Can I Afford Ozempic, Wegovy, Mounjaro, or Zepbound?

Nearly 40% of US adults struggle with obesity. If you fall into this category, perhaps you can relate to the feelings of frustration with attempt after attempt at dietary weight loss. Perhaps you also feel isolated and trapped in your body. Maybe you also feel branded, devalued, and alone.

This struggle can lead to a natural interest in medical weight loss. By far the most effective weight loss medications that currently have FDA approval for weight loss are Wegovy (the weight loss version of the diabetic drug Ozempic), also known as Semaglutide, which can result in a 16-17% weight reduction; and Zepbound (the weight loss version of the diabetic drug Mounjaro), also known as Tirzepatide, which results in up to a 18-21% weight reduction. Alongside this weight loss, patients can also see up to a 20% reduction of the risk of heart attack or stroke.

This has produced a $200 billion dollar market opportunity for these and other competing drug companies, and herein lies the problem.

The Cost of Ozempic, Wegovy, Mounjaro, and Zepbound

These medications cost an average of $1,100/month to $1,300/month, or $13,000 to $15,000 per year. Due to this exorbitant cost, in the past year most insurances have systemically removed these medications from medication formulary; which means that if you would like to use these medications for weight loss, you will almost certainly need to pay for them out of your own pocket.

How severe is this problem? According to a recently published FOUND study, even as of early 2023, at least 69% of people did not have insurance coverage for this class of medications. Commercial plans are also dropping coverage; coverage declined from 27% in December 2022 to a national average of just 12% by June 2023 and is even worse in many states.

Medicare and Medicaid will also not cover these medications.

So, what does this mean to you in terms of cost? If you want to pursue these medications you’ll need to pay out of pocket, which means a total outlay of up to $15,000 per year. Perhaps you have the resources to pursue this option, but if you are like most of the rest of us you may not. Even if you do, it’s worth asking if you can get better value for your investment in weight loss somewhere else.

Fortunately, there are several alternatives to consider.

Other Weight-Loss Medications

Phentermine, Qsymia, and Contrave are much cheaper and can range from $15 per month to around $150 per month. However, there are two main drawbacks to these options:

1. Less weight loss (most patients lose about 9% of their total weight).
2. Most people rapidly adjust to these medications, which means that their impact is lost or blunted after 3-6 months.

Compounding Pharmacies

There are compounding pharmacies that your provider can prescribe medications to. This generally costs less than $500/month for a 3-month supply of these medications. However, this option has at least 2 drawbacks involving legal and quality issues:

1. What these compounding pharmacies are doing may or may not be legal. They’re trying to circumvent patents, and are operating in a legal grey area. At least one lawsuit is currently pending on this topic.
2. Even more seriously, these compounding pharmacies work by adding additional peptides and medications to the mix. These novel combinations have not been clinically tested for safety or efficacy, and may come with serious and unknown side effects.

Lifestyle Modification

Contrary to popular belief, lifestyle modification can help you to lose weight and is much more affordable than any of the other approaches. Dietary improvements have been shown to be far more effective than exercise for weight loss, though both are valuable. When it comes to dieting, most dietary philosophies (including Mediterranean, Atkin’s, Keto, and vegetarian) yield an average of 8% weight loss.

One dietary philosophy is particularly effective, both in terms of weight loss and when it comes to other health benefits. The Plant-Based Whole Foods diet has several advantages over other dietary approaches. It eliminates processed foods, which is important because processed foods uniformly interrupt weight loss and promote weight gain. It leads to an automatic reduction in caloric density of foods, reduction in calories absorbed, and perhaps an increase in calories burned (which is very helpful for weight loss). Perhaps most importantly, it adds an average of 11 years to a person’s life.

But there’s an important caveat to every diet: this will only result in permanent weight loss if these modifications are maintained for life. This is one reason that the concept of a diet can be damaging to your weight loss journey; all of us subconsciously see a diet as a temporary measure. It’s also one reason that people who suffer from obesity often struggle to lose weight and keep it off. When you suffer from obesity, your body is hardwired to maintain its current weight, and can even go into ‘starvation mode’ in order to prevent you from burning calories. Additionally, many people who suffer from obesity also suffer from compulsive or addictive eating. The combination can make adhering to lifestyle modifications alone very difficult over the long term.

Bariatric Surgery

If you’re suffering from obesity, bariatric surgery is widely considered the safest and most effective, and most cost-effective, way to lose weight and keep it off. Many of our patients lose 90% of their unhealthy body weight or even more, and keep it off even years later. Imagine how that would feel.

One reason that bariatric surgery works so well is that it levels the playing field in your battle with obesity. The anatomical rearrangements reduce your hunger cravings, which can make it easier to stick to a healthy diet for the rest of your life. Paired with the other benefits of anatomical rearrangement, many of our patients find that it is easy to sustain weight loss for the first time in their lives.

Bariatric surgery is also very affordable. At the BMCC, our out-of-pocket costs start at around $12,000, which is less than the cost of just one year of Semaglutide or Tirzepatide. This is an essential point. Semaglutide or Tirzepatide only continue to provide weight loss as long as you continue to take the medication. A 1-year investment in Semaglutide or Tirzepatide therefore only translates to 1 year of weight loss. By contrast, a $12,000 investment in bariatric surgery can translate to a lifetime of lower weight and better health.

In most cases insurance is also happy to pay for bariatric surgery, reducing your financial contribution to a minimal amount in most cases.

Most of our patients say that getting bariatric surgery was one of the best decisions that they ever made.

“I feel like I have won the lottery and have been given a second chance in life! March 25, 2014 was the first day of the rest of my new life and I can’t even start to express in words how grateful I am.”—Rochelle Goforth, gastric bypass patient.

If you’re suffering, don’t wait. Contact our Denver office today.