Weight loss drugs are changing lives on Long island — but at a crushing cost for some

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For years, Patricia Williamson struggled with weight loss.

“I’d been on and off WeightWatchers for 30 years,” the 75-year-old Setauket resident said. “I lost weight on WeightWatchers but I could never maintain it.” 

Williamson’s weight loss journey took a positive turn in October 2018, when a friend recommended the Long Island Weight Loss Institute, a private medical practice in Port Jefferson Station. There, Williamson was prescribed her first GLP-1 injectable, Saxenda.

Six-and-a-half years later, Williamson has shed 80 pounds and moves more easily despite struggling with arthritis.

“Other than how I look, I just feel so much better,” said Williamson, a retired probation officer who splits her time between Long Island and Florida. “I can go down to the beach with my chair and umbrella so much easier.”

GLP-1 agonists, commonly referred to as GLP-1s, are medicines that help regulate blood sugar levels, reduce appetite and encourage increased feelings of fullness after eating by slowing down digestion. The drugs were originally prescribed to treat diabetes but have been proven to be highly effective for weight loss. Nearly 4 in 10 people surveyed in a May 2024 poll by nonprofit health policy research organization KFF said they’ve taken a GLP-1 solely for weight loss.

Some once-a-week injectables have even been approved specifically for weight loss by the Food and Drug Administration. They’ve had such a strong impact on the weight management industry that services like WeightWatchers have pivoted to focus on GLP-1 use.

Long Island residents interviewed by Newsday said they’ve had success with GLP-1s. They also shared a common sentiment: the injectables are just one tool in a longer journey to look and feel better. Still, despite their effectiveness and market success, patients can have a difficult — or impossible — time getting insurance providers to cover prescriptions, often paying out-of-pocket or turning to telehealth services.

Concerns also persist about long-term side effects, with a recent lawsuit filed by Long Island residents contending that semaglutide and tirzepatide — the active ingredients in these drugs — cause vision loss. Proved side effects include constipation and nausea. But there’s currently no scientific evidence linking the drug to blindness, said nurse practitioner Angela Godwin Beoku-Betts. 

“Semaglutides have been around since 2014,” said Beoku-Betts, also a clinical assistant professor at NYU Rory Meyers College of Nursing. “That’s over a decade. I think that’s sufficient to see long-term side effects.”

Despite the questions swirling around the drugs, as well as their lack of affordability for many patients, GLP-1s have taken the weight management industry to major heights.

Weight management evolves

Williamson recalled her 30 years on WeightWatchers with both fondness and exasperation.

“I lost 60 pounds altogether on WeightWatchers, she said.

But she also had to wrestle with cravings, or “the noise in your head,” while trying to follow the program.

“That’s what the injection does, it stops the noise,” she said about modern weight loss drugs.

The weight management industry reached a major inflection point in 2022, when millions began taking GLP-1s instead of using traditional weight loss programs, said John LaRosa, owner of market research company Marketdata LLC.

Before the FDA’s 2021 approval of weight loss injectables, the industry focused on programs like Jenny Craig and WeightWatchers. Jenny Craig filed for bankruptcy in 2023; WeightWatchers followed suit last month, announcing plans to pivot to GLP-1s after reorganization.

“Jenny Craig closed 650 U.S. centers,” said LaRosa. “They found they couldn’t compete anymore with the new weight loss medications.”

Weight loss drugs aren’t new, he added. Phentermine, an oral drug, has been FDA-approved since 1959 but is less effective than GLP-1s.

When Novo Nordisk and Eli Lilly began developing semaglutide and tirzepatide for obesity, Morningstar analyst Karen Anderson was skeptical.

“There had been so many failures, it was hard to take seriously as a real revenue-generating opportunity,” Anderson said.

However, Anderson’s research shows sales have doubled annually for GLP-1s as obesity drugs, reaching $11.77 billion in 2024, up from $4.11 billion in 2023.

“We’ve had a couple years of sales more than doubling, and this year looks like it’s going to be close to doubling, as well,” she said.

Compounded problems

To qualify for GLP-1 weight loss treatment, patients need a Body Mass Index of 27 if they have a comorbidity — one or more medical conditions that co-exist alongside a primary diagnosis and can worsen people’s health, like hypertension or diabetes — or a BMI of 30 without one. Yet most insurance plans won’t cover the drugs for weight loss. A 2022 FDA-declared shortage led to the rise of compounded GLP-1s — pharmacy-made versions not FDA-approved but allowed temporarily.

Bunnii Buglione, 35, of Aquebogue, turned to telehealth provider Ro in December 2024 when her insurance declined coverage. She pays $69 monthly for membership and $259 for four weeks of compounded medication. She’s lost 56 pounds, she said.  

While Buglione said she’s frustrated by how much Ro costs, it’s far less than the $1,500 a month she would have spent at her pharmacy for FDA-approved versions. Buglione had questions about Ro’s legitimacy, so she asked her doctor and family members who work in health care, and they advised her that Ro was a reputable business. 

“I filled out a form when I signed up, but I never actually talked to anyone at Ro,” Buglione said.

Ro said in a statement to Newsday that “patients start their experience with Ro by completing a comprehensive online visit detailing their health history and goals” and may speak to doctors upon request.

Dr. Eileen Barr, an obesity specialist who runs Setauket Medical, said most of her patients use GLP-1s, and that she has prescribed compounded versions due to high prices.

But the FDA ended the shortage designation on the compounded drugs in 2025, and the medicines became unavailable after May 22, leaving only more expensive FDA-approved options.

“Unfortunately, this treatment isn’t as accessible as I’d like,” Barr said. Some patients, she added, may now turn to bariatric surgery.

Brooke Nelson, 46, of Southold, found herself struggling to lose weight after undergoing treatment for breast cancer. Nelson’s treatment triggered early menopause, which caused the former dancer to gain weight and struggle to lose it.

“I do everything I can to not be overweight to reduce my risk of a breast cancer recurrence,” Nelson said. “I have tried everything.”

Nelson was unable to get a prescription covered by insurance after visiting her doctor. After multiple failed appeals to her insurance company, Nelson turned to Eli Lilly, which manufactures the FDA-approved Zepbound and sells direct-to-consumer. She said she pays $300 out of pocket for the drug monthly.

Buglione said she plans to research more affordable options. Now that the compounded drugs are off the table, Buglione said she is even considering getting her GLP-1s from a cousin in Thailand, where she said the drug is much cheaper.

Dr. Louis Aronne, an obesity specialist at Weill Cornell Medicine, urged caution with direct-to-consumer telehealth companies, noting many lack services like nutrition counseling, exercise guidance or side effect management. Aronne is the co-founder of FlyteHealth, a medically supervised weight loss program. 

Dr. Craig Primack, senior vice president of weight loss at telehealth provider Hims & Hers, said that prior to the FDA’s restrictions on compounded GLP-1s, the company offered them as a more affordable option for patients. Now, he said, they offer FDA-approved Wegovy. The company also recently announced it will acquire European telehealth platform ZAVA to facilitate its expansion into Europe.

‘There’s no magic switch to lose weight’

Primack, who’s treated obesity since 2006, emphasized that drugs should be considered as part of a larger weight loss “toolbox.”

Lyndsay Johnson, a patient at Stony Brook, said she has had success combining weight loss drugs with lifestyle changes. Johnson, 40, of East Setauket, said she wanted to lose weight so she could keep up with her two young sons and do more activities with them. She began GLP-1 treatment at Stony Brook’s Bariatric and Metabolic Weight Loss Center in November 2021 and said she has since lost between 150 and 175 pounds.

“I had tried pretty much everything, and I didn’t want to have surgery,” said Johnson.

It was at the center that she learned just how important a holistic approach is to losing weight.

She walks daily with a coworker, takes spin classes and plays soccer with her sons.

Dr. Michael Kaplan, the chief medical officer of the private medical practice Long Island Weight Loss Institute, said that lifestyle changes are part of all his patients’ treatment plans. He emphasized that people who use GLP-1s should include physical activity, dietary modifications and mental health support as part of their weight loss strategy.

“We all feel really strongly that medications as a tool are really helpful, but if you don’t provide [patients] with counseling and good medical care, you’re probably destined for failure,” Kaplan said.

GLP-1-induced weight loss often includes muscle loss, so exercise and healthy eating remain essential, according to Dr. Konstantinos Spaniolas, chief of the Division of Bariatric, Foregut and Advanced GI Surgery at Stony Brook Medicine.

“When someone looks at the effects of medications, that’s on top of lifestyle intervention,” said Spaniolas, who is also the director of the Stony Brook Bariatric and Metabolic Weight Loss Center. “There’s no magic switch to lose weight.”