Obesity Treatments Project Long-Term Social Value for US Employers and Employees

Key Takeaways:

• Evidence-based obesity treatments, particularly incretin-based therapies and metabolic or bariatric surgery (MBS), were associated with significant reductions in chronic disease incidence, especially for type 2 diabetes (T2D) and hypertension.
• Treatments yielded 5-year cost savings ranging from $2450 to $12 001 and generated workplace productivity gains of $25.8 billion.
• The combination of treatment benefits projected a net social value of $59.1 billion, with a $2.35 return per dollar invested over 5 years.

Obesity is associated with significant economic burden, costing US employees an estimated $6472 annually compared to those without obesity. High health care spending may also be due to limited coverage, as only 19% of employers with over 200 employees offered coverage for glucagon-like peptide 1 receptor agonists in 2025.

While many studies have documented the clinical effectiveness of obesity treatments, few have assessed their full economic value.

Researchers used the Disease Prevention and Treatment Microsimulation Model to evaluate the clinical, economic, and social benefits of obesity treatments among commercially insured adults. The study projected outcomes over 5 years for 3 evidence-based therapies: intensive lifestyle management (ILM), obesity medications, and MBS.

The analysis included 57.6 million commercially insured adults with obesity. Within this sample, 47.3 million (82%) had only obesity and 10.3 million (18%) had at least 1 obesity-related complication.

Clinical Efficacy

Over 5 years, incretin-based therapies and MBS were associated with significant reductions in chronic disease incidence. This effect was most prominent for T2D, with incretin-based therapies reducing cases by 45%, MBS by 43%, ILM by 30%, and older medications by 25%.

Incretin-based therapies reduced hypertension incidence by 44%, MBS and older medications by 31%, and ILM by 30%.

Across all treatment types, reductions in coronary heart disease, myocardial infarction, and stroke ranged from 9% to 28%, 11% to 29%, and 23% to 33%, respectively.

Economic Benefits

Among adults without comorbid T2D or cardiovascular disease, first-year per-person savings were $386 for older medications, $454 for ILM, $1120 for incretin-based therapies, and $2234 for MBS.

Cost savings grew during the study period, with 5-year savings of $2908 for ILM, $2450 to $7304 for obesity medications, and $12 001 for MBS. At the population level, obesity treatments resulted in medical savings of approximately $9.7 billion after 5 years.

Obesity treatments generated $25.8 billion in productivity gains. The main drivers of benefit were presenteeism reduction ($12.5 billion), increased labor force participation ($9.2 billion), reduced absenteeism ($3.5 billion), and fewer disability and workers’ compensation claims ($521 million). Overall, workplace benefits offset 59% of treatment investment.

In terms of quality-adjusted life-years gained, obesity treatments projected a 5-year value of $38.8 billion. They were also associated with $29.6 billion in mortality-reduction benefits.

Social Value

Positive returns on investment occurred as early as the second year.

Combining medical savings with productivity gains resulted in a social value of $35.4 billion, recovering 81% of treatment investment.

The addition of quality-of-life and mortality-reduction benefits provided obesity treatments with a net social value of $59.1 billion, with a $2.35 return per dollar invested over 5 years.

Implications for Managed Care

Although obesity treatments have substantial upfront costs, they may provide long-term benefits through improved health outcomes, increased work productivity, and extended lifespans.

The authors concluded, “These findings support expanding commercial insurance coverage for obesity treatment, demonstrating that comprehensive benefit strategies produce greater long-term value than approaches focused solely on short-term medical budget impact.”

Reference

Dall TM, Chen F, Sapra T, et al. Benefits and costs of treating obesity among adults in commercial insurance plans. Diabetes Obes Cardiometab Care. 2026;1(3):320-329. doi:10.2337/doci25-0006