The Right to Lose Weight Determined by Insurance, Income, and Culture — Behind the GLP-1 Boom: The Fading "Effort Theory" and the Strengthening "Medicalization"

The Right to Lose Weight Determined by Insurance, Income, and Culture — Behind the GLP-1 Boom: The Fading "Effort Theory" and the Strengthening "Medicalization"

2025年11月11日 07:52

1. The Concurrent Phenomenon of "Obesity Crisis × Ozempic Boom"

Obesity in the United States has been a long-term social issue, but 2024 data shows a slight improvement with 19 states having an adult obesity rate of 35% or higher, down from 23 states the previous year. Meanwhile, the prescription of the "weight loss drug" GLP-1 has rapidly expanded, becoming a new phenomenon involving healthcare, economy, and culture. An article published by Fox News on November 9 (Eastern Time) visualized "which states are particularly using GLP-1" using insurance claim data, showing the overlap with the geography of obesity. TFAH


2. Data Reveals "GLP-1 Hot Spots"

Based on data from the insurance analysis company Purple Lab, GLP-1 Newsroom compiled state-by-state estimates showing that in states like West Virginia (about 24%), Kentucky (about 22%), Louisiana, and Oklahoma (about 20%), more than 15% of the population is receiving GLP-1. Conversely, Hawaii is low at about 5%. Such high usage rates are concentrated in the South, Midwest, and Appalachia. It is noted that the estimates do not include out-of-pocket purchases, combination drugs, uninsured, and some telemedicine, indicating that the actual situation may be even greater. GLP-1 Newsroom


Point: The numbers are the "minimum line". Including usage not reflected in insurance claims, the actual usage numbers could be higher. GLP-1 Newsroom


3. A Phenomenon "Overlapping" with the Geography of Obesity

Among the states with high adult obesity rates (WV, MS, LA, AL, AR, OK, KY, TN, IN, TX), the overlap of GLP-1 prescription rates exceeding 15% in many states is observed. In other words, the heavier the burden of obesity and diabetes in a region, the higher the dependency on GLP-1. The 2024 state-by-state obesity rates are published by TFAH (Trust for America's Health) based on BRFSS, and the disappearance of states with less than 25% obesity rate is also noteworthy. Fox News


4. Insurance, Policy, and Income Determine the Spread

The spread of GLP-1 is not determined solely by medical necessity. Medicaid coverage, the strictness of prior authorization, and out-of-pocket costs in each state influence the speed of introduction. As a result of federal and state system differences, even with similar health issues, the outcomes vary. According to the materials, only a limited number of states still recognize GLP-1 for obesity treatment under Medicaid. Price negotiations and expansion of indications (e.g., adding sleep apnea as an indication) are factors that widen regional differences in system and market movements.


5. Medical Professionals' Perspective: Expectations and Caution

Among doctors, there is little disagreement that GLP-1 is a powerful intervention for diabetes and obesity, but there are cautious voices regarding expanding indications and the expectation of "universalization". Specialists appearing in the Fox article mention applications in cardiovascular and addiction fields, while pointing out the need for caution in conclusions based on the rapid expansion of prescriptions. In clinical settings, the challenge is how to balance the foundations of exercise, nutrition, and sleep with **the continuity of medication (cost, supply, side effects)**. Fox News


6. Reactions on Social Media: A Three-Layer Structure of Praise, Concerns, and Ethical Debate

(1) Success Stories and Hope
On platforms like Reddit, experiences such as "reduced urge to drink" and "easier self-management" are shared as behavioral improvements, with an analysis indicating that the overall sentiment is neutral to slightly positive. Reddit


(2) Anger Over Costs and Access
Voices of dissatisfaction and anger over rising insurance premiums and heavy out-of-pocket costs are prominent. In threads about local health insurance news, the rapid increase in GLP-1 spending is discussed as a factor driving up insurance premiums. Reddit


(3) Information Bias and Underreporting of Side Effects
Posts from influencers tend to emphasize success stories, and there is criticism that adequate explanations of side effects and costs are lacking. Academic reviews also point out misleading information on social media and underreporting of side effect information.

In summary, the three-layer structure of **joy (I lost weight!) — anger (It's too expensive!) — anxiety (Is it safe?)** accelerates the debate, compounded by regional disparities of "usable/unusable".


7. Economic Ripple Effects: Corporations, Insurance, and Regional Healthcare

GLP-1 forms a massive market involving pharmaceuticals, retail, food, and fitness, affecting employer insurance and state finances. Particularly in high-use states, the tug-of-war between rising drug costs and improved health outcomes continues. Whether short-term cost increases or reduced long-term complication risks will prevail depends on appropriate adaptation and **continued support (side effect management, rebound measures)**.


8. "Cautionary Notes" to Interpret

  • Limitations of Data: Insurance claim-based data does not capture out-of-pocket, combination, telemedicine, uninsured. Consider the bias towards lower reporting. GLP-1 Newsroom

  • Understanding Obesity Rates: **State-by-state obesity rates (BRFSS) and national average (NHANES)** use different methodologies. Even with a high level of **40.3% nationwide**, state rankings are different. TFAH

  • "Not Solved by Medication Alone": Prescribe to medically appropriate targets alongside behavioral changes—this is the common understanding among academic societies and public health.


9. Practical Notes for Users (To Be Saved)

  1. Consult Your Primary Doctor: Always share your medical history (cardiovascular, gastrointestinal) and concurrent medications.

  2. Check Insurance Coverage: Conditions vary greatly by state and insurance plan. Check if prior authorization is needed and the limit on the number of times.

  3. Source Credibility: Success stories on social media should be taken as reference only. Verify with academic reviews and primary information from public institutions.

  4. Simultaneous Lifestyle Updates: Diet, exercise, sleep, alcohol. Use medication to lay the foundation and habits to solidify it.

  5. Plan for Interruptions and Switches: Prepare for supply shortages and cost fluctuations, and decide on weight rebound measures during interruptions with your doctor.


10. Conclusion

The map of GLP-1 is also a map of health disparities in the United States.
It is rational that the spread is more advanced in high-burden areas, but the involvement of insurance, income, and culture creates a divide between **"effective society/inaccessible society."** The more social media raises the heat, the more caution is required in implementation.
**Aligning evidence (TFAH/BRFSS, insurance claim data) with the reality of daily life (voices on social media)** to design sustainable weight loss with both medication and lifestyle habits—this is the only way to turn the boom into a societal benefit. GLP-1 Newsroom


Reference Article

America's Obesity Crisis Meets Ozempic Boom, Data Reveals GLP-1 Hot Spots
Source: https://www.foxnews.com/health/america-obesity-crisis-meets-ozempic-boom-data-reveals-glp-1-hot-spots

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