AMA adopts new policies to improve affordable access to obesity treatments

CHICAGO - Physicians and medical students convened for the Annual Meeting of the American Medical Association's (AMA) House of Delegates today and adopted new policies aimed at improving patient access to evidence-based obesity treatments while advancing broader efforts to address prescription drug affordability and insurance coverage barriers.

The new policies build upon longstanding AMA policy supporting affordable access to prescription medications, prescription drug price transparency, pharmacy benefit manager (PBM) oversight, and coverage parity for evidence-based obesity treatment.

Recognizing obesity as a complex chronic disease that often requires long-term management, physicians adopted policy supporting innovative payment arrangements that could help patients afford emerging anti-obesity medications (AOMs). The policy also supports pilot and demonstration programs to evaluate coverage models for obesity treatments, including glucagon-like peptide-1 (GLP-1) agonists and glucose-dependent insulinotropic polypeptide (GIP) therapies.

In addition, physicians called for long-term coverage policies that promote consistent drug pricing, formulary tier selection, benefit structures, and coverage criteria across private and employer-sponsored health plans to help reduce cost variability and treatment disruptions.

The new policy further supports equitable access to comprehensive obesity care, including disease management services, nutritional therapies, health promotion initiatives, and prevention interventions for patients with obesity and individuals at elevated risk.

"Obesity is a chronic disease that requires sustained, evidence-based treatment and comprehensive support," said AMA President Bobby Mukkamala, MD. "As new therapies emerge, patients should not face insurmountable financial barriers to clinically appropriate care. These policies advance practical approaches to improving affordability, expanding access, and ensuring patients can receive the full range of services needed to achieve better long-term health outcomes."

The AMA also reaffirmed existing policy supporting affordable prescription drug access, greater PBM transparency and accountability, and efforts to lower prescription drug costs for patients.

In related actions, physicians also adopted additional new policies aimed at expanding access to and ensuring evidence-based obesity care that include:

Access, affordability, and safety of GLP-1 receptors agonists

The AMA will advocate for legislation and regulations for public and private health insurers to cover GLP-1 medications for obesity and type 2 diabetes at affordable prices, helping reduce patients' out-of-pocket costs. The policy also calls for appropriate screening for eating disorders, body image concerns, and weight history before these medications are prescribed. In addition, the AMA will advocate for greater pricing transparency and cost-control measures among drug manufacturers, insurers, and policymakers to improve access to evidence-based obesity and diabetes treatments.

Pairing behavioral and lifestyle medicine principles and practices with GLP-1 and other anti-obesity medications

The AMA supports insurance coverage, reimbursement, and sustainable payment models for clinician-led lifestyle intervention programs used alongside GLP-1 and other anti-obesity medications. The policy seeks to expand access for underserved, rural, and historically marginalized populations while making clear that patients should not be required to participate in a lifestyle program to receive medication coverage.

Parity in pricing for anti-obesity medications

The AMA opposes pharmaceutical manufacturer pricing arrangements that offer discounted anti-obesity medications exclusively through telehealth or online providers, citing concerns that such practices fragment care and undermine the patient-physician relationship.

Parity in access to evidence-based obesity treatment

The AMA supports coverage parity for obesity treatment across public and private health plans, including medications, bariatric surgery, behavioral therapy, and nutrition services, while opposing insurer practices that restrict or terminate coverage based on weight-loss targets or body mass index thresholds rather than individualized clinical decision-making.

The costs for the patient and broader health care system associated with obesity, including the treatment of weight-related conditions and potential complications, can be substantial. The AMA believes it is crucial to recognize the urgency of addressing this disease comprehensively and proactively through a range of suitable treatments. The policies adopted today are an important step towards reducing barriers to the best course of treatment as determined by shared decision-making between patients and physicians.