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Should the state pay for free weight loss drugs?
Society could benefit greatly if those struggling most with obesity lose weight. But who should have these expensive medications paid for by the public? Last year, only 330 of nearly 200,000 people who use weight loss drugs in Norway got this support.
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Severe obesity costs society a lot of money.
It's not simply from healthcare costs, but also from sick leave, reduced productivity, or simply being unable to work.
In other words, severe obesity is not just a problem for the individual.
What does it cost?
But determining the cost of all of this is proving difficult for researchers.
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“There is a lot of uncertainty,” Christina Hansen Edwards said in a lecture for health economists at the University of Oslo.
She is a researcher at NTNU's Department of Public Health and Nursing, and is concerned about how obesity affects not only the individual, but society as a whole.
“So it's not just about health,” says Edwards. “Obesity-related health problems can also affect whether a person is able to work. Or whether they are less effective at work."
She also notes that results from different studies vary greatly.
Society affects obesity
At the same time, people with severe obesity are not simply a cost to society.
The relationship also goes in the other direction.
Society imposes substantial costs on people with obesity as well.
Modern Western society contributes greatly to some people struggling with obesity (BMI over 30) or severe obesity (BMI over 40).
Today, cheap and easily accessible calories are available almost everywhere.
It’s therefore no wonder then that many give in to temptation. A majority of the population struggles to maintain what is defined as a normal weight.
This has been the case for a long time, without society managing to address this major public health challenge.
Effective weight-loss drugs
But now we have something new: effective weight-loss medications.
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These drugs have the potential to help a very large number of people.
Even so, patients struggling with severe obesity don’t automatically receive weight-loss drugs almost free of charge through the Norwegian state reimbursement system.
On the contrary.
The vast majority of obese and severely obese people who are prescribed these drugs have to pay for them themselves. Their doctor prescribes them on a standard prescription rather than through the state-funded reimbursement scheme.
Weight-loss injections such as Wegovy and Saxenda are only paid for by the public sector in very special cases. In such situations, a medical specialist or a hospital has to submit the application.
In August 2025, the news publication Dagens Medisin reported that nearly nine out of ten people with severe obesity receive a rejection when applying for such support (link in Norwegian).
There may now be nearly 200,000 users of weight-loss drugs in Norway each year, according to figures from the Norwegian Institute of Public Health (NIPH). Other figures Science Norway has obtained from NIPH show that no more than 330 of these individuals had the medication paid for by the state in 2025.
A controversial Norwegian policy
Norway has decided that the possibility of increased workforce participation resulting from a medication should not influence whether the public sector helps pay for it.
This decision is controversial.
In some other countries, the state takes the possibility of increased workforce participation into account when deciding whether to fund an expensive medication.
“This means that politicians in Norway have decided that it should not matter whether providing Wegovy through the reimbursement scheme leads to more people being employed,” says health economist Christina Hansen Edwards.
Costs more than NOK 200 billion per year
The Norwegian consultancy firm Menon Economics has attempted to calculate the costs associated with overweight and obesity. They were commissioned by Novo Nordisk.
Here are three estimates from their report:
Norway's GDP would have been more than 2 per cent higher in the absence of overweight and obesity.
The total societal cost of overweight and obesity for Norway was NOK 238 billion (25.5 billion USD) in 2022. Of this, 36 billion (3.9 billion USD) was related to healthcare costs, 70 billion (7.5 billion USD) was related to lost production, and 132 billion (14.1 billion USD) represented estimated costs associated with individuals’ disease burden and lost years of life.
8 per cent of healthcare resource use can be linked to overweight and obesity.
Difficult to measure
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But Edwards is sceptical about whether it's really possible to arrive at figures as precise as those presented by Menon Economics.
“We know that there can be major consequences if many people with severe obesity are frequently on sick leave, perform less effectively at work, or leave the workforce altogether. Severe obesity also affects what kind of job a person can have. We see that this affects both the individual and the entire society,” she says.
But measuring these effects has proven to be very difficult.
“The numbers reported in different studies vary a lot,” she says.
"We need to know more"
There are many sources of uncertainty, Edwards explains. Some factors are difficult to measure because obesity has such complex causes and consequences.
In addition, the long-term effects of medications that patients will likely need to use for extended periods remain uncertain.
“That's why we need better models to understand the consequences of obesity,” says Edwards. “We need to know more about when, during the course of treatment, it may be most beneficial and fair for people with obesity to receive medications subsidised by the state.”
Government agency proposes helping more patients
The Norwegian Medical Products Agency (NOMA) recently conducted negotiations with Novo Nordisk on how much the price of Wegovy could be reduced when the Norwegian state acts as a major purchaser.
These negotiations are secret.
But NOMA believes it has now reduced the price sufficiently to recommend that the weight-loss medication be made available through the state reimbursement system to more patients with severe obesity than those who currently receive it (link in Norwegian).
This group is defined as people with a BMI above 35 who have at least two weight-related comorbidities.
This study of more than 17,600 patients over a period of five years clearly showed lower rates of illness, fewer hospital admissions, and generally significant health benefits among people with obesity who received weight-loss medication.
Would cost more than NOK 100 million annually
Even with a lower price for the state, the cost would likely exceed NOK 100 million (10.7 million USD) per year. More than 70,000 patients could become eligible, according to NOMA.
No political decision has yet been made.
But several sources indicate that the matter may be considered as part of the state budget for 2027 (link in Norwegian).
If politicians approve this expenditure next year, it could mean less money for other patients affected by cancer, mental health problems, and other conditions.
But it could also mean more people in the workforce.
And perhaps fewer patients with cancer or mental health problems resulting from severe obesity.
It is worth noting that the authorities in both Sweden and Denmark have so far shown the same reluctance to pay for weight-loss drugs as Norway.
References:
Brækhus, L.N. Nær 9 av 10 søknader om Wegovy på blå resept får avslag. Fagfolk klør seg i hodet (Nearly 9 out of 10 applications for Wegovy on a blue prescription are rejected. Professionals are scratching their heads), Dagens Medisin, 2025.
Edwards et al. Helsetjenestekostnader ved overvekt og fedme på individnivå versus populasjonsnivå – en HUNT-studie (Health service costs of overweight and obesity at the individual level versus population level – a HUNT study), Journal of the Norwegian Medical Association, 2023. DOI: 10.4045/tidsskr.22.0726
Menon Economics: Samfunnskostnader knyttet til overvekt og fedme (Social costs associated with obesity and obesity), report commissioned by Novo Nordisk, 2023.
Norwegian Institute of Public Health statistics: Legemidler for vektreduksjon (Weight-loss drugs), 2026.
Ryan et al. Long-term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial, Nature Medicine, 2024. DOI: 10.1038/s41591-024-02996-7
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Translated by Nancy Bazilchuk
Read the Norwegian version of this article on forskning.no
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