The rise of the popular obesity and diabetes drugs Wegovy and Ozempic has forced weight loss companies to radically change their business models.
WeightWatchers and Noom have for years promoted diet and exercise as the main ways to lose weight, but both recently debuted plans to offer prescriptions for Wegovy and similar drugs as part of a strategy that recognizes obesity as a chronic disease.
WeightWatchers announced the change in March when it bought Sequence, a telehealth company that provides prescriptions for obesity drugs. In the coming months, WeightWatchers said it would implement a program for members who take the drugs.
Meanwhile, subscription app Noom launched its own telemedicine platform last month, called Noom Med, which provides access to medications. Noom, founded in 2008, offers psychological advice to help lose weight and helps people track their eating and exercise habits.
The companies said their decisions to expand into prescription drugs came in response to an evolving scientific understanding of obesity, as well as requests from customers looking to incorporate drugs into their weight-loss regimens.
«We have always followed the science, and as the medical community has transitioned to this concept of obesity as a disease, we would be remiss not to join in as well,» said Dr. Linda Anegawa, Noom’s chief medical officer.
Dr. Gary Foster, WeightWatchers’ chief scientific officer, similarly said that offering drugs was a «natural next step» for the company.
«We know the science and success of GLP-1 use and consumer interest is strong. As science and consumers evolve in this space, we must also meet their needs,» Foster said in an email. (GLP-1 refers to GLP-1 agonists, the term for the class of weight-loss drugs that includes Wegovy.)
Demand for Wegovy has skyrocketed since 2021, when the Food and Drug Administration approved it for weight loss in obese and overweight adults and at least one weight-related health condition, such as high blood pressure or high cholesterol. Wegovy’s sister drug, Ozempic, is based on the same formula but at a lower dose and was approved for people with type 2 diabetes in 2017.
Both drugs are brand names for semaglutide, a drug that can lower blood sugar and suppress appetite by mimicking a hormone that signals the brain when a person is full. semaglutide cut body weight by an average of 15% in trials.
Unlike, a 2018 study found that, at best, diet, exercise, and behavioral counseling help people lose an average of 5% to 10% of their body weight.
«What these drugs have really shown us is that obesity is a biological-metabolic problem. It can’t be overcome simply with lifestyle interventions, for the most part,» said Dr. Eduardo Grunvald, an obesity physician at UC San Diego Health.
WeightWatchers and Noom «are catching up with the science,» Grunvald said. «But it’s also profit driven, obviously. That’s where the demand is.»
Meanwhile, weight-loss companies that don’t integrate drugs into their business models could run into trouble, according to Linda Bolton Weiser, an analyst at DA Davidson Companies, a wealth management firm. Jenny Craig, which sold a prepackaged food diet plan but never offered prescription drugs, closed its doors last month.
«For companies that can’t strategically figure out how to do the drug thing, and if they offer a food product, those companies may suffer,» Weiser said. «That would be Medifast with their Optivia, that would be Jenny Craig, that would be Nutrisystem.»
Weiser said that because FDA labels specify that people should use obesity drugs in combination with diet and exercise, WeightWatchers and Noom can «check all the boxes for you.»
Expand access to weight loss medications
Dr. Fatima Cody Stanford, an associate professor of medicine at Massachusetts General Hospital, said that because obesity doctors have a hard time caring for such a large number of patients, people with obesity could benefit from having access to prescription drugs through weight loss companies.
«There is a huge demand right now for our services and we are not enough to go around,» Stanford said.
He estimated that around 5,500 people are on the waiting list at his hospital, and all of them have been deemed eligible for anti-obesity drugs.
Dr. Spencer Nadolsky, Sequence’s chief medical officer, said some people are having a hard time getting the drugs because some general practitioners aren’t yet comfortable prescribing them.
Kailey Wood, 36, of Buffalo, New York, said she had trouble talking to her primary care doctor about weight loss, so she turned to Sequence.
«It would make me nervous. I’d rehearse what to say and ultimately shut myself down and feel helpless,» Wood said.
Through Sequence, Wood was prescribed Mounjaro, a drug approved to treat type 2 diabetes that doctors can off-label for obesity. She lost 65 pounds, she said.
«Taking these weight loss drugs has validated what I knew: that my body was working against me and that I wasn’t broke,» Wood said in an email.
Stanford noted, however, that Wegovy is in short supply. People usually start with a low dose and then increase, but the FDA has reported limited availability of the three lowest doses of Wegovy.
«Starting someone new on the drug is challenging at best right now,» Stanford said.
Grunvald said he is also concerned that for-profit companies could overprescribe the drugs in the future.
«That’s where the potential for inappropriate prescribing comes into play, when you’re motivated by volume,» he said.
But Noom Med and Sequence shot down that idea.
«We’re not writing dishonest prescriptions for people with a BMI of 23 trying to wear a size 8 swimsuit,» Anegawa said.
Is it worth paying for subscription services?
Sequence and Noom Med said they will offer prescriptions based on FDA criteria: a body mass index, or BMI, of 30 or higher, or a BMI of 27 or higher in combination with other weight-related health conditions. However, Anegawa said that Noom Med doctors are allowed to prescribe off-label drugs in accordance with guidance from groups like the Obesity Medicine Association.
Physicians must be board certified to work at Sequence, while Noom Med employs board certified physicians and nurse practitioners supervised by physicians experienced in obesity care.
The programs are generally similar.
Sequence clients complete an intake questionnaire to determine their eligibility. From there, they can schedule a consultation to discuss your medical history and start taking your medications. Doctors monitor side effects and weight loss results, and clients have simultaneous access to fitness trainers and dietitians.
With Noom Med, clients get blood work done before their first appointment, then a doctor assesses their weight and health history. If the person is offered a medication, they can send a message to the doctor via an app to report the side effects, and the doctor can adjust the dose accordingly.
Obesity drugs are generally meant to be lifelong drugs; data consistently show that people who stop taking semaglutide regain most of the weight.
One drawback of the WeightWatchers and Noom programs, Grunvald said, is their cost.
Noom Med is priced at $49 per month on top of the standard Noom subscription, which starts at around $42 per month for four months, then moves to around $70 to $209 per month, depending on the plan. A Sequence subscription costs $99 per month. With both programs, people have to pay separately for medications, which cost more than $1,000 a month without insurance.
Since weight-loss drugs alone often encourage healthier habits, Grunvald said some clients may not make much use of the other components of these programs.
«The question is going to be, is it necessary? Is that additional cost necessary?» he said.