The Unseen Challenge: Why Few Are Accessing Weight Loss Medications

Weight loss medications like Ozempic, Wegovy, and Mounjaro have captured widespread attention, dominating headlines in pop culture and scientific discussions. Everyone’s talking about them, but it turns out getting a prescription is much harder than simply hearing about them.

New research from Yale, published in the Journal of the American Medical Association on April 29, reveals a surprising truth: only 3% of eligible adults in the U.S. have actually received a prescription for these weight loss drugs.

A Powerful Tool Not Reaching Everyone

These medications have garnered significant media attention due to their effectiveness, not just for weight loss, but also for improving overall cardiovascular health. Researchers at Yale wanted to understand who was actually receiving these prescriptions and if there were any gaps or disparities. They found that very few people who could benefit from these powerful new treatments are actually getting them, indicating these valuable medications are not reaching everyone who needs them.

Who’s Missing Out? Unsettling Differences in Prescriptions

The Yale team analyzed nearly 40 million adult health records from 280 U.S. healthcare systems between 2020 and 2024. Even among the small 3% who did receive prescriptions for semaglutides (like Ozempic and Wegovy) and tirzepatides (like Mounjaro), persistent differences emerged:

• Gender: Men were less likely to receive prescriptions than women.
• Location: People living in rural areas were less likely to get prescriptions.
• Socioeconomic Status: Individuals in communities facing more economic challenges were also less likely to receive prescriptions.
• Race and Ethnicity: Black, Hispanic, and Asian patients were consistently less likely to receive prescriptions compared to White patients. These disparities remained consistent over the entire three-year study period.

These findings are particularly concerning because Black and Hispanic patients have higher rates of obesity in the United States compared to White patients. These minority populations often carry a greater burden of obesity, yet may face barriers to accessing these medications. This could be due to less frequent visits to specialists who can prescribe these drugs, or challenges like high costs and insurance coverage even when they do see a specialist.

It’s also suspected that the actual number of people filling prescriptions might be even lower, as the study only counted prescriptions written, not those actually picked up from the pharmacy.

The Cost Barrier: A Major Hurdle

A significant reason for these low prescription rates and glaring disparities often comes down to cost. Without insurance, medications like semaglutide and tirzepatide can cost $1,000 or more per month. Even with insurance, broad coverage for these medications isn’t guaranteed. Furthermore, government programs like Medicare and Medicaid are currently prohibited from covering these medications when prescribed solely for weight loss.

Patients might receive a prescription but then not fill it because of inadequate insurance coverage and high out-of-pocket costs. Many factors related to social determinants of health contribute to these differences in access.

Why These Drugs Are So Important

These low prescription rates and obvious differences are troubling, especially given the significant benefits these drugs can offer millions of Americans.

Studies have shown that semaglutides and tirzepatides are not just effective for weight loss; they also:

• Can lower cardiovascular risk factors like blood pressure, cholesterol, and glucose.
• Can reduce the risk of heart attack, stroke, and cardiovascular death.

The protective effects are so impressive that researchers believe the benefits generally outweigh potential side effects like nausea, vomiting, or stomach pain.

Researchers are continuing to investigate these real-world prescribing trends and compare the benefits to those seen in clinical trials. They are also examining prescription rates in specific groups, such as patients with heart failure and severe obesity.

The overall takeaway is that while we have effective medications for obesity, their adoption is very slow. There’s a long way to go to ensure these effective treatments are available to everyone who needs them, especially certain subgroups that are currently being left behind. More effort is needed to address these disparities.

Source: Yale School of Medicine| May 5, 2025