Is weight loss medication worth the cost? Effectiveness, costs and realistic expectations

Short answer: Weight-loss medication costs money, but in clinical trials it results, on average, in weight loss of 15 to 21 per cent, which is significantly more than can be achieved through lifestyle changes alone. Whether the cost is worth the investment depends on your health risks and the guidance you are seeking in this regard.

The cost of weight-loss medication is the most frequently cited barrier for people considering starting a course of treatment. In our customer satisfaction survey, 40 per cent of customers cited cost as a barrier before starting treatment, more than any other factor. This is understandable: weight-loss medication is a significant expense, and people naturally want to know whether it is worth the cost. In this article, we take an honest look at what weight-loss medication costs, what clinical benefits it offers, and how to weigh up the pros and cons.

Why price is the biggest barrier

Price carries more weight than any other concern before people start taking weight-loss medication. In our customer satisfaction survey, 40 per cent of customers cited price as a barrier, which is more than ‘nervousness about starting online’ (36 per cent) or concerns about safety (31 per cent). Even after getting started, price remains a recurring theme: a small proportion of customers spontaneously mention costs as an area for improvement in the open-ended responses.

Nevertheless, a large proportion of customers are so satisfied afterwards that they would recommend Goodweigh to someone in a similar situation. The question, therefore, is not whether price plays a role – because it certainly does – but whether the investment is commensurate with what you get in return.

How much do weight-loss medicines cost, and why?

The cost structure of a medical weight-loss programme usually consists of three parts: the medicine itself, medical guidance and postage. Semaglutide and tirzepatide are patent-protected substances that are relatively expensive to produce, which is reflected in the price. In addition, you pay for ongoing monitoring by a healthcare professional, which is necessary to track dosage and side effects. An overview of the various weight-loss medicines shows that the active ingredient and dosage form vary from medicine to medicine, which also affects the price.

This medicine is not reimbursed in the Netherlands for weight-loss treatment; reimbursement via basic health insurance applies only to type 2 diabetes in specific situations. An Irish study of a programme with controlled access to liraglutide illustrates how healthcare systems are grappling with the question of when and for whom GLP-1 medicines should be reimbursed – a debate taking place in virtually all European countries.

Alternative approaches to weight loss also cost money and time. A course of treatment with a dietitian often lasts from months to years, a gym membership is an ongoing expense, and bariatric surgery is sometimes covered but is more invasive and irreversible. None of these approaches are free; the question in each case is what value for money they offer.

What are the benefits: the clinical data

The clinical data form the basis for weighing up cost against results. The STEP 1 study in the New England Journal of Medicine showed that weekly semaglutide leads to an average weight loss of approximately 15 per cent of body weight over 68 weeks. The SURMOUNT-1 study, also published in the New England Journal of Medicine, showed that tirzepatide results in an average weight loss of 20.9% over 72 weeks.

By comparison, lifestyle intervention alone – such as changes to diet and exercise without medication – yields, on average, a more modest result in the long term. A comparative review in *Current Obesity Reports* shows that lifestyle interventions alone typically result in weight loss of 5 to 10 per cent, compared with 15 per cent or more with pharmacological treatment. These are average figures, and individual results vary, but the difference in the magnitude of the effect is what you are paying for.

What about those who choose based on price?

Customers who choose primarily on the basis of price are generally satisfied afterwards, although our survey shows that customers who chose on the basis of reliability or guidance are slightly more satisfied. This difference says a great deal about managing expectations.

Anyone who knows in advance that a programme requires time, patience and guidance starts with realistic expectations, which are subsequently confirmed. This does not mean that it is wrong to choose based on price, but it does mean, in particular, that it is worthwhile to familiarise yourself in advance with what the guidance entails. Anyone who familiarises themselves with this via how the Goodweigh programme works will start with a more realistic picture of what lies ahead.

The illegal route: a real risk

Cheaper sounds appealing, but the illegal route to GLP-1 medicines carries risks that are disproportionate to the savings. Semaglutide and similar medicines are offered online outside the regular channels, without a prescription, without medical supervision and without any guarantee of authenticity or correct dosage.

A study in the *Journal of Medical Internet Research* of semaglutide products sold online without a prescription showed that the actual purity differed significantly from what was stated: between 7.7% and 14.37% of the stated active ingredient, compared with a claimed 99%. Endotoxins were also found in some products. Without medical guidance, there is also a risk that side effects will not be detected in time.

The wider costs of being overweight

In addition to the cost of treatment, there is also the cost of not treating the condition. Obesity is associated with an increased risk of type 2 diabetes, cardiovascular disease, joint problems and mental health issues. A systematic review in the *International Journal of Obesity* shows that the economic costs of obesity, through healthcare expenditure and loss of productivity, are rising sharply worldwide.

This is not a reason to feel guilty, but a useful context in which to consider the issue. According to Farmacotherapeutisch Kompas, medical guidance regarding weight-loss medication is particularly important because the effects and side effects vary from person to person, and this guidance plays a role in determining value for money.

How do you weigh up the options?

There is no single answer that applies to everyone, but a number of questions can help you make your choice. How long have you been trying to lose weight using other methods, and what results have you seen? What health risks are associated with your current weight? What level of medical guidance do you want in this regard, and what does it cost you to stay as you are?

Would you like to know what a course of treatment at Goodweigh involves? Take a look at the prices for the medical weight-loss programme, or read more about the Goodweigh weight-loss programme. If you’re still unsure, book an initial consultation to find out whether it’s right for you – with no obligation whatsoever.