Thank you for the important work you do in delivering healthcare services to those enrolled in the Medicaid program. And I understand the need for balance in determining what services to provide. But further restricting access to life-changing and life-saving GLP-1s and other anti-obesity medications neither promotes the goals of Medicaid nor helps those Virginians served.

I have lived in the Commonwealth of Virginia for almost 40 years. During that time, I have seen obesity rates climb unabated. Currently, 35.2% of Virginia adults fall into the obesity category, leaving Virginia with the 21st highest obesity rate among all states. The Trust For America’s Health, The State of Obesity: Better Policies for a Healthier America 2023 (https://www.tfah.org/wp-content/uploads/2023/09/TFAH-2023-ObesityReport-FINAL.pdf). When you add in those who fall into the overweight category, the total rises to 67.3% of Virginia adults who are impacted by excess weight. These dire statistics call for immediate action rather than for restricting obesity care.

Providing a full range of obesity care, including broad access to anti-obesity medications, is particularly important in the Medicaid context because obesity has a disproportionately high impact on those at lower socioeconomic levels. The Trust for America’s Health just last week recognized the importance of providing access to the full range of obesity care when it specifically recommended that “State Medicaid programs should also expand coverage of obesity-related services, such as obesity and nutritional counseling provided by professionals like registered dieticians, obesity medications, and bariatric surgery.” Your proposed policy change does the opposite by further restricting those who could greatly benefit from GLP-1s and other anti-obesity medications.

As a person who has lived and struggled with obesity since childhood, I know first-hand how important it is to have access to all science-based tools to treat this vicious, complex, chronic disease. I can no longer count the number of diets and exercise programs I’ve tried to manage my weight over my lifetime. I would have some short-term success, but I could never sustain any weight loss I achieved. In the past decade, I have finally found true obesity care that has included behavioral, nutrition, and psychological counseling as well as anti-obesity medications (including a GLP-1). Combining these tools has led to sustainable weight loss that has improved my health and my quality of life.

Notably, the excess weight I have carried has taken a toll on my body (e.g. osteoarthritis, gall bladder disease, high blood pressure, blood clotting) that has required extensive medical treatment and associated costs. Had I been able to control my weight at an earlier time, these costs likely would have been avoided or at least minimized. The savings in hospital stays alone would have been far greater than the costs associated with years of GLP-1 use.

You have the power to help people gain control over their obesity and their lives with good, science-based care. Please don’t take that away by further restricting access to anti-obesity medications.

Patricia Nece

Virginia Resident