Dr. Arnold Saperstein
Integrating Weight Management and GLP-1 Support
For decades, the healthcare industry has treated type 2 diabetes and obesity as separate challenges—one with clinical protocols and evidence-based guidelines, and the other with wellness coaches and motivational speeches. But we know they are tightly linked and managing them in silos is limiting outcomes for patients and straining budgets for payers and employers. That’s why rethinking diabetes care means acknowledging the overlap with obesity—and addressing both through coordinated, clinical care.
With the rise of GLP-1 receptor agonists like Ozempic®, Wegovy®, and Zepbound®, there’s new momentum and urgency to revisit how we support individuals with complex, cardiometabolic conditions. These medications hold real promise—not just for blood sugar and weight loss, but for broader cardiometabolic health. However, without the right clinical and behavioral support, their impact can be short-lived and financially unsustainable.
The question now is how do we build a care model that ensures that the successes obtained by utilizing GLP-1s can be maintained in the long term?
The Overlap Is the Norm, Not the Exception
More than 70% of adults with type 2 diabetes are overweight or obese. Most also carry additional comorbidities: hypertension, dyslipidemia, or chronic kidney disease. Yet our healthcare infrastructure—from benefits design to vendor selection—continues to divide these conditions across narrow programs.
The result?
- Redundant and fragmented member experiences
- Gaps in care coordination and safety oversight
- Missed opportunities for holistic improvement
In contrast, research continues to point toward integrated care as a more effective path forward. When conditions are treated together—by teams that can assess the interplay between medications, behaviors, and biometric trends—outcomes improve and costs are easier to manage. Rethinking diabetes care in this way allows us to move toward broader, more durable outcomes.
GLP-1s Are a Catalyst, Not a Cure
GLP-1s have reshaped the treatment landscape, offering indications for diabetes and obesity and, more recently, cardiovascular and even sleep apnea benefits. But despite their promise, they come with real risks and real complexity:
- Side effects like nausea, dehydration, and muscle loss
- Nutritional deficiencies if not supported with clinical nutrition
- Potential medication interactions with antihypertensives, insulin, or diuretics
These challenges underscore a central truth: GLP-1s require clinical oversight, not just prescription. Effective use depends on personalized monitoring, lifestyle alignment, and coordination with other therapies. Without that support, we risk undercutting their potential—and overpaying for underperformance.
From Siloed Programs to Coordinated, Clinical Support
The alternative is clear: a care model where diabetes and obesity aren’t addressed in isolation, but as part of an integrated, whole-person strategy.
That model requires:
- Interdisciplinary Teams: Registered dietitians, certified diabetes care and education specialists (CDCES), prescribing clinicians, and behavioral health professionals working together, not in parallel.
- Personalized Support: Titration guidance, biometric interpretation, and real-time side effect management alongside behavior and nutrition interventions that reflect each individual’s needs and goals.
- Coordination with Primary Care and Specialists: Communication loops with existing providers are essential for medication safety and trust. Integrated care shouldn’t compete with brick-and-mortar care—it should complete it.
- Real-World Data Integration: Using lab values, biometric trends, medication usage, and social determinants to drive clinical decision-making and flag when interventions are (or aren’t) working.
Why This Matters Now
As GLP-1 demand surges, payers are increasingly pressured to demonstrate value. Many have turned to lifestyle apps, digital coaching platforms, or condition-specific tools. While these may offer convenience, they often fall short in high-risk, comorbid populations.
What’s needed isn’t more content or more nudges. It’s the right clinical care, delivered with the frequency, personalization, and context today’s patients require.
In a virtual-first world, programs can be both accessible and scalable—but only if it’s grounded in evidence-based clinical care.
Looking Ahead
We’re at a turning point in rethinking diabetes care. Health plans and employers are re-evaluating their chronic care investments, recognizing that engagement alone isn’t enough. Without integrated care and medical oversight, even the best therapies struggle to deliver sustainable value.
Supporting individuals with diabetes and obesity doesn’t require two separate programs, it requires one cohesive approach that:
- Understands how these conditions intersect.
- Uses medications wisely, supports behavior change meaningfully, and empowers patients to be active participants in their care.
- Aligns outcomes and costs—not just for today, but for the long term.
Let’s stop treating complexity with fragmented care.
Instead, let’s design systems that match the reality of patient lives and build on the clinical relationships that drive real outcomes.
