With GLP-1 medication costs being a top concern for employers heading into 2026, UnitedHealthcare is addressing the challenge through its Total Weight Support program, aimed at improving weight loss outcomes for employees while managing the costs of medication adherence.
“In our conversations and consultations with employers, they are all looking for solutions for their employees who are dealing with obesity and metabolic conditions that bring better value,” Rhonda Randall, DO, chief medical officer for UnitedHealthcare’s commercial business, told Becker’s. “Total Weight Support was put into the marketplace as a comprehensive solution for employers who are looking for that full-person approach to care for their beneficiaries and employees dealing with obesity.”
The demand and high cost of GLP-1 medications, which can exceed $1,000 per month, have led insurers and self-funded employers to make significant changes to their GLP-1 coverage policies in recent years, including dropping coverage entirely. In 2025, UnitedHealthcare took part in a study that analyzed data from 224,000 commercial members and found that individuals living with obesity face healthcare expenses that are 2.3 times higher than those without obesity, with an average annual cost increase of over $662 per person.
“We see a very high rate of members that start these medications and don’t keep taking them,” UnitedHealthcare’s Chief Analytics Officer, Craig Kurzweil, previously told Becker’s. “The economics and adherence rates just make the math really hard for GLP-1s in their current state to be an effective tool or solution for employers to combat this problem.”
Total Weight Support, introduced in 2024, aims to tackle these challenges by taking a whole-person, evidence-based approach to weight loss. The program is available exclusively to self-insured employers and offers employees a choice between two vendors: Real Appeal Rx and WeightWatchers for Business.
The program combines personalized coaching, education, and tracking tools to help employees with medication adherence and lifestyle changes. Real Appeal Rx offers live 1:1 or group coaching sessions, medication-related support from pharmacists, and progress tracking tools like a smart scale and fitness app. WeightWatchers for Business provides a more self-directed approach, with customized plans focusing on food, fitness, and water tracking, along with meal plans, recipes, and coaching.
“We want to create long-term, sustainable weight loss—not a yo-yo effect,” Dr. Randall said. “We want people to achieve slow, steady, manageable weight loss, and, along the way, decrease the side effects of the drug that could lead to stopping it.”
In January, a study examining more than 125,000 adults in the U.S. found that the majority of patients discontinue GLP-1 RA therapy within the first year, with those without Type 2 diabetes showing the highest dropout rates. A Blue Cross Blue Shield Association study in 2024 showed that 30% of patients stopped using GLP-1 medications within the first month, and 58% of patients discontinue GLP-1 use before reaching a clinically meaningful health benefit.
“Due to the side effects, there’s a high drop-off rate. So you have a medication that’s expensive, and then you don’t finish it because of the side effects,” Dr. Randall said. “Changing your lifestyle to support the medication is really, really important. That drop-off in adherence is just one of the many reasons why a comprehensive, whole-person approach to obesity care is important.”
Total Weight Support also covers weight loss medications for eligible members with prior authorization, allowing employers to offer comprehensive solutions for employees struggling with obesity.
“Medication by itself is not a silver bullet. In fact, it may even introduce unintended risks if used alone,” Dr. Randall said. “You also want to have a personal relationship with the physician or prescriber who is giving you these medications.”
