Teamwork makes the weight-loss dream work

Dr. Michelle Gourdine, SVP, Chief Medical Officer, CVS Caremark, highlights how members can achieve their weight-loss goals and adopt a healthy lifestyle with the CVS Weight Management program.

• 31% percent of adults in the U.S. are overweight and more than 40% are obese, which increases stress on the heart and joints, leading to heart disease, stroke, arthritis and additional health issues, Dr. Gourdine says.

• Obesity is a chronic medical condition that requires care, and there are a variety of types of support, including nutrition, physical activity, behavior modification and medical interventions.

• The CVS Weight Management program takes a team-based approach and empowers CVS Caremark members to develop sustainable habits to achieve long-term weight loss. The data is remarkable, Dr. Gourdine says. For instance, GLP-1 users experienced an average weight loss of 16% after one year in the program.

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Matt McGuire

A lifelong writer, editor and content strategist. Senior Manager, Enterprise Communications, CVS Health

What is Big Questions Answered?

Big Questions Answered helps us understand important CVS Health initiatives by taking a closer look at new products, powerful innovations and the big changes the company is making to achieve its strategic imperatives and build a world of health around every consumer. The company's senior leaders answer big questions from host Matt McGuire.

Matt McGuire
Roughly 75% of adults in the U.S. are considered overweight, and there's a stigma as well as health risks that come with it. Some people address this on their own by counting calories and exercising. Others need help as they adjust their diet or address issues like emotional eating.

On today's episode, we'll discuss how a team-based approach helps people meet their individual weight-loss goals, the buzz surrounding GLP-1 weight-loss medications and ways for people to sustain a healthy weight.

Welcome to Big Questions Answered, a podcast that helps us understand the important initiatives at CVS Health. I’m Matt McGuire from the Enterprise Communications team. I’ll be your host as we take a closer look at new products, powerful innovations and the big changes we’re making to achieve our strategic imperatives and build a world of health around every consumer. Thanks for joining me today as we get our big questions answered.

I'm here today with Dr. Michelle Gourdine, Senior Vice President and Chief Medical Officer at CVS Caremark. In her role with the company, Dr. Gourdine ensures the quality and safety of our services, and that our work is based on a continuous evaluation of scientific evidence. Dr. Gourdine is also a clinical assistant professor in the departments of epidemiology and preventive medicine and pediatrics at the University of Maryland School of Medicine, and she is senior associate faculty at the Johns Hopkins Bloomberg School of Public Health.

Dr. Gourdine, thank you for joining me today.

Dr. Michelle Gourdine
Matt, it's a pleasure. Look forward to the conversation.

Matt McGuire
So, Dr. Gourdine, there's been a lot of conversations lately, really good conversations about body image and how people can be healthy at every size. They point out that there's a stigma and bias that comes with being overweight, which I believe we need to acknowledge. But it's also important to recognize the health risks that come with being overweight. Could you talk about those health risks and how they relate to personal wellness?

Dr. Michelle Gourdine
Yeah, Matt, you have some important points, and I want to start with a conversation about stigma and bias because it's real — especially in society, when we're talking about weight. And what we know, directly from people who live with obesity, is that they often have to deal with judgment and blame. People think that they have they have a lack of will power, that they don't have self-discipline. And honestly, I believe that this stigma and bias is really driven by, sort of, a lack of acknowledgment of the complexities of obesity. It's a very complex condition.

The other thing I want to sort of point out is that at any rate, how we see and how we talk about our bodies matters. And not only for people of every weight, but it certainly can help or hurt the way that obesity is understood and managed. You know, again, circling back to the stigma and bias points, these judgments that people feel can often result in people being less likely to seek help. That's how I sort of think about all of this. And I think it's an important way for us to frame what we're talking about here today relative to obesity. So, let me just land on that for a second as well, because I think it's important for us to really define what we're talking about when we talk about obesity.

Obesity is defined simply as excess body fat. It is not a choice. It is a chronic medical disease that requires care. And having obesity and living with obesity can cause a lot of very serious problems that impact a person's life in the long term. And just by way of example, it puts extra stress on the heart, which increases the risk of heart disease and stroke. Extra body fat puts extra stress on joints, it increases the risk of arthritis and other joint issues. It contributes to high blood pressure and unhealthy cholesterol and diabetes. So, we really need to think about obesity as a serious medical problem, Matt.

Matt McGuire
Yeah. So, thanks for defining obesity and the stigma, bias points, and challenges that accompany it. So, a recent study tells us that 31% of adults in the US are overweight and more than 40% are obese. And these stats are staggering. I'm curious, what are your thoughts on how to support people who need help reducing weight and meeting their health goals.

Dr. Michelle Gourdine
Yeah, those statistics are really sort of difficult to wrap your head around when we’re talking about the sheer magnitude of adults who are overweight and obese. If you combine the two, we're talking close to 75% of the population is who is at risk based on excess body fat. And here's the other thing that I have to say as well. I'm a pediatrician by training, and the other thing that's really distressing is that when you look at children and adolescents, 20% are living with obesity. And so that's astounding because when you think about what their life and their health and well-being are going to be without appropriate treatment, you know, we can already imagine the issues related to diabetes and to heart disease and the other conditions that I talked about being a part of their lives as they mature into adulthood. And so that's why it's really important for us to address this issue.

What typically happens with an individual is that a conversation is initiated between that person and their primary care provider about the need to lose weight. And it really is related to decreasing the risk of developing other diseases. And, so, I think that, you know, it's important for us to really recognize again that obesity is a medical condition, that it impacts adults and children, and people absolutely need support in helping to reduce their weight, and meeting their health goals.

Matt McGuire
So, when it comes to helping people achieve and sustain a healthy weight, what have we seen that works?

Dr. Michelle Gourdine
So again, I can't emphasize this enough, because this really contributes to removing some of the blame and judgment from people who are struggling with their weight. Many, many people — probably most — need help losing weight. So how do we support them? That comes in a number of ways. There are some people — obviously, we all probably know individuals who have counted calories, who have undertaken a rigorous exercise program and have been quite successful in losing weight that way. But that's not true for everyone.

There are other people who need additional support. And what we know about obesity is that oftentimes that additional support is driven by, you know, neurological and metabolic factors that are unique to each person. So, what I'm not talking about here? I'm talking about factors that control your appetite — let you know when you're feeling full, that control your stomach emptying, that control the secretion of insulin, which has to do with your blood sugar.

So, you know, the way we think about supporting people and achieving and sustaining a healthy weight, i like to think of four things. Yes, nutrition is very important. You know, how do you choose the right foods to stay healthy? The knowledge around that is not intuitive. We don't necessarily always know as just regular individuals what are the right foods to eat? What are the wrong foods to eat? There are some people who have more knowledge about that than others. But help and helping people choose the right foods to stay healthy or to help the body heal or to improve the medical condition is really important because the fact is that what we eat directly affects how we feel and how our body works. So that's one thing.

Secondly, physical activity. Obviously, that's a no-brainer. Exercise has so much beneficial impact on weight loss, on maintaining a healthy weight, on reducing stress, on when you're older maintaining your ability to be strong and reduce your risk of falls. The list goes on and on in terms of physical activity. But there are a couple more areas of support that I think are important to highlight.

The third one I want to talk about is what we call behavior modification. So, what does that mean? Actually, what that is intended to do is to help individuals to better understand what triggers and coping mechanisms drive our eating, drive our motivation for physical activity, and so forth. People have heard of the term emotional eating. I will confess that, you know, if left to my own devices, I certainly am. If I get stressed. I crave sugar and salt. And those are not very healthy things to crave. And so what you need to do is to recognize that, “Oh, these are triggers that I have that drive and unhealthy habits in terms of my eating and my exercise,” and figure out ways to identify alternative coping mechanisms that are healthier for you. So, that's what that behavior modification piece does, and it's a really, really important part of supporting people in their weight-loss journey.

And then finally, medical interventions. And they fall into a couple of categories — medications and surgery. Let's not forget about bariatric surgery. That is still a very valuable and useful mechanism for people who want to lose weight. However, there obviously are considerations that come into play relative to which one of those avenues is chosen. But the important and exciting thing about that is that there are medical intervention options for people to help them. Finally, a team-based approach to supporting people to meeting their individual weight-loss goals is really, really important.

Matt McGuire
Yeah. So, Dr. Gourdine, I have to confess, I'm certainly familiar with emotional eating. When I get a little stressed at work, a bowl of salty potato chips sometimes appears on my desk.

Dr. Michelle Gourdine
Ha, yeah, me, too, Matt.

Matt McGuire
Yeah. So, there's been. A lot of buzz recently about different weight management drugs and, I'm curious, how do these factor into the team-based approach to support people that you just talked about?

Dr. Michelle Gourdine
The main class of drugs that we are really buzzy about are what we call the GLP-1s. So, the Ozempics or Wegovys, and then GLP-GIP drugs, Zepbound and Mounjaro. Those are probably the most popular. Those are the ones we talk about most. It's important to note that certain versions of these GLP ones have been around for 20 years. They started out as diabetes drugs and as time went on there were observations that these drugs also drove weight loss. And, so, additional research was done and investigation to determine how these drugs work on reducing weight or managing weight and how well they work. And, so, fast forward, now we have a number of anti-obesity medications. These medications really join an arsenal of anti-obesity medications that have been on the market for decades.

What's different about these drugs compared to the earlier generations of anti-obesity medications is that these drugs have gotten safer and better at doing their jobs. When we think about GLP-1s, the early generation of these drugs — drugs like Liraglutide, the brand name is Saxenda — they reduced weight about 5 to 8%, which was roughly the same as the maximum sort of effect that we generally saw for people who are adopting healthy lifestyle choices, like nutrition and physical activity for those people for whom those activities worked. The new generation of drugs that I listed earlier — the Wegovys, the Ozempics, the Zepbounds, the Mounjaros — are highly, highly effective medications. We’re seeing upwards of 15 to 20% reduction in body weight. And what's more, people are actually feeling better because the other health conditions that we talked about earlier are improving.

This weight loss, this magnitude, is really comparable to bariatric surgery. So, you can imagine that, it's no surprise that, many people are opting for these drugs rather than undergoing surgery. The issue with these drugs is they are costly. They’re very expensive. They cost upwards of $13,000-to-$16,000 a year to be able to access these drugs. And, so, we know that affordability is a huge piece of ensuring that people obtain the maximum benefit because if you can't afford the medications you're not going to take them.

So, we work at Caremark in particular to help to negotiate these prices down. We also offer in our Weight Management Program that team-based approach that I was talking about earlier where there are program counselors as part of that approach who help patients maintain adherence to these weight-loss drugs. There are a number of reasons that people might want to stop chasing drugs. For example, they may have side effects, and we often hear about side effects in these drugs. Rather than stopping the drug, though, there are things that providers can do in terms of sort of titrating the dose down to help manage those side effects so that people can remain on the drugs long enough to achieve their ideal weight.

So broadly, bottom line, highly effective weight management drugs, really driving a good amount of weight loss and helping people to feel better about themselves. But we also have to address issues of affordability and make sure people are fully supported to optimize the impact.

Matt McGuire
So, the CVS Weight Management program has been in market since 2023 and it had a much larger launch in early 2025, becoming available to more than 3,000,000 CVS Caremark plan members. I'm curious, what are some of the early results we're seeing from patients?

Dr. Michelle Gourdine
This is exciting. So let me just reiterate because it's important that the pillars that we talked about, you know focusing on — nutrition and lifestyle support, behavior modification, medication management — those are the key pillars of the Weight Management program. This program has been in effect, as you said, since 2023, and the data from this program is really remarkable.

First of all, the member satisfaction rate of people who have been involved in this program that said, they're satisfied with the support they're receiving from this program is 92%. That's pretty remarkable. And it really does sort of point to the level of support that people feel they are getting with this program.

We've seen, on average, a weight loss of 16%, so 16% reduction in body weight after one year in the program. Again, highly significant. Really, at the level of what you would see with bariatric surgery before these drugs were available.

And then we notice that even if patients voluntarily decide, again, we don't encourage this, that if they voluntarily decide they want to discontinue to use these weight-loss drugs, but decide to continue with the Weight Management program — so continuing to get that support with nutrition and lifestyle — 94% of these patients have been able to maintain their desired weight six months after discontinuing the use of anti-obesity medications. So what does that say to us? This says to us that patients need help when working to reach their health and wellness goals. This is not just an option where a prescription is written, it's given to the patient, they go out and take the med and everything is fine. That additional support is absolutely vital to make sure that patients achieve their weight-loss goals and also are able to sustain those weight-loss goals over time.

Matt McGuire
So Dr. Gourdine, we all read and hear a lot of stuff about people keeping the weight off or not keeping the weight off once they stop using weight-loss medication. What can you tell us about these patients in the long term?

Dr. Michelle Gourdine
Yeah, you know, let's be honest. Anyone who undertakes a weight-loss journey of any type, be it with medication assistance or not, wonders about that key question: Once I'm done, will I regain the weight? That's an undesirable outcome, and that's absolutely something that patients are concerned about, their family members are concerned about, their healthcare providers are concerned about.

What we know, again, from the Weight Management program is that we can help people adopt those healthier eating habits and physical activity behaviors they're more likely to keep the weight off. And, again, this is nothing trivial because there are so many factors that we talked about earlier in terms of behavior modification that trigger people to eat, or trigger their motivation, or lack thereof to exercise, or to eat healthily. And having that help, having that helping hand, having that friendly voice on the other end of the phone, or using technology in order to communicate with someone who knows you, who understands the issues that you are dealing with and the barriers that perhaps might get in the way of you being able to achieve your weight-loss goals, that is just invaluable.

And, so, this really does contribute to people's long-term success on their weight-loss journey. Nothing's a silver bullet. GLP-1s are an absolutely great tool, and the Weight Management program, we have found, is really helpful at ingraining healthy habits into people's lives and helping them to learn how to do things differently.

So, this approach, we believe, is highly effective. Our data has shown that it's highly effective. We will continue to track and monitor that data, and we'll continue to learn from the awesome people that we have the privilege to help achieve their weight-loss goals every single day.

Matt McGuire
Dr. Gourdine, you've shared a lot of great information today, some of which I really need to pay attention to for my own personal health. Thank you very much for stopping by.

Dr. Michelle Gourdine
Matt, it's been a pleasure. Thanks so much.

Matt McGuire
And a big thanks to you for tuning into this episode. Until next time, I’m Matt McGuire. I look forward to joining you again to get more big questions answered.