Weight management: Why medication is only the beginning

Published September 29, 2026

Group insurance plan sponsors may have more influence over weight management than they realize.

The answer isn’t another coverage enhancement or a one-off wellness program. It’s helping people access the right support early and stay connected to it over time.

Obesity is a chronic disease shaped by biological, psychological, social and environmental factors, as well as certain medical conditions and medications. In 2024, more than two-thirds (68%) of Canadian adults aged 18 to 79 were overweight or living with obesity, up 13.3% from 2016¹.

As scientific understanding of obesity evolves and treatment options expand, the conversation is shifting. The focus is now on how to integrate comprehensive obesity and overweight care into group insurance plan coverage and avoid the gaps that can come with a fragmented approach.

Spot the risk before it becomes a claim

Plan sponsors already see the costs associated with obesity, including drug claims and care related to sleep apnea, diabetes and cardiovascular disease. The first effects of overweight and obesity, however, often emerge long before a claim is filed. They show up in productivity: absenteeism and presenteeism both climb as obesity severity increases, and presenteeism has a way of becoming absenteeism.

Presenteeism is harder to measure, because the person is still showing up to work. However, its cost to the business can be just as real. Among people living with obesity, studies have found an association between sleep problems and presenteeism. Obstructive sleep apnea is estimated to affect between 40% and 90% of people who are overweight, depending on the severity of their condition.

Someone who’s fatigued, struggling to concentrate or managing physical limitations may remain at work while requiring additional support and working below their usual capacity. To a manager, that can look like a performance issue, when it may be a health issue.

Presenteeism doesn’t automatically lead to disability, but it can be an early warning sign. Even when obesity isn’t listed as the primary cause of a claim, it’s frequently in the background, contributing to hypertension, type 2 diabetes, osteoarthritis, cardiovascular disease, musculoskeletal disorders and mood disorders, all of which already drive cost and disability outcomes. Obesity can shape how a claim unfolds without ever appearing in the initial diagnosis.

For employers, this is more than a clinical footnote. It can help explain why a disability is extended, a recovery takes longer or a return to work becomes more complicated, even when obesity isn’t identified as part of the picture.

Obesity should, therefore, be viewed as a risk factor. For example, based on our internal estimates, a typical group of 500 people saw approximately $457,000 a year in disability and premature mortality costs linked to obesity in 2025, before factoring in comorbidities.

What plan members want from group benefits plans

Anti-obesity medications are having a moment, and that is prompting plan sponsors to pay closer attention. Plan members want access, while employers are weighing the cost and the risk that comes with it. For many organizations, the question isn’t whether to cover weight management anymore; it’s what effective support looks like.

Plan members are pushing this shift along. In a national survey we conducted in 2025, 55% of respondents felt that group insurance plans should include weight management services. Another 74% said they would join an employer-supported program if it were accessible, personalized and affordable².

The Benefits Canada 2025 Health Care Survey also found that 65% of plan members wanted access to weight-loss medications through their group benefits plan³.

Medication coverage on its own is not a complete strategy. Without support, people may stop treatment and the progress they make goes with it.

One-off programs won’t move the needle

Obesity care works best when it goes beyond isolated interventions. Success takes more than treatment adherence. It also depends on addressing factors that extend beyond nutrition or individual willpower. Psychological and social issues, along with practical constraints, influence whether people engage in the process and remain committed to it.

For many people, the hardest part is knowing where to start. A proper initial assessment can establish a clear starting point. Skip it, and someone might consult a dietician without anyone accounting for the comorbidities or behavioural barriers most likely to cause a relapse.

Getting people to start a program is the easy part. Making sure they stay in the program and stay on the medication, and everything else that makes the change last, is what determines whether it works.

Success doesn’t need to be life-changing to count. Even moderate progress can make a difference. A 5% to 10% weight loss can meaningfully improve health and lower risk on its own⁴.

Supporting without diagnosing

Obesity care raises two important questions for HR leaders: how involved should the employer become, and what role should managers play?

The line is clear. HR teams and managers don’t need to become clinicians. Their role is to reduce barriers and clear the path to the right resources.

Employers are not responsible for diagnosing conditions or prescribing treatment. Instead, they can reduce barriers and make services and resources easier to access. This includes:

• Clearer communication
• Better information
• Less stigma
• Simpler access to resources
• A better understanding of how the available services work together

Use the data you already have

Obesity care is moving fast, and the evidence, especially in Canada, is still evolving. Weight management programs are one tool companies can use, but the evidence base is still developing. That’s a real constraint for organizations trying to act today.

However, it doesn’t mean waiting on the sidelines. As the evidence evolves, it can help teams fine-tune programs and tailor interventions to different people, rather than simply determine, after the fact, whether they work. Insurers can share anonymized data on disability causes, drug utilization and how people are engaging with health care providers. Organizations can pair these insights with internal indicators, such as absenteeism trends by role or department, to flag emerging risks and help target support where it will land.

This helps organizations turn data into insights and insights into better-informed decisions, allowing them to target support more effectively.

Obesity and weight management give group insurance plan sponsors an opportunity to rethink how they support health overall. Medication has a role to play, but it’s the integrated care pathways that produce lasting results.

The conversation is no longer only about coverage. It’s about creating conditions for better health, stronger productivity and a lower long-term risk of disability through integrated, sustained support.