Shawn Davis, MD, on How Payers Should Think About Obesity Treatment Return on Investment

One of the most pressing financial debates in obesity medicine is how payers and health organizations should think about the cost of bariatric surgery and glucagon-like peptide-1 (GLP-1) receptor agonists relative to the long-term savings they generate. Shawn Davis, MD, a physician at Kelsey-Seybold Clinic in Houston, Texas, specializing in obesity care, acknowledges that the upfront investment is significant and that convincing payers remains an ongoing challenge. However, she points to research cited by the Obesity Medicine Association referencing a study that valued the annual economic cost of obesity at $1.4 trillion as a benchmark for understanding what's at stake if the disease goes unmanaged.¹ The study took costs of other chronic health conditions associated with obesity, such as diabetes and Alzheimer disease, into consideration as well as loss of productivity and attendance at work.

From a clinician's perspective, Davis states that the return on investment is real and observable. She says that patients treated for obesity become more productive, have more energy, and require less chronic disease management over time. "The benefit long term," she notes, "I don't think we have a good value on that yet"—a fact that she says is a call for better data collection. The key metric here is the delta between upfront treatment costs and downstream savings in hospitalizations, medications for comorbidities, and lost productivity. These data are currently missing in the conversation with payers and how we think about obesity treatment return on investment.

Her program is actively working to track this delta, although she acknowledges the challenge is compounded by the fact that obesity is not yet a covered benefit for most patients, limiting the population they can observe over time. The implication is that health systems and payers need to build the infrastructure to measure these outcomes longitudinally. Without that data, the value argument remains compelling in theory but hard to operationalize in contract negotiations.

Reference

1. Waters H, DeVol R. Weighing down America: the health and economic impact of obesity. Milken Institute. November 1, 2016. Accessed April 3, 2026. https://milkeninstitute.org/content-hub/research-and-reports/reports/weighing-down-america-health-and-economic-impact-obesity