of it as a long-term investment in your health.