Sharing this because I want to hear people who know more than me scream about it (which I kind of expect you will).
from OPM to FEHB carriers: Cut costs, MAHA style - Government Executive
The Office of Personnel Management instructed insurers who participate in federal and postal workers’ employer-sponsored health benefits program last week to promote a series of “well care” initiatives as an effort to reduce costs as the companies prepare their offerings for this fall’s annual open season.
The notice took the form of OPM’s annual “call letter” to companies that participate in the Federal Employees Health Benefits and Postal Service Health Benefits programs.
[among other things] the letter calls for insurers to require other interventions before patients may pursue GLP-1 drugs for obesity. Feds seeking a GLP-1 prescription would first have to participate in an obesity management program including intensive behavioral therapy.
[In the call letter, see starting on p.6 “Prevention and Treatment of Obesity”. They cite DRAFT FDA Guidance for industry on developing these drugs, marked Not for Implementation.
FDA indications for anti-obesity medications reinforce that nutrition, behavioral interventions and physical activity regimens should precede drug treatment of obesity and that anti-obesity medications are not recommended for cosmetic or convenience weight loss.15 This is consistent with guidance from nationally recognized clinical bodies including the American Diabetes Association, the American Association of Clinical Endocrinology and the USPSTF.
[citation links at bottom of each page]
FDA: Obesity and Overweight: Developing Drugs and Biological Products for Weight Reduction: Guidance for Industry (Draft guidance released January 2025) Carriers must cover the full extent of the USPSTF recommendations addressing healthy weight in adults,16 children and adolescents,17 and pregnant women.18 The primary USPSTF recommendation is intensive behavioral therapy (IBT), a combination of structured lifestyle interventions pertaining to nutrition, physical activity, and behavior change outside the realm of mental or behavioral health treatment for eating disorders.
but they also want….[bold could be helped with GLP-1s]
emphasis should be placed on ensuring access to treatments for conditions that are recognized to adversely impact fertility, such as obesity, prediabetes, chronic reproductive health conditions to include male factor infertility and hypertension,
Anyway.
Citations are at the bottom of each page of the call letter. Notably absent is https://www.jacc.org/doi/pdf/10.1016/j.jacc.2025.05.024 2025 Concise Clinical Guidance: An ACC Expert Consensus Statement on Medical Weight Management for Optimization of Cardiovascular Health