Wegovy and Zepbound are reshaping health care spending, new research finds

GLP-1 weight-loss drugs are changing how Americans get care and how the health care industry earns money, according to new Wells Fargo research reported by USA TODAY on Aug. 20, 2026 ^[1]. The research examined how drugs including Novo Nordisk's Wegovy (semaglutide) and Eli Lilly's Zepbound (tirzepatide) are reshaping the industry's economy ^[1].

"It shifts the profit centers from late-stage treatment and intervention to really being more proactive with the management of obesity," said Robin Wenzel, head of Wells Fargo's industry insights ^[1].

Fewer weight-loss operations

A May 2026 study in the peer-reviewed journal JAMA found bariatric weight-loss operations dropped 34% from 2022 to 2024 while GLP-1 use increased 140% over the same period ^[1]. The article frames the two trends as related: some patients may be prescribed medication such as Wegovy or Zepbound instead of having surgery ^[1].

The American Society for Metabolic and Bariatric Surgery will soon release its own figures on the decline in weight-loss surgeries since GLP-1s became more widely used, said Dr. Joe Northup, the group's president ^[1]. Northup said some patients stop the medications because of side effects or because they do not reach their weight-loss goals, and he expects a future in which some patients use medication while others choose surgery. "We're starting to see patients come back (for surgery) after having tried these medicines for a year or six months," he said ^[1].

Heart health and open questions

One study found semaglutide, sold as Ozempic and Wegovy, reduced major adverse cardiovascular events by 20% in overweight or obese adults without diabetes ^[1]. A June study in the Journal of the American Heart Association found that GLP-1 users with obesity and an autoimmune disease such as celiac disease or rheumatoid arthritis were less likely to suffer strokes, blood clots in the veins or lungs, or other cardiac events than a similar group who did not take the medications ^[1].

Dr. Fatima Cody Stanford, an obesity medicine specialist at Massachusetts General Hospital and Harvard Medical School, said the heart benefits show up in practice. "I can attest to the fact that we see this in clinical practice," she said. "We actually see this happen" ^[1].

It is still unclear how the drugs will affect the number of hip and knee replacements, the article says. People who lose weight might put less wear on their knees, or weight loss could make more people with obesity eligible for joint-replacement surgery, or they might become more active and accelerate joint wear ^[1]. A 2024 JAMA Network Open study linked weight loss among overweight or obese adults to lower health care spending overall, but the article says those savings depend on whether consumers can get the medication ^[1].

Who pays

Medicare has launched coverage of GLP-1s for older adults, but some employers and insurers are balking at the cost ^[1]. Starbucks said it would no longer cover GLP-1 weight-loss medications for employees beginning in October ^[1]. A recent Mercer survey found about 6% of large employers will drop coverage of GLP-1 weight-loss drugs in 2026 and another 5% plan to drop coverage in 2027; nearly half of large employers covered the drugs in 2025 ^[1].

Both Lilly and Novo Nordisk have cut prices for consumers who buy directly from the drugmakers or through telehealth companies that have partnered with the drugmakers, according to the article ^[1]. Specific figures on how many patients start weight-loss treatment through telehealth or direct pay rather than a primary care visit have not been reported ^[1].

The article also describes a next-generation pipeline. Lilly said its experimental shot retatrutide produced weight loss of 19% to 28%, results that were on par with weight-loss surgery for some people; it mimics three hormones — GIP, GLP-1 and glucagon ^[1]. Wells Fargo reported that the pipeline of weight-loss medications now surpasses cancer drugs as the most valuable category of products on the horizon, and Goldman Sachs projects global sales of about $105 billion by 2030 ^[1].

Why it matters for patients

Where someone gets GLP-1 treatment, and who pays for it, now shapes whether that treatment continues. Stanford said she has watched major Massachusetts insurers scale back coverage for weight loss. "For those patients who loss coverage and weren't able to afford out-of-pocket options, we're seeing weight gain and the reemergence of those cardio-metabolic diseases that had gone into remission," she said. "That's really a missed opportunity for these patients who were gaining health. We're seeing a reversal" ^[1].

The article says the medications remain difficult to afford for people whose insurance does not cover them, or who are uninsured ^[1].

What happens next

The American Society for Metabolic and Bariatric Surgery has not said when its surgery figures will be released ^[1]. Employer coverage changes take effect on different schedules: Starbucks' change begins in October, about 6% of large employers plan to drop coverage in 2026 and another 5% in 2027 ^[1]. Retatrutide is still experimental and has not been approved ^[1].