By Maggie Kingsbury, BSN, RN, CEN
As a registered nurse serving patients in Northern California, I see the devastating impact of obesity-related illnesses on a daily basis. The physical and emotional toll these conditions take on individuals and their families is profound—but what’s often overlooked is the significant burden they place on our healthcare system and economy.
In Napa County, over 50% of adults are classified as overweight or obese, according to the California Health Interview Survey. This statistic mirrors a broader statewide trend that has only worsened since the COVID-19 pandemic.
Obesity is not just a personal health issue—it is a public health crisis that contributes to chronic diseases such as type 2 diabetes, hypertension, heart disease, and musculoskeletal disorders. These conditions are not only debilitating, but they are also among the most expensive to treat.
Luckily, millions of Californians have access to treatment for obesity. Under the state’s Medi-Cal Rx program, Medi-Cal recipients currently have coverage for FDA-approved anti-obesity medications. But as the Legislature and Governor navigate a budget deficit, this coverage may be on the chopping block.
That, however, would be the wrong way to go about closing the deficit, and pull the rug out from many that are currently using and thriving on anti-obesity medications. Maintaining coverage under Medi-Cal Rx is essential to guaranteeing both the physical and fiscal health of California.
As healthcare professionals, we are trained to prioritize prevention. Covering these medications is a preventive strategy that reduces the need for costly interventions later—hospitalizations, emergency room visits, surgeries, and long-term care. A recent study from Aon showed that after two years of usage, individuals on the medications saw a more than 40% reduction in the risk of hospitalizations caused by serious cardiovascular events like heart attacks and strokes. That reduction alone is not only a significant improvement in health, but meaningful cost savings.
In clinical practice, I’ve seen patients who, with proper medical support including medication, are able to stabilize their health, avoid complications, and stay out of the hospital. This is particularly critical for low-income and working-class individuals in physically demanding sectors such as hospitality, agriculture, and caregiving—industries that are not only the backbone of Napa County’s economy, but that feature a significant number of individuals on the Medi-Cal rolls.
Many of these workers juggle long shifts, physically strenuous tasks, and irregular hours, making it incredibly difficult to prioritize diet, exercise, and consistent healthcare. These occupational pressures, combined with socioeconomic barriers, increase the risk of weight gain and related illnesses.
When these workers fall ill, the impact ripples far beyond their personal lives. Businesses face increased absenteeism, decreased productivity, and higher insurance costs. In 2022, obesity shrunk the economy by nearly $90 billion and reduced the workforce by 353,600. A workforce struggling with chronic disease is less resilient—and that has real consequences for our local and state economies.
Continuing to provide coverage for anti-obesity medications for Medi-Cal recipients is not only a public health imperative, but also a smart economic policy. Research from the Urban Institute and the CDC has consistently shown that every dollar spent on preventive healthcare saves multiple dollars in future treatment costs. A reduction in the state’s obesity rate by just five percent would save more than $30 billion in healthcare costs over 10 years.
This isn’t just about treating illness; it’s about protecting the health of our communities, preserving the viability of our workforce, and building a more sustainable healthcare system for all Californians. When we help workers stay healthy, they remain productive, able to support their families, and contribute meaningfully to the economy.
As a nurse, I am on the front lines of this issue every day. I see the lives that could be changed—and even saved—with continued access to effective obesity treatments. Preventive care must be at the heart of our health policy. We cannot afford to take a step backward.
I urge state policymakers to protect and maintain for anti-obesity medications for Medi-Cal recipients. It’s an investment in people, in prevention, and in the long-term well-being of California.
About the Author: Maggie Kingsbury, BSN, RN, CEN, is an experienced registered nurse with a strong clinical background in Northern California hospitals and clinical settings. In addition to her professional work, she is an active mother and dedicated community volunteer in Napa County.
