Obesity has long been identified as a major barrier to healing injured workers, so it can be tempting for workers’ compensation payers to latch onto a “miracle” weight loss drug to help employees get back to work and reduce their own costs.
Everyone from tech billionaires to Hollywood stars and social media influencers are reportedly using the diabetes drug semaglutide, which goes by the brand names Ozempic and WeGovy, to shed unwanted pounds, and the trend has raised questions about whether it should be used more widely.
With obesity considered one of the most common comorbidities in workers’ comp claims, the potential for the drug to, say, help a worker with an injured knee return to work more quickly appears promising.
But, as we report here, the industry is wary of introducing semaglutide into the comp system, and rightfully so.
The first consideration is the potential side effects of the drug. While the Food and Drug Administration has approved at least one brand of the drug for chronic weight control in adults with obesity, potential side effects include some serious conditions, such as thyroid cancer and gallbladder disease.
Second, the drug must be prescribed long-term, otherwise patients often gain weight after they stop taking it. Such extended prescriptions may be appropriate for treatments covered by the wider healthcare setting but do not fit well with the typically more limited scope of comp.
Additionally, if semaglutide falls into the comp sector, payers would be on the hook for monitoring patients for its continued use and side effects, which could lead to uncapped costs.
That’s not to say that workers shouldn’t expect employers to take a broader view of health care that can help address obesity — promoting and supporting wellness programs to help keep workers healthy, and considering mental health factors when treating physical injuries, both can be important factors in returning to work more quickly.
By prioritizing sustainable interventions and treatments, payers and employers can effectively reduce the risks of weight loss medications while supporting injured workers.
Employers may still consider allowing the use of weight loss drugs in the future, especially if courts hold them responsible for paying for more extreme obesity treatments. So far, employers have only rarely been required to pay for expensive bariatric surgery to treat weight loss in comp cases, but if that trend widens, carefully monitored use of long-term medications may be the better option.
For now, however, the industry’s cautious approach to covering weight loss medications like semaglutide is justified. Instead of following pharmacological fads and reaching for the latest pill bottle, injured workers should be helped and encouraged to live healthier lives to prevent injuries and to speed recovery when they do occur.