Weight loss drgs / Reuters file photo

July 1, 2026, the Centers for Medicare & Medicaid Services (CMS) launched the Medicare GLP-1 Bridge, a temporary demonstration program that expands access to certain weight-loss medications for eligible Medicare beneficiaries. It runs through December 31, 2027.

To qualify, a beneficiary must be enrolled in Medicare Part D and not already have coverage for these medications under their existing Part D plan. They must meet the medical eligibility criteria, including BMI of 35 or higher, or BMI of 27 or higher plus a qualifying weight-related health condition (such as prediabetes or a history of certain cardiovascular conditions). 

The program covers three GLP-1 medications Wegovy, Zepbound (KwikPen formulation only) and Foundayo. GLP-1 medications have revolutionized weight loss and can reduce body weight in obese patients by between 15% and 25% on average after about 1 year.  

Eligible beneficiaries pay $50 per month for the medication. Prior authorization from the prescribing clinician is generally required. That is a significant drop in price from 900 to 1300 a month. 

“Achieving weight loss through diet and exercise is hard. The body’s biology is designed to save you against starvation and is not designed to help you eat less. The idea of these obesity medicines is to reduce the effort required for weight loss by changing those biological signals especially with regard to hunger and how appealing it is to eat when you are not hungry,” said Dr. Jena Shaw Tronieri, Senior Research Investigator, Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania speaking at a briefing organized by American Community Media. 

“With these medicines, the food is still enjoyable but it is not on your mind just as much. The food noise that preoccupied them is silenced,” said Tronieri “and the effort to lose weight is reduced.”

Why do we get obesity in the first place? 

Dr. Fatima Cody Stanford, Associate Professor of Medicine and Pediatrics, Harvard Medical School explained that obesity is a disease of energy regulation and not a failure of willpower. The body has an elaborate system for storing energy, which is shaped by genetics, hormones, the brain’s appetite centers, sleep, stress, the built environment we live in and the food environment we are handed from birth, she said. 

Altered storage and decreased expenditure are driven by forces inside a person’s biology and forces outside of it in the environment around them . Things like food insecurity, portion sizes, chemical exposures, sedentary job, weight bias in the healthcare system, and economic pressure sit outside the ledger. 

Things like genetics, chronic inflammation, hormonal regulation of appetite, disruptive stress, and physiology sit on the inside ledger. For most people living with obesity it is both, an internal biology interacting with an external world that is often not built with their health in mind. 

Sustained exposure to cortisol, the stress hormone, alters how the body stores fat regulates appetite and manages inflammation.

Side effects of the drugs 

The mode of action of these drugs is to mimic the endogenous GLP-1, an intestinal hormone that regulates glucose metabolism and satiety. However, GLP-1 drugs carry known risks and, since their use for weight loss is recent, it may carry unforeseen risks as well. 

The patient has to have pre-authorization in order to obtain the drugs. “We do not give it to patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2. If you have a strong history of pancreatitis, you will not be put on these drugs " said Dr. Stanford. 

When asked what are the main risks for people who do not have diabetes and take it only for weight loss the doctor replied, “For both, GI effects are common, more intense in the early treatment period.”

Gastrointestinal adverse events (nausea, vomiting, diarrhea) are fairly common while pancreatitis and intestinal obstruction are rarer. 

There may be a loss of lean body mass as well as premature facial aging. A significant disadvantage of using these medications is the high rate of weight regain when they are discontinued. 

“These are behavioral medications that do not uncouple energy expenditure," said Dr. Dan Cooper, Distinguished Professor, Emeritus, Pediatrics, UC Irvine Long term consequences can be severe if adolescents are placed on these medicines said Dr. Cooper. Osteoporosis can set in 50 years later. Same applies for heart disease. “If we could control the environment of that child I would be able to fix the obesity problem without any medications. Those are some of the things that we must think about.”

Michelle Mendoza talks about black holes in her eyes during the treatment. 

How long do we treat the patients for?

It is a longtime commitment. Weight loss does plateau off. When you get off the medication, the body does regain weight. Lifetime modifications are key when you are on these medications.

“In our 20s and 30s we should be doing cardio and strength training in a one to one ratio, 30 minutes of cardio, and 30 minutes of strength training. In our 40s and 50s it should be 60 minutes of strength training, and 30 minutes of cardio. In our 60s and 70s, it should be 90 minutes of strength training and 30 minutes of cardio. In our 80s and 90s, 120 minutes of strength training and 30 minutes of cardio. This helps us build bone and muscle. As GLP-1 attacks them, said Dr. Cody Stanford.    These medications do slow the movement down the G.I. track, therefore protein, and fiber should be taken. 

“Until we understand the long-term consequences of using this drug, we have to be very careful in using them. We certainly cannot use them without real lifestyle interventions,” Dr. Cooper said. 

Popular weight loss drugs have recently been linked to a rare eye condition that causes permanent "blacked-out" blind spots. 

 

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