GLP-1 employer healthcare costs: How to lower spend with better outcomes

GLP-1 medications like Ozempic and Wegovy are transforming how employers approach obesity care. Once reserved for diabetes patients, these drugs are now widely prescribed for weight loss. GLP-1 drugs do deliver on their promise of improved cardiometabolic outcomes. Simply, these medications do help users lose weight.

But for health plans and employers, the real challenge goes beyond pharmacy claims. The bigger risk is in the hidden costs that accumulate over time when GLP-1 treatment is not paired with sustainable lifestyle changes. Without movement programs to protect lean muscle and build healthy habits, employers may face a second wave of musculoskeletal (MSK) claims, re-prescriptions, and long-term disability costs.

GLP-1 users often don’t develop the behaviour change needed to sustain weight loss over time. Also, lean muscle mass is often lost during GLP-1 use which leaves people at increased risk of musculoskeletal (MSK) issues as a result of lower strength and stability levels.

GLP-1s are effective, but expensive 

One of the biggest concerns with GLP-1 use is sustainability. Many patients rebound to old habits after stopping treatment.

GLP-1s are clinically effective for weight loss, but their price tag is steep. GLP-1s can cost up to $10,000 per member annually¹, and are projected to account for up to 9% of total medical spend² in some employer plans.

The ROI, however, is not guaranteed.

• up to 70% of GLP-1 users discontinue medication within the first year³
• as many as two-thirds of patients regain weight after stopping⁴. 
• clinical research shows that up to 39% of weight lost comes from lean muscle mass⁵, not fat. 

This creates new risks for MSK pain, falls, and disability. GLP-1s are very effective at delivering on their target. These medications help people lose weight. But without parallel programs that protect strength and function, muscle loss can lead to significant downstream healthcare costs. 

Breaking down the cost burden of GLP-1s for employers

At first glance, GLP-1 adoption appears to reduce downstream spend by improving metabolic health. But a closer look shows additional cost centers that often go unreported:

• High churn risk: 30–50% of users discontinue within a year³, leading to rebound and re-prescription.
• No lifestyle integration: Without physical activity or supporting movement plans to change behavior, GLP-1 users may not develop the habits required to sustain weight loss over the long term.
• Functional degradation: Lean muscle loss and inactivity increase the likelihood of MSK claims and disability risk.
• Absence of ROI tracking: Many employers lack visibility into whether GLP-1s actually reduce long-term claims.

The result is high upfront pharmacy spend with unclear long-term return. Employers must look beyond GLP-1 medication costs alone to see the full financial picture of their investment. By supporting GLP-1 medication prescriptions with structured movement plans, insurers and employers can expect a sizable boost in long term outcomes and returns.

Pharmacy spend is only the beginning of your GLP-1 cost center

Even with careful formulary controls, GLP-1 costs don’t stop at the prescription. The real price often shows up in the months and years that follow. Most of these costs never show up under a GLP-1 code and that’s why a more complete lens is needed to maximize return on investment.

Raw claims data often doesn’t reveal the muscle loss, MSK risk, and productivity losses that can come from GLP-1 patients as a result of Sarcopenia, or lean muscle loss.

Clinical studies show that up to 39% of weight lost during GLP-1 use is lean muscle mass⁵. This is not just a cosmetic concern. Muscle plays a central role in protecting members from costly conditions:

• It drives metabolism and glucose control⁶
• It protects joints and reduces MSK stress⁷
• It supports balance, mobility, and independence⁸

When muscle is lost, members become weaker, less stable, and more vulnerable to MSK issues. This cascades into real costs for employers. Research links sarcopenia to:

• 33% of chronic pain cases in older adults⁹
• 60% higher risk of falls¹⁰
• 2.5x greater disability risk in people with sarcopenic obesity¹¹

These outcomes lead to rising MSK claims, rehab referrals, disability filings, and ultimately higher healthcare spend.

Inactivity increases MSK risk for GLP-1 users

The problem is not just that GLP-1s can drive muscle loss, but that most users start treatment from a deconditioned baseline.

According to the CDC, fewer than 1 in 4 U.S. adults meet physical activity guidelines¹². This means the majority of GLP-1 users already lack the strength and activity habits needed to preserve muscle.

Sword Move’s member base reflects this reality:

• 77% are overweight or obese¹³
• 64% have addressable conditions like diabetes or high cholesterol¹³
• 55% report difficulty with basic physical activity¹³

These are the members most at risk of MSK costs if muscle is not protected during treatment. Employers who passively cover GLP-1s without activity support risk higher downstream claims and avoidable disability.

Why movement is the multiplier for GLP-1 success

GLP-1s suppress appetite, but they do not build muscle, improve function, or create lasting habits. Structured movement fills this gap.

Clinically guided movement programs have been shown to:

• Preserve lean muscle mass during weight loss⁵
• Reduce MSK pain and fall risk⁹ ¹⁰
• Lower re-prescription rates⁴
• Improve adherence and long-term behavior change¹⁴

In Sword Move outcomes data, members who began as inactive showed measurable improvements:

• 69% reached “active” or “healthy active” status within 10 weeks¹⁴
• Average of 4.5 guided movement sessions per week¹⁵
• Sedentary time reduced by 1 hour 22 minutes per day¹⁶
• 91% reported feeling moderately or much better¹⁷

These results don’t just protect health. They reduce downstream claims, improve engagement, and preserve employer investment in GLP-1 coverage.

How Sword Move is lowering total cost of care for GLP-1 users

Sword Move is a digital, physical therapist-supervised solution designed to counteract the muscle loss and mobility decline that can accompany GLP-1 therapy. The program combines clinically validated movement plans with wearable sensors, AI-powered feedback, and continuous clinical support.

Sword Move supports safe GLP-1 weight loss

Move mitigates the MSK risks of GLP-1 treatment and drives long-term behavior change. That means more effective health outcomes and more effective healthcare spend.  

Move is Sword’s digital movement program designed to make protecting muscle simple and accessible. The revolutionary digital delivery model means Move members can complete their exercises from the comfort of home at any time to suit their lifestyle. All they need is the Move app and their complementary Move wearable device.

Each Move member receives:

• A personalized strength-building movement plan developed by their matched Physical Health Specialist that carries a Doctor in Physical Therapy (DPT)
• Real-time guidance is given via the Move wearable (or the patient's own Apple Watch or Fitbit), and the Move app
• The member’s DPT checks on progress, provides ongoing support, and makes program adjustments based on the individual’s needs

Clients receive regular reporting on functional improvement, adherence, and member-reported outcomes. 

Move mitigates the MSK risks of GLP-1 treatment and drives long-term behavior change. That means more effective health outcomes and more effective healthcare spend.  

Use Move as the ROI multiplier for your GLP-1 benefits strategy

GLP-1s are effective at helping members lose weight, but they are not a standalone solution. Employers who cover GLP-1s without integrated movement strategies risk higher MSK claims, repeated prescribing, and rising disability costs.

The smarter strategy is prevention-first. Pairing GLP-1 treatment with Sword Move ensures members preserve lean muscle, build sustainable activity habits, and avoid costly MSK outcomes. This approach lowers total spend while protecting long-term health.