The medical world had heaved a sigh of relief when the GLP-1,Glucagon like peptide-1 [Ozempic , Trulicity etc.} were introduced .It was a win win situation for both doctors and the patients .The main purpose of GLP-1 was blood sugar control but its added bonus of weight loss catapulted it to stardom .
Patients loved it as they could cheat as much as they wanted in their meal menus and still could fit in their dream dresses and look fabulous .They did not have to feel guilty during their medical appointments as they failed to meet the expectations of physicians .
Physicians loved it as their frustration no more hit the roof .Months after months of explaining the risks associated with high sugars were over .The magic numbers in the lab reports of the patients were reached effortlessly and the bipartisan decision of compliance for the medication was without any tug of war .
Obesity has long been recognized as a pervasive morbidity specially in the weaker section of the society where healthy eating is economically impossible .Its ripple effects includes hypertension ,diabetes , sleep apnea and many related problems .
The side effects of GLP-1 were taken more than in stride by the patients .No one cared about a little balding or extra wrinkles on the face or extra folds in the arms .Patients liked what they saw in the mirror .Their self esteem was reaching its peak , as they flaunted their newly acquired waist line .Their behavioral health issues were showing a steep decline . They switched on their selective hearing when other side effects were being enumerated by the physicians
It was as if patients were hanging on to this magic potion with their lives .They were at their best behavior , never missing any appointments, all labs and investigations done at time .In the satisfaction survey , they had the best doctors and the doctors had the best patients .
But most good things in life are built to expire soon .
With the changing winds ,the austerity drive hit the people ,who needed this weight loss medication, the most .MediCal stopped covering it for Obesity .It would cover for people who were diabetics .Thought process stopped somewhere that obesity can lead to diabetes , hypertension , sleep apnea and all the related issues .Their Cinderella lives were over .
Patients of Federally Qualified health center are heart broken .They are demanding it with a child like irrationality but MediCal would only cover if patient had significant sleep apnea or Liver disease with strict parameters and hence difficult to qualify.
Percentage of Obesity and Overweight people in FQHC’s is significantly higher, 76% vs 40% of national average , 2020 and presumably their associated morbidities . If the patients are not left to fend for themselves , the harder way ,a little support ,would go a long way
PS
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