< Wegovy works. But here's what happens if you can't afford to keep taking the drug

STEVE INSKEEP, HOST:

Many people are talking about the weight loss drug Wegovy. It was called a major breakthrough given how well it does work to reduce body weight. But this drug is extremely expensive. And when people can't afford to stay on it, they often experience rebound weight gain that is hard to stop. NPR's Allison Aubrey has been reporting on this. Hey there, Allison.

ALLISON AUBREY, BYLINE: Good morning, Steve.

INSKEEP: Who's eligible for this drug? Who's it for?

AUBREY: Well, a lot of people are eligible. This is a drug for people who have a BMI - or body mass index - of 27 or higher and also have conditions related to obesity, so high blood pressure, high cholesterol. And that's millions of Americans. I spoke to Yolanda Hamilton. She works in a hospital ER. She's 51 years old, was struggling with pre-diabetes, hypertension. She recently lost 60 pounds on the drug, which is taken at home once a week by injection. Here she is.

YOLANDA HAMILTON: I was very surprised about how much weight I lost on Wegovy. And I was very surprised about how good I felt - gave me more energy to do other things, exercising, coming home from work and able to do house chores.

AUBREY: So she was feeling a lot better. And she lost all the weight in under a year.

INSKEEP: Is it clear that that is the normal experience, it works that well all the time?

AUBREY: Yes. This drug really started to take off after the results of a big clinical trial were published in the New England Journal of Medicine almost two years ago. It showed people who took the drug for about six months lost about 15% of their body weight. So for a 200-pound person, that's 30 pounds. I spoke to Dr. Robert Kushner of Northwestern. He's one of the researchers on the study. He also serves on an advisory board at Novo Nordisk. That's the company that markets Wegovy. He says it was surprising. Some people lost even more.

ROBERT KUSHNER: One-third of individuals lost 20% or more of their body weight. Our mouths are really open. I've been involved in this field for over 40 years. We have never seen a medication that caused this amount of weight loss.

AUBREY: So unprecedented results, he says. But what some don't realize is that once people start the drug, they may need to stay on it indefinitely, Steve. Otherwise, the research shows, there's a rebound effect. People tend to gain most of the weight back within a year if they stop the medication.

INSKEEP: Meaning they would be stuck on this drug for life?

AUBREY: Potentially, yes, in order to maintain the benefits. But given the cost of the drug, Steve, which is about $1,400 a month for people paying out of pocket, not everyone can stay on the medication. Yolanda Hamilton changed jobs. And with that, her health insurance has changed. Her new plan denied coverage of the drug. And very quickly, within just a few months, she's already gained 20 pounds back.

HAMILTON: I definitely wouldn't be able to afford the Wegovy at $1,400 a month. And I'm very frustrated about the weight coming back on in so little time.

AUBREY: She says her cravings for sugar and fatty foods is back. And she's hungrier.

HAMILTON: But with the Wegovy, I had no taste for the bigger meals.

AUBREY: And that really makes sense, Steve, given how this drug works. It basically mimics a hormone in our bodies that can help us feel full. So without the drug, the weight is coming back on. And she's now at risk of developing diabetes and heart disease if she continues to gain weight.

INSKEEP: Well, some people listening to that might say, well, I really shouldn't be starting this drug. Maybe I should be trying to change my diet myself or doing a little more exercise.

AUBREY: You know, I think most people would like to lose weight by diet and exercise. But we live in a society where people are sedentary, in part due to our jobs. Yolanda Hamilton sits 8 hours a day at her job. And the unhealthiest foods are the cheapest foods.

INSKEEP: Yeah.

AUBREY: I mean, heart disease is the No. 1 cause of death in the U.S., Steve. And obesity is a big risk factor. It can shave years off someone's life. I spoke to physician Marcus Schabacker. He's CEO of ECRI. They're an independent nonprofit group that aims to make health care more equitable and more cost effective. His group has reviewed the evidence of these new weight loss drugs. He says, at a time when our society spends more than $170 billion a year on obesity-related costs, these FDA-approved medicines should be covered.

MARCUS SCHABACKER: Exercise and diet are key components of tackling obesity, but so are medications which have proven to be effective.

AUBREY: But right now, coverage of Wegovy by insurance plans is pretty spotty. Yolanda Hamilton's doctor is helping her appeal the insurance company's denial. But this is tricky to do. Medicare does not pay for Wegovy. Though, increasingly, there is pressure to change that.

INSKEEP: For now, what can people do if they are denied coverage?

AUBREY: Well, I spoke to Karla Robinson. She's a family physician who is also a medical editor at GoodRx, a company that helps people find affordable prices for generic and brand medications. She points out that since there's no generic version of these weight loss drugs, they're very expensive. And even with coupons available from Novo Nordisk, the manufacturer, for now, without broad insurance coverage, the drugs are just out of reach for many people, especially among people with low incomes, who experience obesity at disproportionately higher rates.

KARLA ROBINSON: Some of the people who need it the most are unable to access it. And so, yeah, we're talking about a huge health equity issue.

AUBREY: So there is momentum to push for change.

INSKEEP: What are the long-term safety effects of taking this drug for the rest of your life?

AUBREY: Well, no drug comes without risks or side effects. The most common side effect with Wegovy are GI symptoms, so nausea, upset stomach. Dr. Kushner says they're usually temporary, fade away after a few months for most people. There's ongoing research to evaluate effects on the cardiovascular system, which so far have been positive. But I will point out the drug does carry a warning to inform people that in animal studies, thyroid tumors developed in some animals given the drug. Now, this has not been seen in people. But the drug is relatively new. So doctors do screen patients for risk factors linked to a specific kind of thyroid cancer. So bottom line, everyone needs to weigh the risks and benefits. I mean, this drug has gotten a lot of buzz from notables. Like, Elon Musk tweeted about using Wegovy to slim down, plenty of TikTok influencers. But, Steve, this is not a drug for cosmetic weight loss. This is a drug for people whose health is at risk due to obesity.

INSKEEP: NPR's Allison Aubrey. Thanks so much.

AUBREY: Thank you, Steve.

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