Shawn Davis, MD, on Access, Coverage, and the Future of Obesity Therapy

Glucagon-like peptide-1 (GLP-1) receptor agonists have long been available only as injectable medications, but the recent FDA approval of oral semaglutide marked a significant shift in how these therapies can be delivered. Many expected it to be a game-changer for patient uptake; however, Shawn Davis, MD, a physician at Kelsey-Seybold Clinic in Houston, Texas, specializing in obesity care, notes that, surprisingly, the removal of the injection barrier has not driven the surge in patient demand she anticipated. In fact, many patients already established on weekly injections have shown little interest in switching to a daily pill. She notes there was also early confusion in the market, as the brand Rybelsus (Novo Nordisk), the oral semaglutide formulation initially available, was approved for diabetes rather than obesity, leading to underwhelming weight loss results when patients and providers didn't follow absorption-specific prescribing guidelines. Now that the data and administration guidance are better understood, interest is growing, but it has been a slower shift than expected.

Adding this new delivery format, she notes, expands optionality and supports shared decision-making but doesn't automatically rewrite prescribing behavior. Patient preference, cost, and clinical context all still drive the conversation.

On the policy side, Davis highlights active advocacy efforts to mandate obesity coverage on par with other chronic diseases like heart disease and cancer and notes that Medicare Advantage plans are expected to begin offering some GLP-1 benefits in the coming year. She describes this development as potentially "revolutionary" in terms of access. Her central argument is that investment in obesity treatment is investment in the health of the broader population and that as long-term outcome data continue to accumulate, the case for policy change becomes harder to ignore.

"Adding life to years and not just years to life" is how she frames the ultimate goal.