Abstract
OBJECTIVE: GLP-1 receptor agonist (GLP-1 RA) coverage decisions for obesity have major health and economic implications. This study examined how loss of GLP-1 coverage affected employee perceptions of their employer and workforce stability. METHODS: This study analyzed data from employees of a healthcare system that discontinued GLP-1 obesity medication coverage. Outcomes were evaluated using chi-square/Fisher's exact tests and multivariable logistic regression. RESULTS: Two hundred forty-seven adults prescribed GLP-1 for obesity who lost coverage (mean age 49.27 years-SD: 9.89, BMI 32.85 kg/m(2)-SD: 8.49); 90.28% were female, 40.08% non-Hispanic White, 30.36% non-Hispanic Black, 19.84% Hispanic, and 9.72% Other. Following loss, 80.57% reported worsened employer perceptions, 17.81% considered changing jobs, 49.39% felt devalued, and 64.38% believed their employer didn't value their health. Burnout was common (88.67% past year; 65.19% past month). NHB and Hispanic employees were less likely than NHW to report worsened employer relationships (aOR = 0.29 and 0.34), while those with incomes ≥ $150,000 were 2.5x as likely to report negative impact (aOR = 2.57). CONCLUSION: Loss of GLP-1 coverage was linked to reduced employee satisfaction, increased burnout, and greater turnover risk. Lower reported impact among NHB and Hispanic employees may reflect disparities in perceived job mobility. These consequences may undermine workforce stability and offset cost savings that motivate coverage restrictions.