Older adults are expressing their discontent with medication barriers. A large majority of older Americans feel that health insurance, including Medicare, should cover anti-obesity medications, according to a new University of Michigan study. More than half of older adults who meet criteria for obesity said they were interested in trying one of these drugs to manage their weight. Current law prevents Medicare from covering medications to treat obesity, and most private plans don’t cover the most effective newer weight management drugs because of cost.
However, 83% of older adults surveyed agreed strongly or somewhat that health insurance should cover weight management medications. Asked specifically about Medicare, 75% of respondents said the insurance program for older and disabled Americans should cover obesity medications. However, the percentage was much lower (30%) when respondents were asked if they’d favor having Medicare cover the drugs even if it meant paying a higher premium for their own coverage.
“As our nation contends with the impacts of the obesity epidemic on older Americans, and the costs of both obesity-related conditions and the medications that can treat obesity, data like these can inform the discussion over coverage and access,” said Dr. Lauren Oshman, the lead author of the study and an associate professor of family medicine at the University of Michigan Medical School in Ann Arbor.
Later this year, Medicare will begin negotiations with the company that makes semaglutide. The negotiated price would take effect in 2027. The researchers analyzed data from the National Poll on Healthy Aging. The new analysis dives deeper into the data from the poll, which was conducted online and by phone in summer 2023. The analysis included 2,657 respondents between the ages of 50 and 80.
The poll asked respondents about their knowledge and experience with a wide range of weight management. It asked about the drugs by both brand and generic names.
The poll also asked for respondents’ height and weight so the researchers could calculate their body mass index (BMI), a measure often used as a marker of overweight and obesity. A BMI of 25 to just under 30 is viewed as overweight, and a BMI over 30 is the cutoff for obesity. Approximately 37% of poll respondents met criteria for overweight and 36% met criteria for obesity.
In all, 35% of all poll respondents said they’re somewhat or very interested in using a weight management medication. This figure includes 29% of those with a BMI between 27 and 29.9, and 59% of those with a BMI of 30 or over. About 7% had used Ozempic, the form of semaglutide approved for use in diabetes that also improves weight loss. Just over 1% had used Wegovy, the form of semaglutide approved for obesity, and about the same percentage had used Saxenda (liraglutide), phentermine-topiramate (Qsymia) or buproprion-naltrexone (Contrave). The poll was done before tirzepatide was approved for weight management under the name Zepbound, so the poll did not ask about that medication.
The poll revealed an age gap and 38% of those in their 50s and early 60s were potentially interested in obesity medication, compared with 31% of those age 65 and older. The poll found that 90% of respondents agreed strongly or somewhat with the statement “Obesity is a chronic condition resulting from a combination of genetics, the food environment, medical conditions, and social factors.”
Combating fatigue with a smartphone app
One of the most common side effects of cancer treatments, including chemotherapy and radiation therapy, is fatigue. Cancer-related fatigue is often worse and harder to manage compared to the fatigue in people without cancer and can sometimes persist weeks, months or even years after treatment ends.
Researchers at the Rogel Cancer Center at the University of Michigan now have developed and tested a personalized app that tracks a user’s circadian rhythm and makes behavioral recommendations to reduce daily fatigue. Traditional approaches to managing cancer-related fatigue include medicines, exercise and meditation practices. However, they may not work for everyone. “These measures appeal to only a portion of the population,” said Dr. Muneesh Tewari, a professor of internal medicine and a member of the University of Michigan Rogel Cancer Center. “We wanted to provide something that could be more easily and widely accessible.”
Our bodies have an internal clock that controls our sleep-wake cycle. It follows a 24-hour pattern and affects several processes, such as digestion and body temperature. Disturbances in this system have been shown to worsen fatigue and quality of life in individuals with cancer. The team developed an app called Arcasync that tracked a user’s sleep-wake patterns based on their heart rate and physical activity patterns. Using mathematical models, the app is able to make recommendations such as “seek bright light” at a particular time of day.
With the help of 138 participants, the researchers tested the app on patients who had breast cancer, prostate cancer and blood cancer. For 12 weeks, all participants were asked to report their fatigue levels, sleep disturbances, anxiety, depression and overall health.
The volunteers who used the app had decreased daily and weekly fatigue, demonstrating that personalized recommendations can improve quality of life. “We have shown that you can take a device that is seamlessly integrated into your life and use it to guide your circadian rhythms,” said Dr. Sung Won Choi, a professor of pediatric hematology-oncology and a member of the Institute for Healthcare Policy and Innovation at Michigan. “The reach of this app may be far greater than traditional medications or exercise regimens, regardless of cancer type.”
John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at medicalminutes@gmail.com.
John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute.
