(Image via Pixabay by Clker-Free-Vector-Images)

ON JULY 4, Gov. Healey signed the 2026 state budget into law. Lost in the flurry of news coverage on a holiday weekend was the administration’s intention to cut public employees’ access to GLP-1 receptor agonists for weight management and the treatment of obesity.  

These drugs represent a revolutionary advance in the treatment of the disease of obesity, and they have become a life-saving medication for thousands of state employees.  

Those employees will be left without coverage for GLP-1 drugs if the governor’s veto of $27.5 million for the Group Insurance Commission, which handles employee health coverage, is allowed to stand and if the Legislature approves language she submitted in a separate budget package allowing the GIC to make changes in covered benefits midway through the health plan year.

As the Massachusetts-based CEO of the World Obesity Federation, and on behalf of our local Massachusetts member, the Obesity Action Coalition, and over 1 million state residents living with obesity, I urge the Legislature to override the governor’s veto of funding for these life-saving therapies – and not to adopt language in the separate budget bill authorizing the benefit cut. 

The World Obesity Federation is the main partner to the World Health Organization on obesity and has member organizations in over 100 countries. We work to advance policies aimed at preventing and managing this disease that affects over 1 billion people worldwide.   

By 2035 over half of humanity is projected to be overweight or have obesity, so effective treatments and policies that work cannot come quickly enough, and be made accessible to all. 

What we’ve seen in Massachusetts, where individual blame and prevention-only policies have been insufficient to address what is increasingly recognized as a complex chronic disease, is true everywhere. We can’t prevent our way out of this tsunami, nor can we just treat our way out of it. We must do both.   

The economic impact of obesity is mind-boggling. In 2022, World Obesity published a study showing that the costs of inaction on obesity, as measured by the impact of all the cases of cancer, diabetes, and other diseases that obesity is driving, is currently at over 3 percent of GDP in the United States and projected to almost double by 2060.

There is nothing to suggest that the economic impact at the state level would be substantially different. This means that not treating obesity will lead to far higher costs associated with managing and treating diseases that could otherwise have been avoided. Treating obesity yields a double dividend in terms of the savings and societal benefits of reducing the burden of other diseases.  

It is true that the new medications are costly in the US. Costs can be reined in and rates can be negotiated, especially as some drugs go off patent. But it’s no accident that one of the groups that has been most vocal in calling for solutions that maintain coverage is employers, who see the impact and understand how much neglecting obesity harms their most valued asset.  

It is not widely known among public employees that the governor has proposed removing their coverage of GLP-1s. That means there are thousands of teachers, firefighters, police officers, maintenance workers, and other people who contribute every day to making the Commonwealth work, who are soon going to be notified that they no longer have this coverage.  

The same is true for retirees covered by the GIC. Study after study tells us that obesity often returns quickly once GLP-1s are removed, and we also know that the cycle of gaining/losing/gaining only exacerbates the progression of the disease — and the diseases caused or made worse by obesity.  

Therefore, the removal of coverage worsens the health of our public workforce, rather than just restoring the status quo. These are the people at the heart of what makes Massachusetts such a great state.  

The governor’s proposal makes an exception for those for whom the drugs are “medically necessary” a carveout that mostly refers to those with diabetes. 

This is problematic for two reasons. First, there are many other diseases that are associated with obesity that don’t seem to make the cut. Why not cancer? Sleep apnea? Musculoskeletal diseases? The list of diseases is 200 strong. Second, the diabetes that these drugs treat is driven by obesity. Why wait to treat something downstream when it can be much more effectively managed sooner?   

The only explanation seems to be the persistent stigma about obesity that has been one of the engines of its growth. Patients with obesity will, time and again, encounter misinformed health care professionals who blame or shame them for having what the American Medical Association and WHO have confirmed is a chronic disease. The governor’s unfortunate choice of words suggests the therapies are cosmetic and not medical.    

In the coming months, before the cut to state employees’ coverage is intended to take effect, the WHO will launch global GLP-1 guidelines, calling for a step change in access and affordability. It is anticipated that GLP-1s will also be included on the WHO essential medicines list, alongside medications for malaria, HIV, and, yes, diabetes.

Shouldn’t Massachusetts lead the way, rather than leave its citizens behind on this critical issue?  

Johanna Ralston is CEO of the World Obesity Federation.