Alise Certa had tried everything — niche diets, extreme exercise, starving herself — and yet, by the time she turned 50, she weighed nearly 300 pounds, the heaviest she had ever been. So, at the recommendation of her doctor, in fall 2022 the Essex Junction resident decided to give Wegovy a try.
The results were remarkable. The popular weight-loss drug, administered by a weekly injection covered by her employer-sponsored health insurance plan, significantly reduced her appetite. More importantly, it seemed to change her brain, subduing the incessant thoughts of food that had long plagued her mind.
Certa lost more than 81 pounds in her first year and a half on the medication and had to buy a new wardrobe. People began treating her differently. She felt different, too. She had more energy and less pain.
I could walk around and not be exhausted.
Alise Certa
I could walk fast.
A visit to New York City one weekend showed her just how far she’d come. “I could walk around and not be exhausted,” she said. “I could walk fast.”
Then, at the beginning of 2024, Certa learned that her employer’s health plan was only going to cover Wegovy and other GLP-1 weight-loss drugs for people over a certain body mass index.
Certa had already fallen below that threshold. Instead of a small co-pay, the injections she expected to take for the rest of her life would now cost her $900 to $1,200 a month out of pocket, far more than she could afford.
Vermont health insurers and private employers have been steadily scaling back coverage of the popular weight-loss drugs known as GLP-1s in an attempt to rein in costs. The drugs can be life-changing. But they’re also expensive, with some costing roughly $16,000 a year, and insurers say their exploding popularity has contributed to premium rate increases.
Since January 1, plans offered through Blue Cross Blue Shield of Vermont, the state’s largest insurer, and MVP Health Care have stopped covering GLP-1s for weight loss alone. The same goes for the plans that cover public school teachers. Private employers, meanwhile, have yanked coverage or erected new hurdles that make it more difficult to get a prescription covered.
That’s part of a national shift, and drugmakers are scrambling to respond. Some have rolled out direct-to-consumer programs that offer steep discounts to those who pay for their prescriptions themselves.
Lilly launched a self-pay option in 2024 featuring vials of Zepbound from which patients draw the drug using a syringe and then inject themselves. And last month, Novo Nordisk released a pill version of Wegovy that can be purchased directly from the manufacturer for just under $200 a month.
Despite the lower price, that’s quite a hike for people who previously paid $30 or less to fill a prescription.
“We’re driving an entire area of chronic disease into a self-pay system, which is only going to worsen inequities,” said Dr. Kimberley Sampson-Paine, an obstetrician-gynecologist at the Southwestern Vermont Medical Center in Bennington who specializes in weight management.
Certa managed to keep taking Wegovy thanks to her parents, who offered financial support after seeing how the drug benefited her. She has since switched to Zepbound and has been using the cheaper vials even though needles make her squeamish. (Her husband has been administering her weekly injections.)
“My goal is to stay on this forever,” said Certa, who’s now 55 and weighs 215 pounds.
Others have had no choice but to discontinue the drugs.
Jennifer Martin, 53, of Shelburne was prescribed Wegovy in summer 2024. She, too, had spent her entire adult life struggling with her weight, despite living a healthy and active lifestyle.
“We’re an ingredient household,” she said. “We don’t buy soda. We don’t buy juice. We drink whole milk, tea and water.”
With Wegovy, she felt sated for the first time in her life. “I would eat when I was hungry, but I wasn’t hungry all the time,” she said.
Then she switched jobs. When she went to a pharmacy to pick up her prescription, she found out she no longer had coverage for it — and that it would cost her $3,000.
She left the pharmacy without the medication and has since regained the 20 pounds she lost. She’s hoping to get back on the drug one day but isn’t sure when she’ll be able to afford it.
The class of drugs known as GLP-1s mimic a natural hormone called glucagon-like peptide-1 that can influence a range of metabolic factors. The drugs were originally developed and prescribed to control diabetes, as they proved to help reduce blood sugar without some of the main side effects of insulin, such as weight gain.
But experts soon realized that GLP-1s could actually reduce weight, and far better than other weight-loss drugs, by slowing digestion and helping people feel fuller. The drugs have also been found to reduce food cravings, providing a line of defense against the ultra-processed foods that experts say have contributered to the rising level of obesity in the U.S.
The U.S. Food and Drug Administration approved the first GLP-1 specifically for weight loss in 2014, and a slew of other options have since come to market, allowing them to reach a wider audience. Americans spent nearly $72 billion on the medications in 2023, a 500 percent increase compared to 2018. Roughly 12 percent of Americans are now using one of the drugs, according to recent national surveys.
Some patients report serious gastrointestinal side effects, such as diarrhea, constipation and nausea. But studies have shown that the drugs can be highly effective in helping people lose weight, particularly when paired with exercise and healthier eating.
“These medications make those lifestyles sustainable for the people whose biologies are fighting against them,” Sampson-Paine said. She estimated that she’s worked with nearly 100 patients who have had great success on GLP-1s, including some who have shed 200 pounds.
It is unclear exactly how many people currently use GLP-1s in Vermont, which ranks among the healthiest states in terms of obesity rates. Last fall, when Blue Cross Blue Shield of Vermont told Seven Days it was dropping coverage, it said nearly 3,500 members would be affected.
The company noted that Americans pay far more for the drugs than people in other countries and that patients often stop taking the medication within the first few months, before it can be effective.
“Half the money we spend on the GLP-1s is not going to anyone’s benefit,” Tom Weigel, the insurer’s vice president and chief medical officer, said in an interview last year. “That’s millions and millions of dollars.”
Patients who suddenly stop using GLP-1s often regain weight and can be at higher risk of diabetes and other ailments. Desperate, some who have lost coverage have turned to cheaper, pharmacy-made imitations of GLP-1s that have not been approved by the FDA. But those drugs, created through a process of mixing drug ingredients known as “compounding,” are becoming harder to find amid a federal crackdown on the pharmacies that produce them in bulk.
Sampson-Paine has seen dozens of patients in recent weeks who are distraught over the recent insurance changes. She recalled one woman who broke down because she had no idea how she’d be able to manage the new payments.
The woman said her lower-weight lifestyle was the only reason she was still alive.
“That’s how transformative it has been on her mental health,” Sampson-Paine said. ➆
The original print version of this article was headlined “Scaling Back | Patients are losing access to pricey weight-loss drugs as Vermont health insurers and employers drop coverage”
This article appears in February 18 • 2026.
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