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GLP-1 receptor agonists — medications like Wegovy and Saxenda — have revolutionized obesity treatment, offering significant weight loss and metabolic benefits. But here’s the catch: the people who need them most often can’t get them. Obesity rates in the US are soaring, especially among low-income and minority communities. Yet these same groups face the steepest barriers to accessing effective treatments like GLP-1s. The reasons why are rooted in more than individual choices — they’re tied to deep, systemic challenges.
Why Social Determinants of Health Matter
Obesity doesn’t exist in a vacuum. The conditions in which people are born, grow, live, work, and age—known as social determinants of health—play a fundamental role in shaping health outcomes, including obesity rates. Data from the CDC consistently shows that obesity is most prevalent among Black, Hispanic, and low-income populations. Geographic disparities highlight that obesity rates are highest in the Southern U.S. and rural areas, where economic hardship and limited healthcare infrastructure further compound the issue.
One of the most significant contributors to obesity in these communities is food insecurity, which limits access to fresh, nutrient-dense foods and increases reliance on ultra-processed, high-calorie options. Many low-income neighborhoods are classified as food deserts, with limited access to grocery stores. Additionally, financial literacy and economic instability prevent individuals from navigating insurance options or accessing weight-loss medications. With the average out-of-pocket cost for GLP-1s exceeding $1,000 per month without insurance, these medications remain unaffordable for many.
Access to healthcare is another major hurdle. Primary care providers and obesity specialists are often scarce in these areas, and even when care is available, long wait times, lack of transportation, and rigid work schedules can make appointments nearly impossible. Additionally, physician bias and weight stigma exacerbate disparities, with studies showing that providers are less likely to discuss weight-loss treatments with patients from lower-income or minority backgrounds, often attributing obesity solely to personal responsibility rather than the complex interplay of factors affecting health.
The Paradox: High Obesity, Low GLP-1 Access
Despite high obesity rates in underserved communities, these populations have some of the lowest access to GLP-1 medications. Insurance coverage is a huge part of the problem. Medicaid, which insures a large portion of low-income individuals, often doesn’t cover GLP-1s unless they’re prescribed for diabetes—not obesity. Private insurance plans may offer coverage, but high deductibles, prior authorization requirements, and high co-pays make access difficult even for those who are covered.
Physician behavior also plays a role. Some providers may hesitate to prescribe GLP-1s in lower-income communities, assuming that patients in these communities will be non-adherent to treatment or unable to afford medications, reducing prescription rates even among those who might qualify. The result is a widening gap in obesity treatment access, further exacerbating health disparities.
The Role of Virtual Cardiometabolic Care in Expanding Access
Digital health platforms are stepping in to fill the gap—and they’re showing real promise.
Virtual obesity care allows patients to connect with a full care team from home. That includes physicians, registered dietitians, behavioral health specialists, and pharmacists, all working together to provide holistic obesity management. Medical nutrition therapy (MNT), delivered by registered dietitians through telehealth, is critical in ensuring patients receive tailored, evidence-based dietary guidance that complements medication use. Research suggests that combining GLP-1 therapy with structured nutrition interventions and exercise enhances weight loss outcomes and improves metabolic health.
Telehealth can also help reduce bias in treatment. By standardizing treatment protocols and using data to guide decisions, digital health platforms can ensure that all eligible patients are considered for GLP-1 medications and other anti-obesity medications (AOMs), medical nutrition therapy, and other weight management options. Virtual visits also allow for more private, stigma-free conversations about weight, which can improve patient engagement.
Right now, social determinants of health are standing in the way for too many underserved Americans. By leveraging telehealth to deliver multidisciplinary, patient-centered care, we can break down barriers to make evidence-based obesity treatment more accessible to those who need it most. It’s not just about better health outcomes—it’s about creating a more equitable healthcare system for everyone.
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