The rise of the popular obesity and diabetes drugs Wegovy and Ozempic have compelled weight-loss companies to fundamentally shift their business models.

WeightWatchers and Noom have for years promoted diet and exercise as the primary ways to lose weight, but both recently debuted plans to offer prescriptions for Wegovy and similar drugs as part of a strategy that recognizes obesity as a chronic disease.

WeightWatchers announced the change in March when it purchased Sequence, a telehealth company that offers prescriptions for obesity drugs. In the coming months, WeightWatchers said it would roll out a program for members taking the medications.

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The subscription app Noom, meanwhile, launched its own telemedicine platform last month, called Noom Med, which provides access to the drugs. Noom, founded in 2008, offers psychological tips to assist with weight loss and helps people track their eating and exercise habits.

The companies said their decisions to expand into prescription medications came in response to an evolving scientific understanding of obesity, as well as to requests from customers looking to incorporate medications into their weight-loss regimens.

"We have always followed the science, and as the medical community has transitioned into this concept of obesity as a disease, we would be remiss in not joining as well," said Dr. Linda Anegawa, Noom’s chief of medicine.

Dr. Gary Foster, chief scientific officer at WeightWatchers, similarly said that offering medication was a "natural next step" for the company.

"We know the science and success of GLP-1 use and consumer interest is strong. As science and consumers are evolving in this space, so are we to meet their needs," Foster said in an email. (GLP-1 refers to GLP-1 agonists, the term for the class of weight-loss drugs that includes Wegovy.)

Demand for Wegovy has soared since 2021, when the Food and Drug Administration approved it for weight loss in adults with obesity and those who are overweight and have at least one weight-related health condition, such as high blood pressure or high cholesterol. Wegovy's sister drug, Ozempic, relies on the same formula but at a lower dose and was approved for people with Type 2 diabetes in 2017.

Both drugs are brand names for semaglutide, a medication that can lower blood sugar and suppress appetite by mimicking a hormone that signals to the brain when a person is full. Semaglutide cut body weight by an average of 15% in trials.

In contrast, a 2018 study found that at best, diet, exercise and behavioral counseling help people lose an average of 5% to 10% of their body weight. 

"What these drugs have really shown us is that obesity is a metabolic biological problem. You can’t just overcome it with lifestyle interventions, for the most part," said Dr. Eduardo Grunvald, an obesity medicine physician at UC San Diego Health.

WeightWatchers and Noom are "sort of catching up with the science," Grunvald said. "But also it’s profit driven, obviously. That’s where the demand is."

Meanwhile, weight-loss companies that don’t integrate medication into their business models could struggle, according to Linda Bolton Weiser, an analyst at D.A. Davidson Companies, a wealth management firm. Jenny Craig, which sold a diet plan of prepackaged foods but never offered prescription drugs, closed its doors last month.

"For companies that cannot strategically figure out how to do the drug thing, and if you offer a food product, those companies may suffer," Weiser said. "That would be Medifast with their Optivia, that would be Jenny Craig, that would be Nutrisystem."

Weiser said that because FDA labels specify that people should use obesity medications in combination with diet and exercise, WeightWatchers and Noom can "check all the boxes for you."

Expanding access to weight-loss drugs

Dr. Fatima Cody Stanford, an associate professor of medicine at Massachusetts General Hospital, said that because obesity medicine doctors struggle to serve such a large number of patients, people with obesity could benefit from having access to prescription drugs through weight-loss companies.

"There’s such a high demand now for our services and not enough of us to go around," Stanford said.

She estimated that around 5,500 people are on the waiting list at her hospital center, and all of them have been deemed eligible for obesity medication.

Dr. Spencer Nadolsky, Sequence's medical director, said some people have difficulties obtaining the drugs because some general practitioners are not yet comfortable prescribing them.

Kailey Wood, 36, of Buffalo, New York, said she struggled to talk to her primary care doctor about weight loss, so she turned to Sequence.

"I would get nervous. I would rehearse what to say and ultimately I would get shut down and feel helpless," Wood said.

Through Sequence, Wood was prescribed Mounjaro, a drug approved to treat Type 2 diabetes that doctors can prescribe off-label for obesity. She lost 65 pounds, she said.

"Taking these weight-loss medications has validated what I knew: that my body was working against me, and that I wasn’t broken," Wood said in an email.

Stanford noted, though, that Wegovy is in short supply. People typically start with a low dose, then ramp up, but the FDA has reported limited availability of the three lowest doses of Wegovy.

"Starting someone new on the medication is challenging at best right now," Stanford said.

Grunvald said he also worries that for-profit companies might over-prescribe the medications down the line.

"That’s where the potential for inappropriate prescribing comes in, when you’re motivated by volume," he said.

But Noom Med and Sequence both pushed back against that idea.

"We're not writing rogue prescriptions for people with a BMI of 23 who are trying to fit into a size 8 swimsuit," Anegawa said.

Are subscription services worth the cost?

Sequence and Noom Med said they'll offer prescriptions in accordance with FDA criteria: a body mass index, or BMI, of 30 and above, or a BMI of 27 and above in combination with other weight-related health conditions. However, Anegawa said Noom Med clinicians can prescribe medications off-label according to guidance from groups like the Obesity Medicine Association.

Clinicians must be board certified to work at Sequence, while Noom Med employs board-certified physicians and physician-supervised nurse practitioners with experience in obesity care.

The programs are generally similar.

Sequence customers fill out an intake quiz to determine their eligibility. From there, they can book a consultation to discuss their medical history and get started on the drugs. Clinicians monitor side effects and weight-loss results, and customers have simultaneous access to fitness coaches and dietitians..

With Noom Med, customers get bloodwork done before their first appointment, then a clinician evaluates their health and weight history. If the person is offered medication, they can message the clinician through an app to report side effects, and the doctor can adjust their dosage accordingly.

Obesity drugs are generally meant to be lifelong medications; data consistently show that people who stop taking semaglutide regain most of the weight.

One drawback of the WeightWatchers and Noom programs, Grunvald said, is their cost.

Noom Med is priced at $49 a month on top of the standard Noom subscription, which starts at about $42 per month for four months, then moves to about $70 to $209 per month, depending on the plan. A Sequence subscription costs $99 per month. With both programs, people have to pay separately for the medications, which carry price tags of more than $1,000 a month without insurance.

Given that weight-loss medications on their own often encourage healthier habits, Grunvald said it's possible that some customers won't have much use for the other components of these programs.