Obesity Is a Chronic Disease—And Benefit Design Must Reflect That

Obesity is more prevalent than previously reported, affecting an estimated three in four U.S. adults, and it is a chronic disease with risk rising as waist circumference increases. It drives significant medical costs and productivity losses. While weight loss is possible, obesity cannot be cured and requires ongoing management, similar to type 1 diabetes. Environmental changes, healthy eating, and physical activity can reduce weight, but disease-related physiological factors make long-term adherence difficult and relapse common. Behavioral therapies may support change but are rarely sufficient alone. Pharmacologic treatments, including GLP-1 receptor agonists, are clinically effective but require continuous use, as discontinuation leads to predictable weight regain and loss of cardiometabolic benefits (West et al., 2025). Bariatric surgery can produce meaningful weight loss but carries risks and limited long-term durability for most patients. As a result, obesity care is best delivered through a physician-led, multidisciplinary model that supports long-term treatment, appropriate escalation of care, and sustained engagement, with benefit designs that emphasize clinical oversight, adherence, and evidence-based decision-making.

West, S., Scragg, J., Aveyard, P., Oke, J. L., Willis, L., Haffner, S. J. P., Knight, H., Wang, D., Morrow, S., Heath, L., Jebb, S. A., & Koutoukidis, D. A. (2026). Weight regain after cessation of medication for weight management: Systematic review and meta-analysis. BMJ. https://doi.org/10.1136/bmj-2025-085304