Seniors across the US are likely to join the wave of consumers using GLP-1 drugs to lose weight and fight diabetes under an 18-month program implemented by the Centers for Medicare and Medicaid Services (CMS) starting July 1.
The program, known as Medicare GLP-1 Bridge, will make three drugs – Wegovy, Zepbound and Foundayo – available for $50 per month to those enrolled in Medicare Part D. Roughly 56 million people are enrolled in Medicare Part D, a federal health insurance program primarily used by those 65 and older, according to the Kaiser Family Foundation.
The Medicare GLP-1 Bridge program is a CMS pilot program that was planned as a way to give Medicare recipients access to low-cost GLP-1 drugs temporarily in advance of a more permanent program known as the BALANCE (Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth) program.
Bridge program expanded
The bridge was expected to run from July through December 2026, but the Part D component of the BALANCE program was delayed, so the Medicare GLP-1 Bridge program was extended to the end of 2027.
CMS has not explicitly stated why it is declining to make the program permanent at the end of the year, or what will happen at the end of 2027, but B2B news publication Fierce Healthcare reported in April that health plans are being cautious.
The BALANCE program was connected to the Trump administration’s negotiations with GLP-1 makers Eli Lilly and Novo Nordisk in 2025 to lower the price of the drugs in the US, but CMS Director Abe Sutton told Endpoints News that healthcare plans were concerned about instability in Medicare Part D, Fierce Healthcare reported.
UnitedHealthcare, the largest insurance provider in the US, is participating in the Bridge program but noted in an April quarterly earnings call with investors that it would like to find a path to coverage.
Bobby Hunter, chief executive officer of Government Programs at UnitedHealthcare, said that “there are some notable challenges and outstanding questions with the currently planned structure.”
“We are still working through that process internally and look forward to continuing the dialogue with CMS,” he said. “We provided specific recommendations that we believe would serve all stakeholders well. As you know, we will be participating in the Bridge demo starting in July; we think we will learn a lot about the best way to advance this priority through that experience.”
Seniors on GLP-1s
Healthcare experts have mainly supported the plan to expand GLP-1 coverage, but not without caution.
The Obesity Society, an organization of scientists dedicated to the study and prevention of obesity, applauded the Bridge program in a letter to CMS Administrator Mehmet Oz.
“We are actively communicating with our members and the public about the program and encouraging individuals to seek treatment when it launches on July 1,” the organization wrote. “At the same time, while we support the implementation of the Bridge Program, we respectfully urge CMS to consider additional policy changes necessary to ensure comprehensive, patient-centered obesity care.”
Similarly, Marion Nestle, the Paulette Goddard Professor of Nutrition, Food Studies and Public Health, Emerita at New York University, said GLP-1 users need support as they navigate using the drugs.
“[The Bridge program] will make the drugs more widely available and access more equitable, but we still need a healthcare system that makes the drugs available to everyone who needs them and that gives users the support they need to achieve the desired health outcomes,” Nestle said.
Dr. Vanita Rahman, clinic director of the Barnard Medical Center, which is operated by the Physicians Committee for Responsible Medicine (PCRM), said that while the program is well-intentioned “GLP-1 agonists do not address the underlying drivers of obesity, such as binge or emotional eating, habitual overeating, widespread availability of calorically dense foods with a poor nutritional profile, eating with distractions and increasing restaurant portion sizes.”
She warned that the drugs also come with side effects, such as “abdominal bloating and discomfort, nausea, vomiting, constipation, inflammation of pancreas, and in some studies, an increased risk of severe and irreversible eye disease.”
“Research shows that 50% of users stop the medications within 12 months, and since the medications do not address the underlying causes of obesity, people regain the lost weight within 20 months,” she said. “On the other hand, a low-fat plant-based diet coupled with strategies to address binge and emotional eating, distracted eating and sensible portion sizes can lead to long-lasting weight loss without any of the side effects seen with GLP-1 agonists.”
Healthy diet first
GLP-1 use should not take the place of a healthy diet, especially for seniors, according to PCRM Senior Media Relations Specialist Kim Kilbride.
“It’s great that we are making medications more affordable,” she said. “However, in the case of GLP-1s, we risk the medications being recommended as an easy weight loss solution that doesn’t first address diet.”
Research shows that those who discontinue GLP-1s gain the weight back within about a year and a half.
She warned that affordability could lead seniors to consider them as a “first-line solution” that they might discontinue once they lose the weight or if the Bridge program ends.
“GLP-1 medications work by reducing a person’s appetite. In some cases, this puts the patient at risk for not meeting certain nutrient needs. In older adults specifically, this may not be the best strategy for weight loss because muscle loss is already a concern as we age,” she said. “With rapid weight loss and reduced appetite, muscle loss may be accelerated. Older individuals should be encouraged to work with a registered dietitian who can help them lose weight in a way that allows them to also meet their calorie and nutrient needs.”
