Maya Cohen's entree into the world of obesity medicine came as a shock.

She went to see a doctor who prescribed her a weight-loss drug. Ms. Cohen, who lives in Cape Elizabeth, Maine, rushed to get it filled.

The pharmacy was charging her $1,500 a month. Her insurer wouldn't cover it because it was classified as avanity drug.

She complained to her insurer, but to no avail.

Dr. Apovian was not surprised by Ms. Cohen's denial. She says it's a common response from insurers when she prescribes weight-loss drugs.

Obesity specialists hope that with the advent of effective drugs, the situation will change.

The maker of the medicine Dr. Apovian prescribed and patient advocacy groups have been lobbying insurers to pay for weight-loss drugs. They have been lobbying Congress to pass a bill that would require Medicare to pay for the drugs.

The status quo has not changed.

More than 40 percent of Americans are obese, and most have tried to lose weight and keep it off, only to fail. Many suffer from medical conditions that are linked to Obesity, including diabetes, joint and back pain and heart disease, and those conditions often improve with weight loss.

There are physical changes in weight regulating pathways that make it difficult for people to lose weight. Something physical is holding them back.

ImageMs. Cohen in 2016.
Ms. Cohen in 2016.Credit...via Maya Cohen
Ms. Cohen in 2016.

Obesity should be treated as a chronic disease like heart disease, diabetes, high blood pressure or any other chronic illness. They say that rarely happens.

The access to medicines for the treatment of obese people is poor in this country.

Even if a patient's insurer will cover weight loss drugs, most doctors don't suggest them and patients don't ask for them as they don't realize there are good treatment options.

The medical system is to blame. It is the biggest chronic disease of our time, and no one is learning anything about it.

The newer, more effective and safe drugs made by Eli Lilly and the newer, more effective and safe drugs made by the newer, more effective and safe drugs made by the newer, more effective and safe drugs made by the newer, more effective and safe drugs made by the newer, more effective The number of people who are eligible for these drugs has not changed much from the earlier studies. Most insurers, including Medicare, pay for the same percentage of surgery as those who get it.

If you are heavy, pull yourself up from your bootstraps and try harder.

Many patients and doctors share a perception that makes them reluctant to seek medical help or prescription medication.

Insurers don't cover weight-loss drugs, that's the problem Ms. Cohen ran into.

Obesity specialists have found a way to get an effective but expensive drug for obese patients whose insurers won't pay.

ImageOzempic, or semaglutide, is often covered by insurance companies as a diabetes drug.
Ozempic, or semaglutide, is often covered by insurance companies as a diabetes drug.Credit...Ryan David Brown for The New York Times
Ozempic, or semaglutide, is often covered by insurance companies as a diabetes drug.
ImageMs. Cohen took a mix of prescription weight-loss pills.
Ms. Cohen took a mix of prescription weight-loss pills.Credit...Ryan David Brown for The New York Times
Ms. Cohen took a mix of prescription weight-loss pills.

There are quirks in the way the company markets its drugs. Semaglutide is a drug that can be used for both diabetes and for weight gain. Ozempic has a list price of $892 for four weeks. Insurance companies cover it for people with diabetes.

The two weight loss drugs that are of the same class are liraglutide and semaglutide. The suggested retail price for both is about 1,300 a month. If it is used to treat obese people, the drug costs 51 percent more than if it is used for diabetes.

It is hard to get.

Most U.S. insurers don't pay for Saxenda or Wegovy because they are weight-loss drugs, and the company has asked doctors not to start new patients on it.

Eli Lilly hopes to get a weight-loss drug approved for obese people. The name was approved to treat diabetes. The retail price of a diabetes drug is almost $1,000 a month.

The manufacturing issue that caused the Wegovy supply problem should be fixed later this year, according to Douglas Langa, an executive vice president.

The difference in price between the two drugs was explained by the fact that they were based on the same medicine. He said Wegovy's price reflects efficacy and clinical value.

He was appalled.

She said that it was a gross inequity to charge people more for the same drug because of their weight. She finds herself in a situation where she has to be excited about her patients with diabetes because their insurers pay for the drug.

When patients have high blood sugar levels, Dr. Apovian finds herself rejoicing.

Her insurance company wouldn't cover Saxenda. She had a copay of $70 a month for Ozempic.

Ms. Cohen was five feet fall and weighed 192 pounds when she saw Dr. Apovian. She has lost 54 pounds. Her waist size was 46 inches. Her joints do not hurt and she has more energy.

Ms. Cohen said that it has changed her life.