GLP-1 medications like Wegovy, Ozempic, and Zepbound are among the most powerful tools we’ve ever had to address obesity. They’re also among the most expensive. So it’s no surprise that employers are asking: What’s the return on investment of covering weight loss medication? And more importantly — how do we make that ROI as strong as possible?
This guide walks through the full picture: what drives cost, what drives results, and how self-funded employers can build a program that delivers real outcomes — without runaway pharmacy spend.
GLP-1s are clinically effective — but financially risky
There’s no denying the effectiveness. Clinical trials and real-world data consistently show:
- Average weight loss of 15–20% on semaglutide or tirzepatide
- Improvements in blood pressure, cholesterol, and blood sugar
- Reduced risk of developing type 2 diabetes and cardiovascular disease
These outcomes are meaningful — both for employee health and long-term cost avoidance. But they come at a steep cost. Most GLP-1s are priced between $12,000 and $16,000 per person per year.
For self-funded employers, the math gets serious fast:
- If 5% of your population enrolls, you could see a 4–6% increase in total health plan costs
- At 10%, costs could spike 8–10% — even before considering complications or non-adherence
This is why it’s not enough to cover GLP-1s. The true ROI depends on how you deliver them.
The hidden cost drivers behind GLP-1 programs
Most cost overruns aren’t caused by the number of people taking GLP-1s — they’re caused by how those programs are structured. The biggest culprits include:
1. High-dose prescribing by default
Many vendors escalate members to the maximum dose, regardless of need. But higher doses = higher costs + more side effects.
2. No dose management strategy
Without clinical oversight, members often stay on high doses far longer than necessary.
3. No behavior change support
GLP-1s suppress appetite — but they don’t build habits. Without structured coaching, weight regain is likely after stopping.
4. No offboarding plan
Programs without a tapering strategy leave members on medication indefinitely — which drives up long-term spend.
5. No data transparency
If you can’t see who’s progressing, who’s escalating doses, or who’s ready to stop — you can’t manage the benefit effectively.
When these issues compound, GLP-1s become a line item with no end in sight.
Measuring ROI: what really matters
If you want to understand the ROI of covering weight loss medications, you need to look beyond engagement numbers or enrollment rates. The real indicators of value are:
Clinical outcomes
- % weight loss at 3, 6, 12 months
- Improvements in blood pressure, HbA1c, cholesterol (where available)
Medication usage metrics
- Average GLP-1 dose per member
- Time on medication
- Escalation and tapering rates
Coaching and behavioral engagement
- Weekly session attendance
- Improvement in lifestyle domains (sleep, nutrition, stress, activity)
Downstream cost trends
- Change in claims for obesity-related conditions (diabetes, hypertension, MSK, sleep apnea)
- Reduced incidence of emergency visits and high-cost procedures
Satisfaction and retention
- Member satisfaction scores
- Program NPS and testimonial feedback
- 6+ month coaching retention rates
These metrics help employers assess cost efficiency and sustainability — not just participation.
The cost of doing nothing
It’s worth noting: not covering weight loss support isn’t free either.
Obesity-related conditions already cost U.S. employers over $173 billion annually in medical expenses and productivity losses (CDC). These costs show up in:
- Higher rates of type 2 diabetes, hypertension, and cardiovascular disease
- Increased MSK claims due to joint and back issues
- More absenteeism and disability leave
- Lower workplace engagement and energy
With over 40% of working-age adults living with obesity, the status quo is not cheap — and doing nothing is often the most expensive option of all.
Case study: How Embla lowers GLP-1 costs by 66%
Embla is a digital obesity clinic designed specifically for self-funded employers. Our model blends:
- Lowest effective dose protocols (we start low, stay low, and escalate only when needed)
- High-touch video coaching based in Acceptance & Commitment Therapy (ACT)
- Offboarding support for safe, sustainable tapering once goals are met
Here’s what we’ve seen across thousands of members:
- 16.7% average weight loss in 12 months
- Achieved using 66% less GLP-1 medication compared to traditional dose-escalation protocols
- 8 out of 10 members taper off medication without regaining weight
The impact? Lower total cost of care, fewer side effects, and higher engagement.
Designing a benefit that delivers true ROI
To make GLP-1 coverage work for both your employees and your budget, build your benefit around these five principles:
1. Behavior change first
GLP-1s don’t teach you how to eat, move, or cope with stress. Coaching does. Make 1:1 support the foundation — not the afterthought.
2. Start low and stay low
Avoid automatic dose escalation. A lowest-effective-dose model reduces spend and improves tolerance.
3. Build an off-ramp
Weight regain isn’t inevitable — but it is likely if there’s no tapering plan. Help members offboard safely and successfully.
4. Track what matters
Ask vendors for real data: weight loss, dosage trends, coaching engagement, and offboarding success. Engagement alone isn’t enough.
5. Choose a vendor built for outcomes
Look for partners who do more than prescribe. The right partner will help you manage medication use, deliver behavioral support, and measure success.
Final thoughts: treat GLP-1s like a strategic investment
When paired with coaching, structure, and dose control, GLP-1s can be a game-changer. They improve lives, reduce chronic disease risk, and support a healthier workforce.
But without structure, they’re just another runaway benefit line item.
Employers who succeed in this space will be those who:
- Treat GLP-1s as a clinical pathway, not a quick fix
- Measure ROI based on outcomes, not access
- Partner with vendors who prioritize sustainability over speed
At Embla, we’re proud to help employers deliver better weight loss outcomes — using fewer drugs, less spend, and more human support.