The global hype around GLP-1 ‘weight-loss’ drugs shows no signs of quietening down. And it’s also causing a stir among employee benefits (EB) industry leaders considering how to respond to the phenomenon.

With over half of the world’s population predicted to be overweight or obese by 2035 – at a forecast global economic impact of US $4 trillion annually – the potential GLP-1s have as a weight loss drug could be vast.¹

Their increasingly mainstream popularity poses questions for multinational employers and insurers. Both need to balance the steep upfront investment with whether covering GLP-1s can ultimately reduce costly obesity-related health issues in the long run – potentially boosting wellbeing and productivity.²

In this month’s Viewpoint, we explore how the EB industry is responding to the GLP-1 trend and suggest practical considerations for employers and insurers putting together their strategy.

Glucagon-like peptide 1 (GLP-1) agonists were originally intended for Type 2 diabetes patients, helping them manage their conditions. The drugs are typically injectable and work by helping to lower blood sugar levels.

A rise in ‘off-label’ use came after their promise as a weight loss solution emerged. While researchers are still studying exactly how the drugs help people lose weight, it’s believed they curb hunger and slow the movement of food from the stomach into the small intestine.³ The global clamour around their use as weight-loss drugs has led brands like Wegovy, Ozempic and Mounjaro to become household names.⁴

In the short-term, GLP-1 drugs can cause a range of side-effects, most commonly including: gastrointestinal symptoms like nausea, vomiting, diarrhoea, constipation and sometimes facial sagging and wrinkling due to rapid weight loss.⁵ While the effects of GLP-1 drugs for their original intended users – treating diabetes patients – is well-established, the long-term effects of their ‘off-label’ use for weight loss is yet to be fully understood – triggering a call for caution from some healthcare experts.⁵

Despite hype around the drugs’ ability to lead to rapid weight loss, studies are showing they must be paired with lifestyle change to ensure their effectiveness.

A recent American Journal of Lifestyle Medicine scientific manuscript, ‘Health and Well-Being Coaching Adjuvant to GLP-1 Induced Weight Loss,’ indicated that higher success rates for sustained weight loss can be achieved when GLP-1 therapy is combined with health coaching, compared to relying on the medication alone. The publication also suggests that greater improvements in mental wellbeing and positive lifestyle changes can be expected among individuals who receive health coaching alongside GLP-1 therapy.⁸

To see how the GLP-1 trend has been affecting multinational employers' medical claims, we analysed MAXIS’ data. We looked at all GLP-1 claims in Bahrain, Canada, Egypt, Jordan, Kuwait, Mexico, Oman, Qatar and the UAE in our data between 2020-2024.

Our claims data shows that the first two years (2020 and 2021) accounted for more than two-thirds of our clients’ total spending on GLP-1s. This is despite only 25% of the claims (incidence) taking place in these years. In the years since (2022-2024), we’ve seen a steady increase in GLP-1 claims incidence, yet the paid amount is lower than 2020 and 2021. This could reflect interventions by insurers fine-tuning conditions regarding off-label use, and achieving rebates and discounts that have lowered spending on GLP-1 claims.

It’s also worth looking at which countries we see the most GLP-1 claims in. In our 2020-2024 data we see some interesting trends. The four markets where we see the most significant claims incidence and paid amount are Canada, UAE, Egypt and Mexico.

In 2024, the UAE accounted for more than 57% of our total paid amount for GLP-1s, despite making up less than one third of claims incidence. Canada had the largest claims incidence, accounting for one third of all claims in our GLP-1 data, yet the paid amount was at just 27%.  

In Canada, Aon reports GLP-1 drugs alone are still adding approximately 1.2% to the expected medical trend forecast in 2025.¹¹ While the United States is not included in our claims data, reports show the US is the biggest market for the weight-loss drugs – with claims already topping many US employers' annual pharmacy spending.¹²

Aon has released significant early findings that GLP-1 drugs are having impacts on employee health and care costs - it announced it would begin investing in GLP-1 weight management programme for its own US staff. Aon’s research, analysing 50 million commercially insured lives, including 139,000 prescribed GLP-1 users from 2022-2024, found that within two years of beginning to take the drugs, patients’ positive health outcomes improved medical trend by seven percentage points. It also found a 44% reduction in risk of hospitalisations caused by major adverse cardiovascular events, along with a lower incidence of claims for pneumonia, inflammatory bowel disease, osteoporosis and alcohol and substance use disorders.¹³

Management consulting firm Kearney forecasts that GLP-1 use is poised to disrupt healthcare demand, which could lead to reduced call for certain clinical services linked to obesity and its associated health issues – such as knee replacement surgeries.¹⁴

We recognise the growing interest and potential health benefits of GLP-1 medications, particularly in managing obesity and related metabolic conditions. At the same time, we understand there are concerns – about long-term costs, clinical appropriateness and equitable access. That’s why instead of taking an all-or-nothing approach, employers could take a responsible, evidence-based coverage for their people. This means: 

• Prioritising access for those with clear medical need (e.g. diabetes or high-risk obesity-related conditions)
• Requiring clinical guidelines to be followed, with documented need and response to treatment
• Integrating lifestyle and behavioural support alongside the medication
• Continuously reviewing outcomes to ensure value – for both employee health and plan sustainability.

This approach to GLP-1s helps employers avoid blanket exclusions (which can seem harsh or out-of-touch), avoid open-ended coverage (which can be financially risky), and, ultimately shows a thoughtful approach to both employee health and financial risk.