November 2025 may ultimately be remembered as a pivotal moment in how the United States understands and treats obesity. Last month, federal regulators announced an effort to significantly expand coverage for obesity-management medications under Medicare – alongside a new pricing framework designed to lower costs for people paying out of pocket and potentially encouraging more inclusive coverage across the broader insurance market.
For years, the medical community has recognized obesity as a chronic disease. In 2013, the American Medical Association formally adopted a resolution classifying obesity as a “disease state” that requires a spectrum of medical interventions – from behavioral therapy, to surgery, to medications. This designation reflects an extensive evidence base linking obesity to more than 200 other chronic conditions, including heart disease, diabetes, stroke, and several forms of cancer.
Yet despite this medical consensus, coverage for care has not always kept pace. For many years, obesity was treated differently from other chronic conditions, creating barriers for people seeking treatment.
A Significant Shift in Federal Policy
Last month’s announcement marks a major shift in that landscape with Medicare now beginning to offer coverage for obesity-management medications for people with obesity – not only for those with related conditions. Medicaid programs in many states may follow suit. The framework also introduces reduced pricing for individuals paying out of pocket, which could expand access even further. Details are outlined in a recent release from the White House.
If implemented as proposed, these steps could meaningfully broaden access to obesity-management medications, particularly for older adults and lower-income individuals who have historically faced cost barriers to treatment. In the long term, wider access may help reduce complications associated with obesity-related diseases and lower overall health-care costs. This outlook is consistent with a recent Institute for Clinical and Economic Review (ICER) assessment, which found that newer obesity medications are cost effective.
What to Watch
As details emerge, several factors will determine how transformative this moment becomes:
- Coverage specifics within Medicare. The impact will depend on how eligibility is defined, how benefits are structured, and whether complementary services – such as behavioral counseling, nutrition support, and follow-up care – are included.
- State decisions on Medicaid. State-by-state variation could lead to improved yet still uneven access across the country.
- Private insurance response. As public programs expand coverage and reduce costs, private health plans may reassess their own benefit designs, though timelines and approaches are likely to vary.
- Shifts in public perception. As access increases and obesity treatment becomes more normalized, public understanding of obesity as a chronic disease may continue to grow, helping reduce stigma.
- Impact on people with obesity. Arguably the most important measure of success will be how many individuals are able to access care – and whether their lives improve as a result.
An Important Moment with Long-Term Implications
Investing in prevention and treatment of obesity can improve health outcomes and lessen burdens on the broader healthcare system. By improving access and lowering financial barriers, last month’s actions signal a meaningful shift in how the country approaches a complex and costly chronic disease.
Whether November 2025 proves to become a true turning point will depend on implementation, follow-through, and coordinated action across federal and state programs, insurers, employers, providers, and communities. But the significance of this moment is clear: it could reshape obesity care in the United States for years to come.