strength and readiness.” DoD faced agency-wide recruitment shortfalls in 2022 and 2023. Because excess body weight is a common dis- qualification for recruitment and retention of military members, some researchers have suggested that the high prevalence of weight-ineligible young people has compro- mised national security by reducing recruitment. Obesity also places a substantial burden on the Military Health System (MHS), they said. Reports have found that the prevalence of obesity in U.S. military members increased slightly during the COVID-19 pandemic, but prevalence of obesity in the overall U.S. civilian adult population remained level,” the authors advised. On Aug. 31, 2025, the Defense Health Agency (DHA) began implementing revised prior authorization criteria for weight loss drugs. It announced that TRICARE no longer covers weight loss drugs for: • TRICARE For Life beneficiaries. That program acts as a secondary payer to Medicare, covering Medicare deductibles and cost-shares, typically resulting in no out-of-pocket costs for TRICARE- covered services. Coverage is automatic if the beneficiary has both Medicare Parts A and B • Beneficiaries who are only eligible for care at military hospitals and clinics, such as dependent parents and parents-in-law and even then, only on a space-available basis. • Beneficiaries with NATO status or Partnership for Peace Agreement, i.e., foreign force members. TRICARE will continue to cover weight loss drugs for beneficiaries enrolled in TRICARE Prime, TRICARE Prime Remote, TRICARE Prime Overseas, TRICARE NEW YORK—As obesity remains a significant threat to health worldwide, first-generation obesity medications continue to play an important role in clinical practice, according to a recent review article. The study published in Current Atherosclerosis Reports summarized the pharmacologic profiles, clinical trial evi- dence and practical considerations for the use of several first-generation obesity medications: phentermine, orlistat, phentermine/topiramate extended-release, bupropion/ naltrexone sustained-release and liraglutide 3. 0 mg. The researchers sought to understand the mechanisms, ben- efits and limitations of these medications to help clinicians deliver comprehensive and effective medical obesity treat- ment that addresses atherosclerosis and other cardiomet- abolic complications. 1 Obesity, a chronic disease that affects 1 in 8 people worldwide, is associated with over 200 complications that impact nearly every organ system. Studies show that long- term excess adiposity can lead to atherosclerotic cardio- vascular disease, but obesity remains greatly undertreated despite its high prevalence and clinical burden. For most people with obesity, lifestyle modification, the foundation of obesity management, is insufficient as a standalone intervention. While earlier guidelines required patients to try lifestyle modifications and fail to achieve certain results before starting medication, the 2025 ACC Expert Consensus Statement on Medical Weight Management for Optimization of Cardiovascular Health recommended initiating obesity pharmacotherapy along with lifestyle interventions, the researchers reported. Over the past 20 years, obesity treatment has evolved considerably. First approved by the U. S. Food and Drug Administration (FDA) between 1959 and 2014, first-gener- ation obesity medications were the foundation of pharma- cologic obesity management. These medications include monotherapies such as phentermine and orlistat, as well as combination thera- pies such as phentermine/ topiramate extended release and bupropion/naltrexone sustained release. Contrave, for example, is the only FDA-approved oral weight-loss medication combining extended-release naltrexone and bupropion. The weight-loss pill works in two ways to help reduce hunger and control cravings, according to the med- ication’s website. Liraglutide 3. 0 mg (FDA-approved as Saxenda), a glu- cagon-like peptide-1 (GLP-1) receptor agonist originally developed for Type 2 diabetes, was the first incretin-based therapy approved for obesity. These first-generation agents differ in mechanism of action, efficacy and side effect profile, each resulting in 5% or more total body weight loss in clinical trials. FDA approval requires this amount of weight loss, because it First-Generation Weight Loss Drugs Still Play A Vital Role in Patient Care at VA 8 8 by LaTina Emerson
View this content as a flipbook by clicking here.