An Ozempic injection pen. Photographer: Jaap Arriens/Getty Images
Americans are flocking to drugs such as Ozempic, Wegovy and Zepbound, drawn by the prospect of rapid weight loss. But a monthly cost that can exceed $1,000 and scant insurance coverage mean users drop off the treatments almost as quickly as they get on.
A group of companies sees this as an opportunity. Targeting current and former users of the medications, they’re offering telehealth checkups, lifestyle coaching, access to community support groups, exercise advice and other features—all with the aim of keeping the pounds off once the treatment has ended. Monthly fees can be as high as $300.
The services are part of a broader ecosystem that’s springing up around the blockbuster drugs, known as GLP-1s, from Eli Lilly & Co. and Novo Nordisk A/S that are reshaping weight-loss treatment. Online health companies such as Calibrate Health Inc. and Omada Health Inc. in particular are aiming to fill the support role that may not be met by primary-care providers or specialists.
It’s a “huge addressable potential market,” says Ryan Daniels, an equity research analyst at William Blair & Co. And support programs could be worth as much as $2.5 billion annually, according to his firm’s research. William Blair identified more than 20 digital health companies that are supporting people who are taking one of the treatments.
Curbing Hunger Cues
Obesity affects 42% of Americans and costs the US almost $173 billion annually, according to estimates from the Centers for Disease Control and Prevention. Medications such as Wegovy mimic a gut hormone called GLP-1 that the body produces after eating, slowing the movement of food but also interfering with the reward system that makes food pleasurable.
But when people stop taking the drugs, the cravings return. A study from 2022 showed that patients regained two-thirds of the weight they’d lost a year after quitting—even after embracing healthier lifestyles while on the medications. And there’s a lot of churn among users: One study by pharmacy benefit manager Prime Therapeutics LLC released in 2023 found that 68% of patients who started taking GLP-1 drugs for weight loss were no longer on them after a year.
Makers of the drugs say users will likely need to stay on them for life. New York-based Calibrate, a digital health provider, has a weight-management platform that doles out the medicines, as well as a program that helps those who want to stop using the drugs. “People want sustained weight loss, and they don’t want to be on medication for life,” says Kristin Baier, Calibrate’s vice president for clinical development.
Dubbed Metabolic Reset, Calibrate’s program costs $1,749 a year and includes one-on-one video coaching every two weeks, as well as a curriculum that helps users improve their eating, sleep, exercise habits and emotional health. Baier says some customers are able to shorten the length they take a GLP-1 drug to only seven or eight months.
‘Healthier Choices’
Emily Epperson, a 48-year-old Dallas attorney, began taking a GLP-1 medication in July 2023 after feeling unable to quiet her nagging thoughts about food. By mid-January she was confident enough to stop—in part thanks to the coaching she was getting from Medifast Inc., a health and wellness company that’s teamed
with telehealth provider LifeMD Inc. to provide support programs and products. Medifast offers the programs under its Optavia brand.
Epperson, who was referred to Bloomberg Businessweek by Medifast, says that the medication’s cost was one factor in halting but that mainly she didn’t want the drug to be a “crutch.”
“I don’t have to go run and get that hamburger at lunch,” she says. “I can make healthier choices that support my health goals.”
Online health provider Omada has a program called GLP-1 Care Track. Health insurer Cigna Group recently tapped Omada as a “behavior-change companion” for people obtaining the drugs through employer-provided health plans. The company plans to expand in the next year and introduce goals for GLP-1 off-ramping and exercise plans in its support programs. Wei-Li Shao, Omada’s president, says he got to see GLP-1 treatments’ efficacy during trials when he worked at Lilly.
At Virta Health Corp., the GLP-1 support program is focused on getting clients on a low-carbohydrate diet, according to Chief Medical Officer Adam Wolfberg. He says the company has seen “pretty dramatic” growth over the past few years and is joining with employers and insurers—which include Blue Shield of California, Blue Shield of Kansas and Providence Health Plan—to provide coverage.
“The patients who are taking these medications and come to Virta are often there because they want to stop this medication one way or another,” Wolfberg says.
Carolyn Bramante, an obesity doctor at the University of Minnesota Medical School, says specialized care is critical after taking GLP-1 drugs, and lifestyle programs can help—but most important, people need to change the way they view weight loss.
“Obesity is a chronic disease,” she says. “Thinking about it in that frame is important. If it is untreated, it will relapse.”