Doctors: NC made the wrong decision about weight loss medication coverage | Opinion

Quick “fixes” for the cost of healthcare can create serious barriers to good health. Right now, there is intense pressure on our healthcare system, and our leaders in North Carolina have tough decisions to make.

Health care costs are partly fueled by an obesity epidemic affecting 34% of adults in our state. Obesity drives risk for more than 200 diseases and medical conditions. But cutting access to care like obesity treatment will only escalate the rise of preventable problems — adding costs and poor health outcomes down the line.

North Carolina has been making wise decisions in expanding access to care for thousands of North Carolinians. These decisions improve lives and productivity and diminish the risk for disability and premature death.

Last year, Medicaid smartly provided coverage for very effective obesity medications. Medications in this class, particularly semaglutide and tirzepatide, sold under the names Wegovy and Zepbound, have demonstrated impressive health benefits in the treatment of obesity, diabetes, sleep apnea and liver disease as well as a reduction in cardiovascular and kidney disease. With this coverage, North Carolinians avoided or delayed unnecessary medical costs due to hospitalization, acute care and development of chronic conditions like type 2 diabetes that can be prevented or delayed by effective weight management.

While North Carolina continues to cover some GLP-1s for diabetes care, the state discontinued coverage of GLP-1s for the treatment of obesity on Oct. 1. For North Carolinians who had access and were seeing health improvements by taking these medications, this change is a setback in the fight to treat and prevent chronic illnesses. People will be at risk for more severe disease, poorer quality of life, higher rates of disability and premature mortality. And healthcare systems and consumers will face escalating expenses tied to these conditions, while economic vitality and quality of life is diminished.

Reducing access to obesity care may provide short-term budget relief, but it risks driving worse impacts in the longer term. As the state cuts coverage for obesity treatments, the diabetes epidemic is only expected to get worse. Currently, more than 1 in 10 North Carolinians have diabetes, numbers that will worsen over time as researchers predict that 50% of North Carolinians will have obesity by 2030, further driving type 2 diabetes rates.

Now is not the time to cut access to powerful, preventive care. While private insurers often focus on short term return on investment, governments should support long-term strategies to enhance the health of people who live in their communities. This responsibility entails not only championing the social and physical conditions that support population health but also safeguarding sustained access to preventive care and life preserving medications.

We urge the state to renew Medicaid coverage for obesity treatment. North Carolinians are relying on us to make wise fiscal choices, but also the right choice for their health and their lives.

Dr. John Buse is the Verne S. Caviness Distinguished Professor and Director of the Diabetes Center at the University of North Carolina-Chapel Hill School of Medicine. He received his MD and PhD from Duke University before training in internal medicine and endocrinology at the University of Chicago. Dr. Susan Spratt is a Professor of Medicine, Division of Endocrinology and Professor of Family Medicine and Community Health at Duke School of Medicine and Senior Medical Director at the Duke Population Health Office. The views expressed in this article do not represent an institutional position or Duke University or Duke Health.

This story was originally published October 27, 2025 at 5:00 AM with the headline "Doctors: NC made the wrong decision about weight loss medication coverage | Opinion."