The burden of obesity has been increasing in recent years. According to the World Health Organization (WHO) in 2022, worldwide just under half of (43% or 2.5 billion) adults aged 18 years or older were overweight, and 16% of these adults were living with obesity. The worldwide adult obesity burden has more than doubled since 1990, and adolescent obesity has quadrupled.

Overweight and obesity also carry an economic burden as these individuals can incur higher medical costs. A study reported that obese individuals were found to have medical costs that were approximately 30% greater than their normal-weight peers.

Furthermore, overweight and obese workers can negatively affect employers’ bottom line by reducing productivity. A 2024 study aimed at quantifying this revealed that in 2023, obese and overweight nonfarm civilian workers incurred costs of approximately $425.5 billion. This total includes $146.5 billion from increased medical expenses to employers—$89.8 billion for direct medical costs and $56.7 billion for other employer-related health expenses—along with $242.6 billion linked to absenteeism and presenteeism. The study concluded that obese and overweight workers were associated with $6,472 and $1,244 in annual economic costs per worker, compared to a worker with a healthy weight.

Sarah Wells Kocsis, a senior director at the Milken Institute and the co-author of the report titled “Modernizing Care for Obesity as a Chronic Disease: A How-To Guide for Employers”, talks about the part employers play in providing obesity care in an interview with the Drug and Device World.

Awareness plays a key role in providing obesity care

Wells Kocsis notes that while it has been scientifically established that obesity is a complex and multifactoral chronic disease, there is a lack of understanding and awareness around the disease, with some in the broader public still classifying it as a lifestyle disorder. Adding, “It’s absolutely critical that we as a country, as well as around the world understand and recognize, obesity as a chronic disease. So that’s sort of step one to this whole conversation.”

According to Wells Kocsis, employers have an integral role in advancing public health and that extends to obesity. “The reason for that is employers are uniquely positioned to drive environmental change in the way that we approach health and health care. So thus, they are going to be part of the solution.”

Wells Kocsis says: “The US workforce comprises 160 million employees. So, the reach of that is enormous in terms of being able to foster a positive impact, where we can have healthier and more equitable workplace systems.”

Adding, that employers have a responsibility and an incentive to drive health care quality and affordability as about half of the US population receive their health insurance through their workplace. Making it imperative to think about the ecosystem in a very holistic manner.

Wells Kocsis notes that this presents an opportunity for the private sector to change policy, where employers, especially larger employers with large purchasing power, can think about and change the offerings of employer-sponsored insurance.

Adding anti-obesity treatments to obesity care

Weight loss therapies like Novo Nordisk’s Wegovy (semaglutide) and Eli Lilly’s Zepbound (tirzepatide) have been increasing in popularity in recent years. The therapies have generated billions in sales, Novo Nordisk’s obesity drugs, Wegovy and Saxenda (liraglutide), generated DKK65.1 billion ($9 billion) in combined global sales in 2024.

But these drugs are expensive. Wegovy and Zepbound’s US list prices are set at $1,086.37 and $1,349.02, respectively. The high prices of these drugs have discouraged many US companies from paying for these drugs. Although Novo Nordisk and Lilly have started programs for cash-paying patients at the cost of $499 per month.

This is a significant investment for most companies, especially considering patients may require lifelong treatment. A 2022 study found that participants regained two-thirds of their prior weight a year following the withdrawal of subcutaneous semaglutide, reinforcing the belief that ongoing treatment is required to maintain improvements in weight.

When considering the cost of anti-obesity medications, Wells Kocsis says that while employers need to understand how to educate their workforce on multiple solutions for managing obesity, they also need to understand the return on investment in providing obesity care. She cited a GlobalData study saying, “We are looking at costs of about $425.5 billion if we do not address this problem. Whether it be a loss of productivity, increased medical costs associated with obesity, and comorbidities associated with this disease – employers are going to end up being impacted by the cost if they do not address it.”

Adding, “If their employees are going back to the hospital, or having to seek care, for reasons that their obesity is impacting their health negatively, it’s going to cost [employers] more on the other side. So, it’s all about going upstream – thinking about prevention models and integrating care.”

Opportunity areas for employers

 “We identified four core opportunities for employers in our guide,” says Wells Kocsis. “First was education, the second was culture change, the third was benefit design, and the fourth was public policy. They’re all interconnected.”

Wells Kocsis says that she has seen improvement in education around obesity, “but we still have work to do around understanding weight bias and stigma”. She notes that obesity impacts a person’s life on various levels and they may face discrimination in the workplace, including participation in programs, having a dialogue with their employers, and the effect on their mental health.

This ties into the company’s cultural mindset and its readiness to change, as per Wells Kocsis. Adding that there are technical aspects of coverage and benefit design in addition to the cultural aspect.

Wells Kocsis highlights the enduring aspect of obesity care, saying that the Milken Institute has been publishing on obesity for ten years. Noting that on March 26, 2025, the Wall Street Journal (WSJ) published a full-page ad, which was an open letter to employers. It listed 68 organizations by name, the Milken Institute was cited as one of the pieces of evidence behind this. Wells Kocsis says, “it was a call to action to America, to employers to say we urge businesses, to start thinking about covering obesity because it is a chronic disease and taking action around that. So, there is this galvanization that is occurring, and that happens as a result of this awareness, this education building around chronic disease. And then it starts moving the conversation into employers really engaging with their health plans to talk about what’s possible.”

Wells Kocsis notes that there is a need for more research on obesity care, especially on the economics of the disease. “We need to continue to think about what is that value proposition. Because in the end that’s going to drive a lot of decision-making by the health plans. It is going to decide whether employers are all in. It is going to drive whether policymakers are going to say yes to coverage because a lot of the policymakers understand that we can’t have flawed policies that don’t recognize obesity as a chronic disease.”