#From FatShot to Public Healthcare: A Society Prone to Obesity, Shrinking Savings - Can the Trump Administration's GLP-1 Price Reduction Plan Save Elderly Women?

From the Frenzy of "Before and After" Photos to National Policy

When you open American social media, "before and after" photos of people who have taken GLP-1 weight loss drugs flood the feed.
Posts saying, "I can't go back to my old self when I was overweight" and "My life has changed" receive a flurry of likes and hearts, while equally prominent are desperate comments like "Where can I get it cheap?" and "Is it covered by insurance?"cmoney.tw

At the center of this "weight loss drug boom" are GLP-1 receptor agonists developed by companies like Novo Nordisk and Eli Lilly. Originally developed as diabetes medications, their secondary effects of suppressing appetite and reducing weight have gained attention, leading to expanded approval as obesity treatments. The issue is the price. The market price is said to be around $1,000 to $1,300 per month, and without insurance, the annual burden exceeds $10,000.MarketWatch

In this context, the White House (under the current Trump administration) has agreed with major pharmaceutical companies to keep the price of GLP-1 weight loss drugs between $149 and $350 and is moving significantly towards allowing their use for obesity treatment under Medicare and Medicaid.Reuters

Traditionally, these drugs were covered by public insurance only under limited conditions such as diabetes or specific cardiovascular diseases, but now there is a possibility they could also cover obesity as a disease itself.TIME

Why Focus on "Women on Medicare"?

In discussions surrounding this deal, the keyword often mentioned is "women on Medicare."

In the United States, Medicare is a public health insurance system for those aged 65 and over or with disabilities, and about 55% of its enrollees are women.medpac.gov

Women, who have a longer average lifespan than men, increasingly make up a larger proportion of the Medicare population as they age, with data showing that women account for about 60% of those aged 85 and over.KFF

However, in terms of retirement assets, women are in a weaker position than men. According to an analysis by KFF (Kaiser Family Foundation), the median financial assets per Medicare enrollee are about $30,000 less for women than men, and this gap widens in the bottom 25% tier. The proportion of those with zero savings or in debt is also higher among women.KFF

On the other hand, the issue of obesity also weighs heavily. About 30% of the elderly aged 65 and over are considered obese,americashealthrankings.org
and studies show that over 40% of women aged 65-74 fall into this category.Centers for Disease Control and Prevention
Obesity increases the risk of diabetes, heart disease, stroke, and sleep apnea, and raises the likelihood of needing care or hospitalization.Japan Heart Foundation

In other words, many women on Medicare face a triple risk of "living longer, having fewer assets, and higher risks of obesity and related diseases."

The "Double Benefit" of the GLP-1 Weight Loss Drug Deal

If this deal is completed, it is reported that Medicare enrollees will be able to use GLP-1 weight loss drugs with a self-pay of about $50 per month.ABC News
This is a significant improvement for those who previously had to pay over $1,000 per month out of pocket without insurance coverage.

1. Health Benefits

GLP-1 drugs have accumulated clinical trial data showing an average weight reduction of about 15-20%, and they are beginning to show effects in reducing the risk of cardiovascular events.American College of Cardiology

Studies have also reported improvements in obesity-related sleep apnea and links to reduced risks of Alzheimer's disease and dementia.AHA Journals

For elderly women, who often have a history of heart disease or stroke and are at higher risk of falls and needing care, this has an impact beyond just "losing weight."
If used appropriately, it could reduce the number of hospital admissions and extend the period of independent living at home.

2. Financial Benefits

Under Medicare, with the implementation of the Inflation Reduction Act (IRA), measures such as the introduction of out-of-pocket caps from 2025 onwards are reducing the burden of high-cost drugs.cms.gov

With the addition of price reductions and public insurance coverage for GLP-1 weight loss drugs, the risk of drug costs burdening households is further reduced.

For women who live long with little savings, there is a possibility of being freed from the dilemma of "running out of retirement funds by taking medication to lose weight."

If the increase in medical and care costs due to obesity-related diseases can be curbed, it could also hold significance as an "investment" from the perspective of the sustainability of the overall social security system.

Expectations and Distrust Swirling on Social Media

However, the atmosphere online is not simply one of welcome.
On platforms like Threads, there are skeptical comments such as, "Do you really think women on Medicare can buy the drug with this new plan?"Threads

Positive voices include,

• "My mother might finally be able to receive the latest treatment."

• "It's the first step in treating overweight people as having a disease, not a 'lack of willpower.'"

Meanwhile, criticisms include,

• "Even $50 is heavy for those living on a pension."

• "Only big pharmaceutical companies benefit, and the burden of taxes and insurance premiums is passed on to the younger generation."

Such criticisms are also prevalent.

Additionally, there is concern that if the atmosphere becomes "overweight = immediately GLP-1," more gradual measures such as lifestyle improvements and mental health support may be postponed.

The Reality of Not Being a "Magic Bullet"—Issues of Safety and Dependence

Among medical professionals, there are ongoing concerns about the lack of data on the long-term safety of GLP-1 weight loss drugs, especially their impact on the elderly.MarketWatch

Nausea, vomiting, muscle weakness, risk of hypoglycemia, and impacts on muscle mass reduction and fracture risk in the elderly are among the many points requiring careful monitoring.

Furthermore, there is the reality that "if you don't keep taking it, the weight comes back."
Obesity is a chronic disease intertwined with lifestyle, social environment, and psychological factors, and it is not a problem that can be solved by medication alone.
Whether a comprehensive support system combining medical consultation, nutritional guidance, exercise programs, and mental care can be established will determine whether this deal can be a "success story."

Concerns about the financial aspect cannot be ignored. Previously, when a proposal for comprehensive coverage of anti-obesity drugs by Medicare was withdrawn, one of the reasons cited was an estimate that it could reach a scale of $350 billion over ten years.AP News

Even though this time the price reduction is part of the package, if millions of elderly people use it long-term, the impact on finances will still be significant.

The Global Obesity Crisis and the Position of "Elderly Women"

Not limited to the United States, obesity is increasing worldwide. International collaborative research predicts that by 2050, 60% of adults and one-third of children globally will be overweight or obese.Le Monde.fr

Another study suggests that using a new definition, about 70% of American adults could be classified as "obese."The Guardian

In Japan too, many women, especially around menopause, struggle with weight gain, and GLP-1 drugs are rapidly gaining traction, particularly in beauty clinics.
However, as in the United States, difficult discussions await on how much public health insurance should cover obesity itself and how to evaluate cost-effectiveness.

The current deal concerning women on Medicare in the U.S. can be seen as an attempt to address the triple burden of "elderly women × obesity × poverty."
Its success or failure will likely have a significant impact on policy discussions in countries around the world, including Japan.

From "Wanting to Lose Weight" to "Wanting to Survive"—Future Points of Discussion

The before-and-after photos flowing through social media timelines are certainly appealing.
However, for elderly women on Medicare, GLP-1 weight loss drugs mean more than just the desire to "wear skinny jeans."

• Preventing heart and brain diseases and reducing the risk of becoming dependent on care

• Escaping from medical costs that deplete savings

• Being freed from the stigma of "personal responsibility" and facing obesity as a disease

This deal could be a step towards making such hopes a reality.
However, it also highlights previously