Investing in Obesity Treatments for Schizophrenia May Boost ROI

Not offering benefits or coverage for certain diagnoses can be an appropriate strategy in some situations. The challenge with “casting the net” this way is that there are many reasons behind any diagnosis. For example, many individuals with schizophrenia take medications that significantly increase weight and can lead to obesity. Because of this, any obesity or GLP-1RA strategy should consider members who experience weight gain due to iatrogenic causes. There may also be broader benefits to this approach. Combining second-generation antipsychotics with a GLP-1 receptor agonist may improve adherence to antipsychotic treatment and potentially reduce costly behavioral health inpatient utilization. Many members are not fully adherent to their psychiatric medications because of concerns about weight gain. Emerging research supports the potential benefit of this approach. In a randomized clinical trial of patients with schizophrenia treated with clozapine or olanzapine, low-dose semaglutide significantly improved glycemic control and produced meaningful reductions in weight, waist circumference, and fat mass compared with placebo after 26 weeks (Sass et al., 2025). Investments in expensive medications may therefore produce greater return on investment than is often recognized.

Sass, M. R., Klausen, M. K., Schwarz, C. R., et al. (2026). Semaglutide and early-stage metabolic abnormalities in individuals with schizophrenia spectrum disorders: A randomized clinical trial. JAMA Psychiatry, 83(2), 128–138. https://doi.org/10.1001/jamapsychiatry.2025.3639