Effects of GLP-1 Medications: Changes to DME Needs

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Losing part of a limb in an accident is a life-changing event. For Dan*, it was also a story of strength and recovery. With a properly fitted prosthetic limb and personalized physical therapy, he regained his independence and can now do most of the things he could before his injury. More recently, his doctor prescribed a GLP-1 medication for weight loss, and his health improved even more. Dan once weighed over 230 pounds, but at his new weight of 190 pounds he is excited about a significant step forward for his overall health.

However, this progress has created an unexpected side effect. Because of Dan’s weight loss, the size of his residual limb has decreased. This means the socket on his prosthetic limb no longer fits properly, and he now needs a new one.

Dan’s story highlights a potential issue that could easily be overlooked: how GLP-1 medications can affect durable medical equipment (DME).

How GLP-1 medications are improving health

GLP-1 medications are changing how doctors treat long-term conditions like obesity, diabetes, heart disease, kidney disease, and obstructive sleep apnea. These medications support weight loss and metabolic improvement, often leading to reduced reliance on medications for high blood pressure and diabetes. Weight reduction can also reduce chronic pain associated with osteoarthritis in the lower back, hips, and knees.

Overall, GLP-1 medications have demonstrated tremendous potential in altering the utilization of a variety of medications, as patients may need fewer medications or obtain the same health benefits with lower doses.

Durable medical equipment sizing considerations

DME, which is often necessary in workers’ compensation and auto injury claims, spans a broad range of equipment, including:

Prosthetic devices (upper and lower limbs)
Braces and compression garments
Wheelchairs
Walkers, scooters, and canes
Shower chairs and transfer benches

These devices help people move safely, protect injured areas, and stay independent during recovery. They also reduce the risk of getting hurt again.

But weight loss can affect how well this equipment works. Many devices are designed to fit a person’s specific body size and weight. After any significant weight loss, adjustments or replacements to these devices may be needed.

Prosthetic limbs: Even minor changes in limb size can affect how a prosthetic socket — the interface between the patient’s amputated residual limb and the prosthetic device — fits, which may lead to discomfort, skin problems, or difficulty walking.
Braces and compression garments: These may become too loose to provide proper support.
Wheelchairs: Changes in body size can affect posture, balance, and safety.
Bathing and mobility aids: These may need resizing or replacement to stay safe and effective.

In some cases, especially with expensive items like prosthetic limbs and custom wheelchairs, these changes can be costly and require careful planning.

Dr. Robert Hall, Medical Director at Optum Workers’ Comp and Auto No-Fault, notes this as an important consideration for payers: “Be on the lookout if an injured person has an assistive device such as a prosthetic limb, wheelchair, or other high-cost DME, and you know they are on a GLP-1 medication. There may be a future need for replacing or making some type of adjustment to the DME item.”

Other functional considerations

In addition to weight loss, GLP-1 medications may contribute to reductions in muscle mass in some individuals. This raises another important consideration: whether a person has retained the strength and power needed to use their DME effectively. For example:

Using a prosthetic limb requires strength and coordination
Manual wheelchairs depend on upper-body strength
Moving with assistive devices requires balance and stability

Because of this, it’s important to monitor not just weight, but also strength and function. Physical therapy may be needed to rebuild muscle mass or improve coordination and balance.

What this means for care teams

For the team of professionals supporting workers’ compensation or auto injury recovery, GLP-1 medications add new challenges. Even if the medication is covered by a different health plan, the original injury claim may still be covering DME.

This means:

Equipment may need to be adjusted or replaced if significant weight is lost
Changes may occur more than once during weight loss
If weight is regained, equipment may need to be refitted again

Looking ahead

Dan’s experience shows that improving health can sometimes lead to new needs. GLP-1 medications offer major health benefits, but they can also affect equipment that people depend on every day.

For individuals using DME, weight loss is not just a success, it’s also something that can affect safety and independence. Regular check-ups, early detection of fit and function issues, and prompt adjustments are important. By planning ahead, care teams can help patients like Dan stay safe and make the most of their progress.

In the next article in this two-part series, we will continue to explore practical considerations regarding GLP-1 medications. As we delve deeper into their use, benefits, and related effects, we’ll also outline concrete strategies to help payers and care teams prepare for possible changes and the adjustments needed to deliver the best care.

*Name has been changed to protect privacy.

Contact us

To learn more about our clinical programs that emphasize whole person care, contact us as expectmore@optum.com.

Also published through our media partnership with WorkCompWire, an online news service offering valuable information regarding workers’ compensation and related issues.