It’s time we changed the way we think about obesity and the medications used to treat it, including GLP-1s like Zepbound. Every person in New Hampshire who needs treatment for the complex, chronic disease of obesity should have access to it.
Obesity is a disease recognized by the medical community, a chronic condition often driven by underlying metabolic dysfunction that cannot simply be overcome by willpower alone. Yet the stigma surrounding obesity remains pervasive in our society. People living with obesity are still too often viewed as lacking discipline or motivation, instead of being treated as patients with a legitimate chronic illness influenced by genetics, hormones, insulin resistance, biology and environment. That stigma has consequences. Untreated obesity can lead to diabetes, heart disease, kidney disease and many other serious health complications. It also shapes the way people living with obesity are treated by society, health care systems and policymakers.
I know because I lived it. For most of my life, I struggled to understand why decades of effort to control my weight always ended with regain. By my early forties, obesity had contributed to high blood pressure that resisted treatment, as well as severe sleep apnea, fatty liver disease and rapidly worsening metabolic health. I was approaching a type 2 diabetes diagnosis, and with my family history, I knew I was losing the fight for my health.
Then I finally reclaimed my life because of GLP-1 medications and my ability to access them. Over the last two years, I’ve lost more than 90 pounds. My blood pressure normalized. My glucose levels returned to a healthy range. I no longer have sleep apnea. My fatty liver disease resolved. These medications also allowed me to successfully adopt sustainable diet and exercise habits that support my long-term health.
Today, however, New Hampshire residents who rely on Medicaid no longer have access to these treatments.
On Jan. 1, New Hampshire ended Medicaid coverage for GLP-1 medications prescribed solely for obesity treatment. What was presented as a cost-cutting measure will likely create greater long-term costs as obesity-related illnesses and hospitalizations increase, placing more strain on an already burdened health care system.
Even people like me with private insurance face barriers to accessing GLP-1 medications through prior authorizations, shifting co-pays and changing coverage policies. But Medicaid beneficiaries suffering from obesity do not even have the opportunity to navigate those challenges because the state eliminated coverage altogether.
Since reclaiming my health with GLP-1s, I’ve advocated for making these medications accessible to all, regardless of income. When someone has asthma, we do not tell them to simply breathe harder. When someone has depression, we do not accuse them of lacking character. We treat their chronic conditions. Yet people living with obesity are still too often expected to suffer and rely solely on willpower, even when effective medical treatment exists.
I’m adding my voice to those calling on the state of New Hampshire to restore Medicaid funding for GLP-1 medications. Let us remember that this issue is not about vanity. It is about health, dignity, and the wellness of our communities.
Brian L. Salerno lives in Merrimack.