The rise of the popular obesity and diabetes drugs Wegovy and Ozempic has forced weight-loss companies to radically change their business models.
WeightWatchers and Noom have for years promoted diet and exercise as the primary ways to lose weight, but both recently debuted plans to offer prescriptions for Wegovy and similar drugs as part of a strategy that recognizes obesity as a chronic disease. .
WeightWatchers announced the change in March when it bought Sequence, a telehealth company that offers prescriptions for obesity drugs. In the coming months, WeightWatchers said it will roll out a program for members taking the drugs.
Subscription app Noom, meanwhile, last month launched its own telehealth platform, called Noom Med, which provides access to medications. Noom, founded in 2008, offers psychological tips to help lose weight and helps people keep track of their eating and exercise habits.
The companies said their decisions to expand into prescription drugs came in response to an evolving scientific understanding of obesity, as well as requests from customers wanting to incorporate drugs into their weight-loss regimens.
“We’ve always followed the science, and as the medical community has moved on to this concept of obesity as a disease, we’d be remiss if we didn’t join in, too,” said Dr. Linda Anegawa, chief of medicine at Nooms.
Similarly, Dr. Gary Foster, scientific director of WeightWatchers, said the drug offering was a “natural next step” for the company.
“We know the science and success of GLP-1 use and consumer interest is strong. As science and consumers are evolving in this space, we too need to address their needs,” Foster said in a e-mail. (GLP-1 refers to GLP-1 agonists, the term for the class of diet drugs that Wegovy includes.)
Demand for Wegovy has soared since 2021, when the Food and Drug Administration approved it for weight loss in adults with obesity and those who are overweight and have at least one weight-related health condition, such as high blood pressure or high cholesterol. Wegovy’s sister drug, Ozempic, is based on the same formula but at a lower dose and was approved for people with type 2 diabetes in 2017.
Both drugs are brand names of semaglutide, a drug that can lower blood sugar and suppress appetite by mimicking a hormone that signals to the brain when a person is full. Semaglutide reduced body weight by an average of 15% in trials.
In contrast, a 2018 study found that diet, exercise, and behavior counseling at best help people lose an average of 5% to 10% of their body weight.
“What these drugs have really shown us is that obesity is a metabolic biological problem. You can’t just overcome it with lifestyle interventions, for the most part,” said Dr. Eduardo Grunvald, a MD at the University of California. obesity at UC San Diego Health.
WeightWatchers and Noom are “kind of catching up with the science,” Grunvald said. “But also his profit, of course. That’s where the question is.”
Meanwhile, weight-loss companies that don’t integrate drugs into their business models may struggle, according to Linda Bolton Weiser, an analyst at DA Davidson Companies, an asset management firm. Jenny Craig, which sold a diet plan of prepackaged foods but never offered prescription drugs, closed its doors last month.
“For companies that can’t figure out strategically how to do the drug thing, and if you offer a food product, those companies may suffer,” Weiser said. “That would be Medifast with their Optivia, that would be Jenny Craig, that would be Nutrisystem.”
Weiser said that because FDA labels specify that people should use obesity medications in conjunction with diet and exercise, WeightWatchers and Noom can “check all the boxes for you.”
Expanding access to weight-loss drugs
Dr. Fatima Cody Stanford, an associate professor of medicine at Massachusetts General Hospital, said that because obesity medicine physicians struggle to serve such large numbers of patients, people with obesity could benefit from access to drugs from prescription through weight loss companies.
“There’s such a high demand now for our services and not enough of us to go around,” Stanford said.
He estimated that about 5,500 people are on the waiting list at his hospital center and all have been approved for obesity drugs.
Dr Spencer Nadolsky, medical director of Sequence, said some people are finding it difficult to get the drugs because some general practitioners are not yet comfortable prescribing them.
Kailey Wood, 36, of Buffalo, New York, said she struggled talking to her primary care physician about weight loss, so she turned to Sequence.
“I got nervous. I would try what to say and eventually I would shut down and feel helpless,” Wood said.
Through Sequence, Wood was prescribed Mounjaro, an approved drug for the treatment of type 2 diabetes that doctors can prescribe off-label for obesity. She has lost 65 pounds, she said.
“Taking these weight-loss drugs validated what I knew: that my body was working against me and that I wasn’t broke,” Wood said in an email.
Stanford has noted, however, that Wegovy is in short supply. People typically start on a low dose, then build up, but the FDA has reported limited availability of Wegovy’s three lowest doses.
“Starting someone new on the drug is at best a challenge right now,” Stanford said.
Grunvald said he also fears for-profit companies could overprescribe the drugs down the line.
“That’s where the potential for inappropriate prescribing comes in, when you’re motivated by volume,” she said.
But Noom Med and Sequence have both dismissed that idea.
“We’re not writing rogue prescriptions for people with a BMI of 23 who are trying to fit into a size 8 bathing suit,” Anegawa said.
Are the subscription services worth the cost?
Sequence and Noom Med said they will offer prescriptions in accordance with FDA criteria: a body mass index, or BMI, of 30 and higher, or a BMI of 27 and higher in combination with other weight-related health conditions. However, Anegawa said Noom Med doctors can prescribe off-label drugs as directed by groups like the Obesity Medicine Association.
Physicians must be board-certified to work at Sequence, while Noom Med employs board-certified physicians and nurse practitioners under the supervision of a physician with experience treating obesity.
The programs are generally similar.
Sequence clients fill out an employment quiz to determine their suitability. From there, they can book a consultation to discuss their medical history and begin taking their medications. Physicians monitor side effects and weight loss results, and clients have simultaneous access to athletic trainers and dieticians.
With Noom Med, clients have blood tests done before their first appointment, then a doctor evaluates their health and weight history. If the person is offered a drug, they can message the doctor via an app to report side effects, and the doctor can adjust the dosage accordingly.
Obesity medications are generally meant to be lifelong medications; data consistently show that people who stop taking semaglutide gain the most weight back.
One drawback to the WeightWatchers and Noom programs, Grunvald said, is their cost.
Noom Med is priced at $49 per month on top of the standard Noom subscription, which starts at about $42 per month for four months, then goes from about $70 to $209 per month, depending on the plan. A Sequence subscription costs $99/month. With both programs, people have to pay separately for the drugs, which run up to over $1,000 a month without insurance.
Because weight-loss drugs alone often encourage healthier habits, Grunvald said some customers may not have much need for the other components of these programs.
“The question will become, is that necessary? Is that extra cost necessary?” he said.
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