A recent analysis details how industry payments to physicians influence GLP-1 prescribing. Learn how patients can navigate options and financial disclosures.
On September 9, 2026, The Washington Post published an analysis of Centers for Medicare and Medicaid Services Open Payments data. The investigation examined general payments to licensed prescribers for meals, travel, consulting and speaking fees. Between 2018 and 2025, Eli Lilly and Novo Nordisk made at least one payment to more than a quarter-million individual doctors and other prescribers. Drugmakers spent more than $270 million on promotional activity linked to the GLP-1 medicines examined during that period.
The financial stakes surrounding these medications are massive. In 2025 consumer and insurer spending exceeded $63 billion for Eli Lilly’s Mounjaro and Zepbound, excluding rebates and discounts. Spending also topped $59 billion for Novo Nordisk’s Ozempic and Wegovy. In that same year, industry payments reached 140,000 individual prescribers, marking the highest annual total in the analysis.
These promotional efforts coincide with rapid mainstream adoption. Nearly one in five United States adults told KFF survey researchers that they had taken one of the drugs for diabetes or weight loss. Prescribing has now expanded well beyond specialist diabetes practices. Internal medicine and cardiology practices are writing prescriptions at high rates to manage obesity and metabolic health.
The investigated medications include products from both major manufacturers. The analysis covered Mounjaro and Zepbound from Eli Lilly alongside Ozempic, Wegovy and Rybelsus from Novo Nordisk. The data also included older GLP-1 medicines like Trulicity and Saxenda. Prescriptions for Soliqua, Bydureon and Byetta were analyzed as well.
Centers for Medicare and Medicaid Services regulations require reporting entities to submit information about payments made to covered recipients. This transparency program also covers certain ownership or investment interests held by physicians or their immediate family members. The reported payments included direct financial transfers as well as in-kind benefits such as food and beverages. Physicians were paid to speak at conferences, meet doctors privately and visit primary-care offices.
They were tasked with explaining clinical trial results and addressing reluctance among prescribers unfamiliar with obesity treatment. The reporting described meetings involving meals at restaurants and takeout food served in medical offices. The competition between Eli Lilly and Novo Nordisk may be increasing the number of promotional meetings. However, physicians interviewed in the investigation said this competition is also encouraging innovation.
They noted that market competition helps lower prices and improves clinical outcomes over time. Transparency remains a central focus, as the Open Payments program is specifically designed to make these financial transfers publicly reportable.
The biological mechanism of GLP-1 medications involves appetite reduction and improved metabolic control. These drugs are approved for diabetes and obesity-related weight management. The recent reporting also notes approved uses involving cardiovascular risk reduction and sleep apnea. However, medication may reduce appetite without automatically building eating skills, preserving muscle or improving sleep.
This metabolic reality means that sustainable weight management requires more than just a prescription. A biological reduction in hunger does not address the environmental or behavioral factors driving daily habits. For this reason, professional guidance emphasizes comprehensive support. A 2025 joint advisory from four obesity, nutrition and lifestyle medicine organizations recommended accompanying GLP-1 therapy with nutrition and lifestyle care.
The medicines are intended to be used with a reduced-calorie diet and increased physical activity. Medication alone cannot manage the emotional and environmental drivers of eating behavior. Incorporating behavioral support helps patients navigate changing grocery habits effectively. Eli Lilly stated that its medical education interactions provide health professionals with current information.
The company noted these are conducted under compliance standards, legal requirements and disclosure rules. Novo Nordisk similarly stated that responsible collaboration between industry and the medical community advances care. Obesity physicians argue that many clinicians historically received limited training in obesity treatment during medical school. Drugmakers hire prominent physicians to explain the science, review clinical trial results and address prescriber reluctance.
Industry-supported professional discussions can provide useful clinical information to doctors. However, they also raise questions about whether recommendations are driven by independent scientific review or commercial promotion. Harvard professor Aaron Kesselheim noted that these educational sessions can easily become marketing. The core challenge for patients is understanding how these educational efforts influence their clinical care.
In our experience at WeightRestart, this tension between science and sensationalism is a familiar problem. "When the new class of weight-loss medications started dominating the news, the media reaction was entirely polarized," our team noted. "It was either a miracle cure or a moral failing. I saw a huge need for calm, objective reporting."
"We decided to cover these medications exactly like any other tool by exploring the clinical data, the benefits and the limitations without any judgment. The response from our readers showed just how starved people were for facts over feelings." Mainstream coverage of this investigative report often frames the data as proof of unethical behavior. The reality is far more nuanced.
The Open Payments data shows that payments occurred, but it does not automatically prove that a payment caused a physician to prescribe a GLP-1 medicine. The reported figures aggregate meals, travel and consulting fees over several years. A large aggregate total should not be interpreted as direct payment for individual prescriptions. Still, financial conflicts can make clinical decisions complicated for patients.
Meredith Rosenthal, a Harvard health economics and policy professor, noted that financial relationships make evaluating evidence difficult. She explained that it becomes hard for patients to know if a recommendation reflects the best evidence or commercial influence. Some doctors received substantial compensation for their consulting work. Robert Busch received approximately $1.2 million between 2018 and 2025, which was the largest amount in the review.
Carlos Campos received nearly $1 million over approximately seven years. Michael Kaplan received about $648,000, and Ethan Lazarus received about $585,000. These physicians offered a different interpretation of their industry relationships. Campos stated that drugmakers hire him to explain the science.
Lazarus emphasized that legitimate consulting is appropriate when a physician provides objective scientific services. Bruce Rowe, a Wisconsin physician who attended a Wegovy presentation, said the clinical data was encouraging. He warned doctors to remain skeptical when a drug company finances the presentation. He also described GLP-1 medication as an important tool rather than a complete treatment strategy.
Clinical observations highlight several challenges for patients managing weight with these medications. The investigation documented substantial evidence of clinical benefit, including weight loss and improved glucose control. However, unresolved questions remain about long-term use and real-world adherence. The reporting cited research showing that real-world adherence for GLP-1 medicines used for weight loss has been 60% or less.
Patients commonly regain weight after discontinuing treatment. Because of this physiological response, some clinicians view these medicines as long-term or potentially lifelong therapies. Weight change is never just a matter of willpower. It is deeply connected to biological signals, environmental cues and medical treatments.
Medical professionals continue to advocate for integrated, multidisciplinary care. David Ludwig, a Harvard endocrinologist, cautioned against allowing medication to become the only tool considered in obesity care. He has sought funding to study whether a low-sugar and low-carbohydrate diet used alongside GLP-1 treatment could improve cardiometabolic outcomes. A 2026 international statement similarly called for integrated care and stated that physical activity should be individually prescribed.
Patient-specific risks also require careful clinical observation. The recent analysis raised concerns about prescribing these medications to people with eating disorders. Older adults may also be vulnerable to falls, fractures or excessive muscle loss during rapid weight reduction. Maintaining lean mass through strength training is a critical component of understanding the long-term changes after starting treatment.
Federal spending is expected to increase after Medicare began covering the medicines for weight loss in July 2026. Private health plans are already facing rising costs associated with GLP-1 coverage. Some employers have even begun eliminating coverage for weight-loss use due to the financial strain. As commercial pressure mounts, patients must remain vigilant about their treatment plans.
Future research is needed to determine the best protocols for ending treatment without significant weight regain. More data on the challenges of post-treatment maintenance will help refine how doctors prescribe these drugs. Until then, adults considering these therapies should ask their prescribers about non-drug options. They should also ask how financial relationships with manufacturers are disclosed.
The medical community must continue to study the intersection of lifestyle interventions and pharmacological support. Responsible collaboration between industry and doctors can benefit patients by advancing science. However, patients must ensure their care plan accounts for nutrition, muscle preservation and individual risk factors. True metabolic health requires viewing medication as part of a larger plan that includes a consistent strategy for sustainable habits.
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