People reach out to me all the time, in emails, and DMs, with their tiny digital smoke signals, all carrying the same quiet, desperate heartbeat:
Pleaseā¦ tell me how to stay on the medication that finally gave me my life back.
Some come in hopeful. Some sound like the last exhale before slipping underwater. Every single one reminds me this isnāt a side project, itās the line between staying afloat and being pulled under.
But when Cherie Shanholtz showed up in my inbox, her message hit different.
The subject line read:
āDesperate help needed for life-saving medication.ā
Cherieās Story: A Life Rebuilt
Cherie once weighed nearly 380 pounds.
Severe obesity.Insulin resistance.Metabolic syndrome.
All the things society labels as āchoices,ā when in reality her biology had been stacking the odds against her for decades.
When she finally got on Ozempic, her world bloomed like a flower and she flew out of it reborn, a little fairy with pixie dust still on her wings.
āOzempic Saved My Life.ā
Cherie lost over 235 pounds.
Her blood pressure came down. Her cholesterol improved. And her breathing finally stopped acting like a full-time job.
She could move without hurting, and actually live in her body instead of going twelve rounds with it every day.
But this is the part we donāt focus on enough.
GLP-1s donāt just give you great selfies, they give you selfhood. She told me, āI always dreamed of wearing beautiful, feminine clothes,ā and for the first time in her adult life, she could actually put them on and feel like the woman sheād imagined as a little girl.
Joy in feeling beautiful is not vanity. Itās deeply human, and she deserved every bit of it.
ā¦for the first time, I can wear clothes that make me feel beautiful and truly like a woman again.ā
āI finally can look in the mirror without flinching.ā
Some people have concerns about GLP-1s causing depression or suicidal thoughtsā¦ no honey. The reality for most of us is the opposite.
Whatās actually depressing is living with chronic inflammation, constant pain, exhaustion, shame, judgment, and being blamed for things you were never in control of to begin with.
When your body stops fighting you, your mind finally gets to breathe. The weight isnāt just physical, itās emotional. And losing it gives you back pieces of yourself you thought were gone forever.
Cherie could finally see herself again.
And just when she started to trust that this otherworldly experience was real, her insurance ripped the carpet out from under her.
A Lifeline Pulled Away
For six months, her insurance covered the medication that made all of this possible. And then out of nowhere it just stopped. No warning. No explanation. One day she was covered, and the next she was stranded.
Cherie paid $800 out-of-pocket trying to hold her life together.
* She sold belongings.
* Skipped essentials.
* Pushed her mental health beyond its limits.
Eventually she found a compounded option, cheaper but still too much after months of bleeding herself dry.
And the stress, the crushing fear of losing the body she fought for, cost her her job.
āThe overwhelming depression and anxietyānot just from losing my lifeline, but from the fear of regaining the weight and losing all that I had worked so hard forāare the main reasons I lost my job.ā
This is what GLP-1 patients are actually living when people call these āvanity drugsā and giggle when they get taken away. This isnāt about Instagram angles. This is survival.
A BMI of 40 or higher can mean up to ā14 years of life lost.ā But beyond the stats, thereās a heavy mental health toll.
Imagine having the freedom to:
* Fly without a seatbelt extender.
* Eat in a restaurant without the side-eye.
* Shop in the āregularā section instead of being relegated to the plus-size aisle.
* Buy clothes because you like them, not because theyāre the only thing that fits.
* Ride a roller coaster.
* Take a photo with friends without hiding behind them.
* To feel human.
Imagine finally getting a glimpse of what ānormalā feels like, holding the things other people donāt even noticeā¦ and then watching every single one of them slip through your fingers.
Imagine standing there, helpless, as your own life starts playing in reverse. Like watching a rerun you never wanted to see again, only this time you canāt look away. You know exactly how it endsā¦ and the dread settles in your bones long before the credits roll.
This is the difference between functioning and falling apart.
Cherie is still fighting, and Iām helping her with every tool I can. But stories like hers are only going to become more common as we head into 2026.
āThis struggle has affected every part of my life, but Iām still fighting.ā
Help Cherie hang in there š
Disclaimer: I donāt get a cent from the button above. This is Cherieās GoFundMe, that she created and manages herself. I am simply sharing it for her with hopes that some big hearted individuals will be willing to help a sister out.
Weāve Played These Games Before
In May I wrote about the coverage drops that hit right after the holidays.
The new restrictions, the prior authorizations, the denials, the out-of-pocket tsunami that blindsided people who thought they were safe. šø
Itās happening again in January 2026
And compound pharmacies are surely bracing themselves for the flood.
The Future of GLP-1 Coverage
2025 was the year employers built the GLP-1 obstacle course; 2026 is the year they put walls around it and shut most of the doors, leaving only a narrow side entrance for the lucky few who can make it through.
2025: The āUh-Ohā Year
The demand for GLP-1s skyrocketed and insurance coverage couldnāt keep up. Employers panicked, pharmacy budgets blew out, and millions of patients got dropped.
Employment GLP-1 coverage:
* 96% covered for type-2 diabetes
* 67% covered for obesity
* 34% covered for heart disease
* 96% of employers worried about long-term GLP-1 costs
The drop-offs were brutal:
* ZepboundĀ®: 14% more people lost coverage (4.9 million cut off)
* OzempicĀ®: 22% more people lost coverage (1.1 million cut off)
* WegovyĀ®: fewer plans with full coverage; more prior-auths or no coverage
* MounjaroĀ®: Unrestricted coverage slipped by 5%, and āno coverage at allā rose by 3%.
From the outside, it might look like GLP-1s were widely covered, but:
* 90% required Prior Authorization (Denial rate: not included)
* 54% required participation in a weight-management program
* 48% required a BMI threshold and/or additional comorbidities beyond FDA indication
If you thought that was bad then buckle up.
2026: The āBuckle Up, Babyā Year
Costs are climbing even faster and employers are bracing for impact. GLP-1 demand isnāt slowing down, and everyone is sweating through their spreadsheets.
What weāre barreling towards:
* Cost trend projection: 9%
* Pharmacy trend: 11ā12%
* Employers seeing rising GLP-1 use: 79% (now)
* Employers anticipating more increases: 15%
* Employers requiring PA for obesity GLP-1s: 90%
Employers and insurance companies are tightening their fists.
As one Washington Post investigation reported, patients are already navigating what one obesity specialist called an āabsolutely insaneā maze of insurance denials, cost barriers, and constant policy shifts. And itās about to get worse.
To sum things up:
2025: GLP-1 demand exploded ā employers panicked ā pharmacy budgets caught fire.2026: GLP-1 crackdown begins ā stricter rules ā coverage stagnates ā cost trend still climbs.
So yes, 2026 sounds terrifying but there is still hope for some.
Hope on the Horizon with a Cliff Beneath It
Letās talk about the Most-Favored-Nations announcement.
Medicare patients will receive MFN-priced GLP-1 coverage, for obesity, nationwide, with a $50 co-pay, and Medicaid can opt in at the same prices.
This is huge, even history-making:
* This could reshape obesity care in America.
* Medicare and Medicaid could finally cover obesity treatment.
* Prices could drop.
* Weight-loss indications could move from āoptionalā to āstandard.ā
Itās the closest thing weāve ever had to a real turning point. But hereās the thing. Every single state has to opt in.
Some states will likely:
* Drag their feet.
* Outright refuse.
* Only cover specific GLP-1s.
* Bury patients in prior auth hell for months.
* And some formularies wonāt update for a year.
However, even if some states make it harder than it needs to be, this is finally opening the door for people who could never afford the out-of-pocket costs in the first place, and that alone is worth celebrating.
But will MFN move the needle on broader coverage?
Commercial Insurance: The Wild Card
The Most-Favored-Nation agreement does not automatically apply to commercial insurers.
This means it doesnāt, force employer plans to lower prices, guarantee theyāll expand coverage, or require them to change a single formulary line item. But that doesnāt mean we are outright screwed.
What we do know:
Manufacturers have promised that commercial prices will be āno worse than MFN.ā
What we donāt know:
Anything beyond that. Thereās no mandate, enforcement, or timeline. And without that pressure, commercial insurers can still do what theyāve always done, continue treating obesity care like a ālifestyle choiceā instead of the medical need it is.
While Medicare and Medicaid inch forward, commercial patients are left hanging over the gap with nothing but compound medication and a prayer.
Thatās the real cliff edge.
Because most people living with obesity are covered by employer-sponsored insurance. And unless those employers decide to cover these medications, unless their benefit managers renegotiate and opt in, none of the MFN relief touches them.
Theyāre still stuck paying around hundreds of dollars a month, which is already out of reach for most households. And with more coverage drops coming, more patients will be forced to pay out of pocket or go without when they canāt afford it. or worseā¦ go grey.
Yes, help is coming.
But not fast enough for the people falling off the cliff in January. And not fast enough for the ones already spiraling in real time.
People like Cherie and Amanda Fratello.
Amandaās Story: Losing Access
You may remember Amanda from Season 1, episode 12 of the GLP-1 Studio Podcast.
At sixteen, she was diagnosed with Hashimotoās and hypothyroidism. A double-hit that lit her body on fire with inflammation.
And doctors did what doctors have done to so many of us: they blamed her.
āMy entire life, itās been my fault. Iāve been called a closet eater, a binge eater, lazy, not trying hard enoughā¦ and none of that was true.ā
It took finding the right doctor, a year of appeals, and prior auth gymnastics before Amanda finally got approved in June of 2024. It felt like someone cracked a window open in a suffocating room.
And it worked. It didnāt just āhelp with weight.ā It gave her life back.
Until it was taken away.
Watching the Car Go Under
In November the notice arrived. Her insurance was dropping coverage for weight loss.
She was terrified of what was going to happen to her. She was terrified of what was going to happen to her. Sheād been paying a $30 co-pay, living paycheck to paycheck, and even compounded options were financially out of question.
At that point she had six shots left.
Iāve talked to Amanda twice since then. First she had one left. Then she had none.
Watching Amanda lose her medication shot by shot felt like locking eyes with someone trapped in a sinking car.
You see the water rising. You see the panic behind the glass. You know exactly what happens next, and youāre pounding on the window, praying for a miracle but you already know canāt help her out in time.
Losing access is like mourning the death of a beautiful life taken too soon.
Amanda is still grieving. Not just the medication, but the version of herself she had only just met.
I wish I could tell you Amandaās story is rare, but this story arc is on repeat.
āIt shouldnāt be this hard. Nobody should have to fight this hard just to not live in pain.ā
What Are We Supposed to Do in the Meantime?
Letās be honest.
Most still canāt afford ādiscountedā compounded options at $190ā$300 a month.
Yes, there are options on paper:
* PAN Foundation, if you fit the diagnosis and income needle-thread
* Manufacturer cash-pay programs, if you have hundreds a month lying around
* Compounded medication, if youāre comfortable with the risk and still have the money
* Medicaid, maybe, if and when your state opts in
* Medicare, maybe, depending on state, indication, and a thousand unknowns
But hope is not a solution. āWait and seeā is not a solution.
For people paying out of pocket right now and the ones bracing for the shove, itās prior-auth and fail-first hell, with hoop after hoopā¦ and then what?
A denial letter and some advice to āeat less and move more?ā
That isnāt a treatment plan. Thatās abandonment with a paper trail.
The Question I Keep Coming Back To
What happens to the people whoāve done it all, and still canāt their medication?
If youāre on a GLP-1 right now:
What would you be willing to do to stay on your medication?And what would you do if you lost access tomorrow?
Thatās the reality millions are living.
And itās why Iām going to keep doing my best to help, sharing resources, connecting them to assistance programs, and amplifying these stories until we stop pretending this is anything other than a healthcare crisis.
The Future of Obesity Care
GLP-1 patients are already reshaping the healthcare landscape, and weāre only just getting warmed up.
What you can do to help:
* Sign the petition for affordable access
* Support my petitions on SWAY pushing for PBM reform, healthcare reform, and shutting down patent evergreening
* Donate to Cherieās GoFundMe so she can afford her next dose
* Help OAC advocate for the Treat and Reduce Obesity Act (TROA)
* Reach out to your local representatives to let them know this issue matters to you.
* Subscribe to the Studio newsletter ā¦and if you ever feel moved to go paid, just know it fuels the caffeine that keeps the sparkle in this work and keeps these stories in the spotlight where they belong.āØ
People deserve better, so I will keep fighting for better obesity care.
Are you with me?
Help me keep advocating š
Disclaimer: Nothing in this article is medical advice. I am not paid, sponsored, or compensated for mentioning any organizations, resources, companies, or individuals. Cherieās GoFundMe is entirely her own and has no affiliation with the GLP-1 Collective. My opinions are my own and do not reflect or represent the views, policies, or positions of any employer, organization, nonprofit, or company. Nothing here should be taken as an endorsement. Always speak with a licensed medical professional about your own health and treatment options.
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